TLIF procedure: Information & TLIF specialists

What exactly is the TLIF procedure?

The TLIF procedure is one of several surgical techniques for stiffening the spine (generally referred to as spondylodesis). It is used to treat herniated discs and other complaints in the lumbar spine. TLIF is used to fix two or more vertebrae.

It is performed via the side of the spine. The surgeon removes the intervertebral disc between the vertebrae. An implant (e.g. a titanium disc prosthesis ) is inserted into the resulting space. He then stabilizes the two vertebral bodies with an internal fixator.

During the healing process, new bone material grows around the implant, which takes around three to six months.

The TLIF procedure is a minimally invasive operation. The spinal canal is not opened.

When is the TLIF procedure useful?

The TLIF procedure has several advantages over other surgical techniques. These include the lower risk of damage to the spinal cord and the nerves in the surrounding area.

The procedure may be necessary if

• the intervertebral discs are damaged or
• bones that are causing back or leg pain need to be realigned.

Typical conditions for which the TLIF procedure is performed are:

• Degenerative disc disease,
• Slipped vertebrae(spondylolisthesis),
• mild to moderate scoliosis,
• spinal stenosis.

The TLIF procedure is also useful for complaints that cannot be improved by physical therapy or the use of medication.

Degenerative disc disease

With increasing age, the intervertebral discs dry out and shrink. An intervertebral disc can become detached from its original position or cause a hernia. The nerves located there then become trapped.

Spondylolisthesis

With spondylolisthesis, vertebral bones slip out of their normal position. This can cause the nerves to become kinked and compressed, resulting in pain.

Structure of the spine. In the TLIF procedure, two or more vertebral bodies are fixed together © bilderzwerg | AdobeStock

Scoliosis

Scoliosis refers to an unnatural curvature of the spine. It is caused by a misalignment of the bones. Scoliosis typically develops due to

• ageing intervertebral discs,
• arthritis or
• after previous operations on the spine.

Spinal stenosis

Spinal stenosis is a narrowing of the spinal canal and the nerve root canals. Enlarged ligaments and facet joints may cause the nerves to become trapped. In many cases, these constrictions result in pain or numbness in the legs.

When is the TLIF procedure not suitable?

The TLIF procedure is not suitable in the following cases:

• In the presence of severe osteoporosis,
• in the case of complaints or other physical problems that could rule out the procedure itself,
• after a previous procedure with a similar level of surgery.

Risks of the TLIF procedure

TLIF is a minimally invasive procedure. This means that the operating time is usually very short and blood loss is very low. Trauma to the spine and surrounding soft tissue is also minimal. Patients can therefore usually resume their usual activities after around six weeks. The need for post-operative pain medication is also quite low in most cases.

Nevertheless, surgery is never risk-free. The general complications include

• Bleeding,
• infections,
• blood clots (deep vein thrombosis) or
• reactions to anesthesia (e.g. nausea and vomiting after waking up).

The following complications can also occur in connection with the TLIF procedure itself:

• The vertebrae do not fuse together as intended. Causes: Nicotine or alcohol consumption during the healing process, osteoporosis, diabetes, malnutrition, obesity.
• Breakage of metal screws or plates used before the bones have fully fused.
• In rare cases, the bone graft may slip out of its correct position. This usually happens if no screws or other materials were used for fixation or if the fusion involves several vertebral levels.
• The bone spacer drops, which can lead to a reduction in decompression.
• Injury to nerves or even the spinal cord during surgery. This can result in numbness or, in the worst case, paralysis.
• Additional strain is placed on bones and intervertebral discs below or above the operated area. This increases wear and tear and causes pain.

Prevention of spinal disorders

If you want to avoid interventions such as TLIF, prevention plays a decisive role. Therefore, pay attention to the following things in your everyday life:

• Use proper lifting techniques.
• Pay attention to your posture when standing, sitting, lying down and all other movements.
• Reduce any excess weight to a healthy level.
• Carry out an appropriate exercise program to strengthen your back muscles as soon as you notice the first signs of back pain.
• Eat a healthy diet.
• Avoid smoking and excessive alcohol consumption. This will also promote a positive healing process should surgery be necessary.
• If possible, carry out regular relaxation exercises and reduce stress.

Complaints that make a TLIF necessary are therefore primarily related to your lifestyle.