Other surgical alternatives include nonrigid stabilisation techniques. However, the tlif procedure places a single bone graft between. Jan 15, 2015 the tlif is defined as transforaminal lumbar interbody fusion. Transforaminal lumbar interbody fusion tlif the spine. If support is also needed from the back of the spine, a series of screws and rods may be used. Posterior lumbar interbody fusion plif implants are increasingly being used for 360 fusion after decompression of lumbar spinal stenosis combined.
Lateral interbody fusion in the lumbar spine for low back pain. Miniopen transforaminal lumbar interbody fusion through a. This approach requires a small incision on the back and can be done as a minimally invasive procedure through a 1 inch portal. Both anterior and posterior approaches for interbody fusion are associated with good fusion rates and outcomes in patients with symptomatic lumbar degenerative disease. Transforaminal lumbar interbody fusion tlif mesfin a. Clinical article comparison of transforaminal lumbar. Posterior lumbar interbody fusion and transforaminal lumbar. Lumbar fusion is an accepted treatment for spinal deformity, iatrogenic instability following decompressive procedures, and more controversially refractory axial back pain caused by degenerative disease of the spine. This approach requires a small incision on the back and can be done as a. The purpose of this study was to quantitatively assess clinical parameters such as surgical blood loss, duration of the procedure, length of hospitalization, and complications for tlif and ap reconstructive surgery for lumbar fusion. How is a endoscopic assisted transforaminal lumbar interbody fusion performed. The procedure may be performed using minimally invasive surgical techniques.
Open and minimally invasive transforaminal lumbar interbody. Transforaminal lumbar interbody fusion tlif is a relatively new technique of lumbar arthrodesis via posterior transforaminal approach to the disc, indicated mainly in. The goal of the surgery is to reduce pain and nerve irritation. What is an anterior lumbar interbody fusion alif procedure. Minimally invasive spine surgery miss has been increasingly advocated during the last decade with new studies being reported every year. Early discharged lumbar spine fusion reduced postoperative.
Transforaminal lumbar interbody fusion tlif diagnosis and. This article describes the transforaminal lumbar interbody fusion tlif fusion technique. Posterior lumbar interbody fusion plif and transforaminal. Transforaminal lumbar interbody fusion tlif spine surgery. In posterior lumbar interbody fusion plif, your surgeon inserts the spacer or cage from the back of the spine. Surgeons perform lumbar fusion using several techniques. Support requiring mandatory hospital participation in spine certnspine scope qi effort as a condition of payment. Caring for myself after anterior lumbar spinal fusion 5 change your positions often and avoid just lying, standing or sitting for long periods during the day. Minimally invasive spinal transforaminal lumbar interbody fusion mistlif at l5s1 is technically more demanding than it is at other levels because of the anatomical and biomechanical traits. The five primary interbody fusion approaches are shown here schematically. More complete discectomy larger surface area for fusion. Oct 18, 2015 a surgical approaches to the lumbar spine for interbody fusion techniques.
Like the plif posterior lumbar interbody fusion procedure, bone graft is used to fuse the spinal vertebrae after the disc is removed. To compare clinical and radiological outcomes of open vs. Posterior lumbar interbody fusion plif video spinehealth. Transforaminal lumbar interbody fusion tlif is a relatively new technique of lumbar arthrodesis via posterior transforaminal approach to the disc, indicated mainly in cases of degenerative disc. A transforaminal interbody lumbar fusion treats spinal instability or weakness by permanently uniting bones of the lumbar lower spine. Minimally invasive transforaminal lumbar interbody fusion. The primary purpose of this procedure is to stabilize the spine by restoring the disc height and fusing the vertebrae together using the patients own bone or a genetically engineered substance known as bone morphogenetic protein bmp. The tlif is defined as transforaminal lumbar interbody fusion. For the most part, degenerative disc disease is a nonprogressive type of back condition and for the majority of people their symptoms will improve over time up to ten years.
Lateral lumbar interbody fusionoutcomes and complications. Transforaminal lumbar interbody fusion tlif allows, as part of the dissection, a far lateral access to the neural foramina to decompress both the traversing and exiting upper nerve root without neural manipulation. A posterior lumbar interbody fusion, called a plif, is a surgery designed to stop the motion at the targeted segment of the spine. Transforaminal lumbar interbody fusion overview youtube. Transforaminal lumbar interbody fusion tlif spine surgeon. A transforaminal lumbar interbody fusion tlif is performed to remove a portion of a disc that is the source of back or leg pain. It is an operation performed on the lower back to remove an intervertebral disc and join two or more spinal bones vertebrae together using screws and a cage. Support mandatory participation in a comparative effectiveness study of lumbar fusion.
A tiny skin nick is made on the skin of the back, near the flank. Compared to posterior lumbar interbody plif and transforaminal interbody fusion tlif, llif allows the placement of wide interbody cages. Anterior approaches allow better access to and visualization of the disc and endplates which facilitate. Transforaminal lumbar interbody fusion is performed under general anesthesia, meaning the patient goes to sleep. Transforaminal lumbar interbody fusion advanced relief. An interbody fusion can be performed using a variety of different approaches. The currently recommended surgical procedures are the anterior lumbar interbody fusion, the posterior lumbar interbody fusion plif, and the transforaminal lumbar interbody fusion tlif 37. If you do any activity that increases your pain, stop it immediately.
Surgeons are comfortable performing tlif because it utilizes a posterior approach, and tlif reduces dural retraction and enables direct neural decompression. Spine surgeons use this procedure to restore structural integrity to the vertebrae of the lumbar spine. It refers to the placement of an interbody spacer, or cage, into the disc space. This helps to improve spinal alignment and enhances spinal fusion. Transforaminal lumbar interbody fusion tlif facet joint removed to gain access to the disc for removal nerve root facet joint left intact cage inserted into disc space front front transverse process posterior lumbar interbody fusion plif front front disc removed and space for cage created surgical instrument holding the nerve out of the way. Spinal fusion may be recommended for conditions such as spondylolisthesis, degenerative disc disease or recurrent disc herniations. Motion is achieved through the intervertebral disc and the two facet joints. Transforaminal lumbar interbody fusion roush spine. Lemma, md minimally invasive spine surgery, scoliosis surgery, baltimore, md overview tlif is an adjunct to posterior spinal fusion. The motion segment outlined in black is the functional unit of the spinal column. Transforaminal lumbar interbody fusion tlif is a contemporary approach to spinal fusion surgery. Disorders it treats spondylolisthesis, spondylolysis, spinal stenosis, segmental instability, ddd, disc.
Transforaminal lumbar interbody fusion complex spine. What is the purpose of a transforaminal lumbar interbody fusion tlif procedure. Transforaminal and posterior lumbar interbody fusion tlif. It is used for various problems such as instability, degenerative spondylolysthesis, isthmic spondylolysthesis, discogenic pain, multiple recurrent disc herniations and foramenal collapse. A comparison of posterior lumbar interbody fusion and. Endoscopic assisted transforaminal lumbar interbody fusion. Posterior lumbar interbody fusion plif a posterior lumbar interbody fusion plif is performed to remove a disc that is the source of back or leg pain and fuse spinal vertebrae with bone grafts. Lumbar fusion surgery is designed to create solid bone between the adjoining vertebra, eliminating any movement between the bones. However, this procedure carcomparison of transforaminal lumbar interbody fusion with direct lumbar interbody fusion. Original study posterior lumbar interbody fusion plif acta. Tlif or transforaminal lumbar interbody fusion brief description of the procedure the trans foraminal interbody fusion or tlif fuses the anterior front and posterior back columns of the spine through a single posterior approach. Lumbar transforaminal lumbar interbody fusion tlif. Pdf transforaminal lumbar interbody fusion tlif versus.
Transforaminal lumbar interbody fusion tlif back surgery. Transforaminal interbody fusion tlif basic anatomical landmarks the posterior elements of the spine lie under these muscles. Jan 08, 2018 presented by paul park, md, faans, of the university of michigan. Fusions in the lumbar spine can be achieved with or without the aid of instrumentation, and can be performed through various anatomic approaches. Recurrent lumbar disc herniation, miniopen posterior surgery, transforaminal lumbar interbody fusion, modified wiltse paraspinal. A transforaminal lumbar interbody fusion tlif is a type of spine surgery that involves approaching the spine from the back, or posterior, of the body to place bone graft between two vertebrae. If you have a lot of discomfort, you can use ice to help. Interbody between the vertebral bodies lumbar having to do with the spine in the lower back fusion a process in which bones fuse, or grow together into one bone. Posterior lumbar interbody fusion plif is a procedure used to treat problems such as disc degeneration, disc herniation, and spine instability. Two common types are posterior lumbar interbody fusion and transforaminal lumbar interbody fusion. Caring for myself after anterior lumbar spinal fusion. It is called a posterior procedure because the spine is approached through an incision on the back. Transforaminal lumbar interbody fusion tlif is a fusion procedure designed to join one vertebral body to the next.
Background context transforaminal lumbar interbody fusion tlif and posterior lumbar interbody fusion plif are both frequently used as surgical treatment for lumbar spondylolisthesis. Transforaminal lumbar interbody fusion tlif is a procedure used to insert a bone graft into the spinal disc space from the side position. Posterior lumbar interbody fusion plif and transforaminal lumbar interbody fusion tlif. Tlif spinal fusion transforaminal lumbar interbody fusion. Posterior lumbar interbody fusion plif the posterior lumbar interbody fusion may be performed to treat the following. The decision to have a lumbar interbody spinal fusion operation to treat lower back pain caused by degenerative disc disease is a very personal one. Most commonly it is performed on the l4l5 or l5s1 segment at the bottom of the lumbar spine. Transforaminal lumbar interbody fusion tlif a transforaminal lumbar interbody fusion tlif is an effective procedure for replacing a damaged disc. Presented by paul park, md, faans, of the university of michigan. Mitlif promises smaller incisions and less soft tissue dissection resulting in lower morbidity and faster. This avoids nerve retraction injuries that are seen often with the plif and bilateral posterior interbody fusion techniques. Perioperative complications in transforaminal lumbar. Transforaminal lumbar interbody fusion tlif the procedure can be performed through a traditional open incision or a minimally invasive procedure depending on the patient and the condition to be treated.
Transforaminal lumbar interbody fusion tlif is a relatively new technique of lumbar arthrodesis via posterior transforaminal approach to the disc, indicated mainly in cases of degenerative disc disease, low grade spondylolisthesis and reoperation. The optimal treatment for degenerative lumbar diseases remains controversial 1, 2. This is an operation where the intervertebral disc, the. In this procedure, the surgeon works on the spine from the back the posterior and removes a spinal disc in the lower lumbar spine. Anterior lumbar interbody fusion british association of spine. Transforaminal and posterior lumbar interbody fusion tlif and plif several fusion techniques are available for lumbar arthrodesis. Minimally invasive spine procedures, such as minimally invasive transforaminal interbody fusion mitlif, have been introduced to reduce approachrelated muscle trauma, to minimise blood loss, and to achieve faster wound healing, quicker ambulation and. Alif is a procedure used to treat problems such as disc degeneration, spine instability, and deformities in the curve of the spine. Percutaneous lumbar fusion is a minimally invasive procedure for the treatment of lower back pain due to a herniated disk. The surgical options for interbody fusion of the lumbar spine include. In this procedure, the surgeon works on the spine from the front anterior and removes a spinal disc in the lower lumbar spine. Spinal fusion such as a tlif is a surgical technique to stabilize the spinal vertebra and the disc or shock absorber between the vertebra.
This surgery is used to treat serious spinal diseases that cause chronic low back pain and radiculopathy. This is called a posterior instrumentation fusion and helps to achieve a posterior fusion in addition to an interbody fusion. The main advantage of tlif is that it allows the com plete removal of the intervertebral disc through the vertebral foramen, decompression of the spinal canal and. Minimally invasive transforaminal lumbar interbody fusion at.
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