Transforaminal lumbar interbody fusion (TLIF)

Transforaminal lumbar interbody fusion (TLIF) is an advanced procedure often used when there is instability in the spine or shifting of a vertebrae fromĀ spondylolisthesis.

TLIF involves fusing 2 vertebrae by placing screws, rods and a cage to stabilize the region. The disc in the front of the spine is removed and replaced with a stabilizing implant containing a bone graft. The two vertebrae are then fused together through the disc space. This procedure can also be done in minimally invasive fashion in select cases in order to cause less disruption of the tissue and allow for faster recovery.

Who is a good candidate for this procedure?

Potential candidates for TLIF are patients with instability in the lumbar spine from disc degeneration, spondylolisthesis (where one vertebra has slipped forward over another), degenerative scoliosis (spine misalignment), or recurrent herniated disc. If these conditions are causing nerve impingement or stenosis resulting in pain, numbness, weakness, or other neurologic dysfunction surgery may be necessary. However, not everyone is an appropriate candidate for this procedure. A surgeon who is trained in TLIF and other spinal fusion techniques is the best person to determine the most effective surgical option for each patient. A consultation with the proper surgeon is crucial in making that determination.


The lumbar spine, or low back, includes the five largest and strongest vertebrae. Between each vertebra is a gel-filled disc that acts like a shock absorber, providing a cushioning effect to absorb pressure and distribute stress. The lumbar spine is vulnerable to many pain-provoking disorders, ranging from simple strains to a herniated disc, degenerative disc disease, spondylolisthesis or spinal stenosis.

When is surgery recommended?

If you have worsening back or leg pain resulting from spondylolisthesis, disc degeneration, a recurrent herniated disc,or other spine abnormality that limits your everyday activities, and all non-surgical methods of treatment have failed, you should consider spinal fusion surgery.

The type of fusion surgery you have depends on many factors including your overall health, the location and severity of your problem, and your pain and disability. It is very important that you are carefully screened by a qualified surgeon who is trained in spinal fusion techniques to determine the most appropriate course of action.

What is the recovery time?

Patients are typically in the hospital for 2 to 3 days after a TLIF operation. If a minimally invasive approach is done, some patients are able to go home the next day. Patients are walking the next day after surgery and have physical therapy while in the hospital to help with walking, mobility, and stair climbing. Some activities are restricted after surgery to allow for post-operative recovery. Typically, lifting is limited to 5 lbs for the first 2 weeks and 25 lbs for the following 4 weeks. Many patients who have TLIF surgery are able to return to normal activities in as little as six weeks. When to return to work will depend on the type of work you do, but typically ranges from 2 weeks to 6 weeks post operatively. As with all surgical procedures, specific recovery time varies by patient and demand.

Surgeons who perform TLIF

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