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Endoportal Transforaminal Interbody Fusion (tlif)

  • Posted on- Jan 05, 2018
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Endoportal transforminal interbody fusion short form is TLIF. Fusion in spine is a process which is performed surgically for the occurrence of spinal vertebra, disc or shock absorber between the vertebras cancelling every movement between the bones. Surgery is performed for the elimination of pain and nerve irritation.

Spinal fusion may be recommended for conditions such as spondylolisthesis, degenerative disc disease or recurrent disc herniations. Surgeons perform lumbar fusion using several techniques. This article describes the transforaminal lumbar interbody fusion (TLIF) fusion technique.


What is the procedure of endoportal transforaminal interbody fusion (TLIF)?

TLIF back surgery is done through the posterior (back) part of the spine.


  • Hardware is taken regarding the surgery for the spine to convince the fusion rate. Screws and rods of pedic are applied in the back of vertebra and insertion of interbody fusion is done from a part of the spine.
  • A grafting of bone is done inside the space of body & at the back of the vertebra for the fusion. Grafting of bone is taken from the pelvis of patient, substitutes in bone grafts are also used.
  • After recovery of grafting, vertebra fuses upward and downward making it a lengthy tube. After recovery of bone graft, vertebra fuses upward and downward in the bone of leg.
  • Interbody spacer and bone graft is done by portion of spine.
  • The posterior column is locked in place with pedicle screws, rods, and bone graft


What is the post-operative care of endoportal transforaminal interbody fusion (TLIF)?



Patients are admitted in the hospital after TLIF spinal surgery for 3 to 5 days. Transfusion of blood is done. Physical therapy begun the day after surgery and patients are mobilized. A spinal brace may be used.
For the limited activity, patients are discharged at simple pain medicine, then the patient should be linked with surgeon for  many weeks and can recover their normal schedule within 4 to 6 weeks or more as per surgery performed.

How is back surgery TLIF performed?



TLIF procedure is performed through a posterior incision exposing the back of the spine.
  • Pedicle screws are placed into the vertebra.
  • With removal of facet joints disc space accounts at a single side, protecting the nerve roots.
  • Disc material is eliminated and disc space is removed.
  • Iliac crest provides bone graft.
  • Interbody cage or spacer is occupied with graft of bone inside the disc space for maintenance of height. 
  • Additional bone is placed in the lateral (side) gutters of the vertebra and the disc space.
  • Pedicle screws are attached to rods or plates.
The wound is closed.


What are the risks of TLIF?

Complications of TLIF are as follow:
  •  Infection
  •  Blood loss
  •  Nerve injury
  •  Lack of a solid fusion
  •  Continued pain or (rarely) increased pain.
Complications include pneumonia, heart attack, stroke, or blood clots. Success in spinal surgery is not guaranteed. Results of TLIF are usual in the case of solid bone fusion with fast pain improvement. A additional health care should be given to the patient to remain untouched with any danger.

What are the benefits of TLIF?



TLIF procedure has several theoretical advantages over some other forms of lumbar fusion:

  • Fusion of bone is suggested as grafting of bone is revealed in both places i.e. gutters of spine and in discs.
  • For regaining normal height, a spacer is inserted. 
  • TLIF is a surgical procedure in which bone graft and spacer is passed inside the  disc space with the help of unilateral approach without forcing retract roots of nerves as much, which decrease injury and scarring around the nerve after comparing with PLIF procedure.
Minimum cost of TLIF is Rs. 4,40,000 to maximum Rs. 8,80,000.

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