TLIF for Ruptured Disc
Transforaminal Lumbar Interbody Fusion (TLIF) for a ruptured disc may be carried in the lumbar spine, but the procedure is not appropriate for a ruptured disc in the neck. This surgery removes the facet joint on one side of the vertebrae where the ruptured material is causing stenosis. This allows the surgeon access to remove the ruptured disc material and decompress the spinal nerves. A bone graft, (either an allograft or autograft) is then inserted to facilitate fusion, and pedicle screws and rods are used to connect the two, or more, vertebrae at the back. TLIF forms a fusion between the anterior and posterior of the spine using only a posterior lateral approach, making this a preferred back surgery for many in contrast to operations requiring both an anterior and posterior approach or more invasive access from both sides of the posterior spine (PLIF). The PLIF procedure doubles the risk of causing nerve trauma during the operation as the surgeon must insert instruments past the spinal nerves exiting either side of the spinal column.
Patients who are considering back surgery for a ruptured disc should discuss their condition with their physician in order to ascertain the options available to them. Ensuring that applicable guidelines are followed prior and post surgery will optimize recovery and reduce complication. It is particularly important if undergoing any kind of fusion, such as TLIF or laminectomy with fusion, to cease smoking prior to surgery, and to follow the general advice of remaining hydrated and well-nourished both before and after the operation, and avoiding bending and stretching activities for the recommended time period after the procedure. Patients will usually be referred to a physical therapist to promote recovery and take preventative steps to avoid failed back surgery syndrome or other complications. Around 85-90% of patients undergoing discectomy achieve resolution of their symptoms, with pain often dissipating fairly rapidly, and numbness and weakness taking a little longer to resolve.