Spinal fusion using TLIF is a less invasive surgical technique in comparison to PLIF but, even so, most patients will stay in hospital for three to five days to aid recovery and prevent excessive mobilization before the spine has had a chance to settle and begin healing.  A spinal brace is usually worn in order to restrict potentially damaging movement that could disturb the instrumentation.  Patients will begin physical therapy the day after surgery and are encouraged to become mobile as soon as possible in order to prevent stiffness and muscle atrophy.  The physical therapists will help to teach the patient safe ways to get in and out of bed (using the ‘log-roll’ technique) and how to sit, stand, and walk safely during the initial recovery period.  Return to work for those in sedentary jobs is usually around four weeks after surgery; patients with more physically-demanding jobs may need to request a temporary change in responsibilities (to desk work) or remain at home for a longer period of time.

Get out of bed using log rolling technique


Medication after Surgery

Narcotic medication is commonly used to help control pain following TLIF surgery.  NSAIDs are usually avoided as they can hamper the growth and fusion of the bone grafts.  Blood transfusion is rarely necessary with TLIF procedures as the cutting of muscles is minimized (this is the main cause of blood loss in PLIF procedures).  The incision site should be kept clean and dry following surgery and nursing staff will give guidance on how to protect the incision when showering.  Submersion of the incision is inadvisable until it has healed and is cleared by the doctor.   Dressings will be changed during the hospital stay but patients may need some assistance with this once they have been discharged.  It may be possible to have a healthcare worker help with the necessary dressing changes at this time if no friend or family member is available to provide  assistance.

The incision site should be monitored for any leaking, tenderness and redness that extends beyond 1cm or so from the wound, or excessive heat in the area of the incision.  If fever or headache occurs, with stiffness of the back and neck then immediate medical attention should be sought as all of these symptoms could indicate infection.  Shallow, superficial infections may be treatable with antibiotics, whereas a deep infection in the bone or an infection that has spread to the meninges may require surgical draining and possible removal of the instrumentation.  Prophylactic antibiotics may be given for some patients to prevent infection after TLIF surgery.

Spinal fusion can take up to six months to occur, and strenuous activities that might affect this process are usually to be avoided until confirmation of fusion is obtained using imaging methods such as X-Ray.  Stretching and strengthening exercises for the spinal muscles are advised and a physical therapy regime is common practice following TLIF.



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