However, the tlif procedure places a single bone graft between. Transforaminal lumbar interbody fusion tlif is a form of spine surgery in which the lumbar spine is approached through an incision in the back. Transforaminal lumbar interbody fusion is performed under general anesthesia, meaning the patient goes to sleep. Posterior lumbar interbody fusion plif and transforaminal lumbar interbody fusion tlif. The decreased soft tissue disruption in the mis technique has been associated with significantly decreased blood loss, shorter length of hospitalization, and an expedited return to work while maintaining comparable arthrodesis. Transforaminal lumbar interbody fusion tlif inform mr malham of medication that you are taking andor have allergies to medications. In 1982, with the rationale of offering a secure fusion in a onestage operation, harms and rolinger pioneered a modified plif technique called transforaminal lumbar interbody fusion tlif. The diagnosis was degenerative disc disease with herniated nucleus pulposus hnp in 26, spondylolisthesis in 22. Transforaminal lumbar interbody fusion tlif versus posterior lumbar interbody fusion plif in lumbar spondylolisthesis. Clinical article cage migration after transforaminal lumbar interbody fusion and factors related to it fengdong zhao, md1, wei yang, md1, zhi shan, md1, jian wang, md2, haixiao chen, md3, zhenghua hong, md3, yu qian, md4, dengwei he, md5, shunwu fan, md1 1department of orthopaedics, sir run run shaw hospital, school of medicine, zhejiang university, 2department of orthopaedics, tongde. Background interbody fusion by open discectomy is the usual treatment for degenerative disk disease but requires a relatively long recovery period.
What is the purpose of a transforaminal lumbar interbody fusion tlif procedure. Transforaminal lumbar interbody fusion tlif spine surgeon. Transforaminal lumbar interbody fusion tlif mesfin a. For additional information on transforaminal lumbar interbody fusion tlif, please contact the vail, aspen, denver and grand junction, colorado area office of spine surgeon and back specialist dr. The optimal treatment for degenerative lumbar diseases remains controversial 1, 2. Two common types are posterior lumbar interbody fusion and transforaminal lumbar interbody fusion.
The transforaminal posterolateral approach is a wellknown standard in endoscopic spine surgery that. Classification of minimally invasive techniques for transforaminal lumbar interbody fusion. Minimally invasive tlif transforaminal lumbar interbody fusion. Your doctor will have already discussed with you why. Feb 03, 2020 transforaminal lumbar interbody fusion, also called tlif, is surgery to correct problems with your spine backbone. Transforaminal lumbar interbody fusion overview the tlif is defined as transforaminal lumbar interbody fusion. A wound drain is inserted to reduce the risk of haematoma blood collection or bruising. This approach requires a small incision on the back and can. Transforaminal lumbar interbody fusion british association of. The interbody fusion technique like tlif maintains load bearing capacity of the spine and a suitable disc height. Like the plif posterior lumbar interbody fusion procedure, bone graft is used to fuse the spinal vertebrae after the disc is removed. Minimally invasive transforaminal lumbar interbody fusion mis tlif using the tubular retractor system allows the use of smaller incisions and has been introduced with the aim of reducing blood loss and soft tissue trauma, increasing the speed of recovery, and reducing postoperative pain as compared with the conventional technique 25, 28.
In this case report, we describe a method to perform transforaminal thoracic interbody fusion ttif, which is an adaptation of an established lumbar fusion. Minimally invasive transforaminal lumbar interbody fusion mis tlif is performed via tubular dilators thereby preserving the integrity of the paraspinal musculature. Kenneth burkus operative techniques for fusing an unstable portion of the lumbar spine or immobilizing a painful vertebral motion segment have been in use for many years. Fortynine patients underwent minimally invasive transforaminal lumbar interbody fusion tlif from october 2001 to august 2002 minimum 18month followup. Lemma, md minimally invasive spine surgery, scoliosis surgery, baltimore, md overview tlif is an adjunct to posterior spinal fusion. Posterior interbody fusion can be performed either as posterior lumbar interbody fusion plif or transforaminal lumbar interbody fusion tlif, fig. The surgical options for interbody fusion of the lumbar spine include. Pdf transforaminal lumbar interbody fusion tlif is a relatively new technique of lumbar arthrodesis via posterior transforaminal approach to. Pdf tlif transforaminal lumbar interbody fusion researchgate.
The goals of minimally invasive transforaminal lumbar interbody fusion tlif and posterior lumbar interbody fusion plif are to address the cause of your back pain and to keep your spine stable by fusing 2 or more of your vertebrae together. Perioperative surgical complications and learning curve associated with minimally invasive transforaminal lumbar interbody fusion. View full text pdf listing minimally invasive lumbar spinal fusion is more effective than open fusion. Transforaminal interbody fusion versus anteriorposterior interbody fusion of the lumbar spine. Transforaminal lumbar interbody fusion advanced relief. Transforaminal lumbar interbody fusion overview youtube. Transforaminal lumbar interbody fusion tlif medstar health. Pdf anterior lumbar interbody fusion versus transforaminal. Currently many techniques have been introduced to cure spondylolisthesis.
Lumbar transforaminal lumbar interbody fusion tlif. Transforaminal lumbar interbody fusion tlif the spine. 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. Transforaminal lumbar interbody fusion tlif is a procedure used to insert a bone graft into the spinal disc space from the side position. Transforaminal interbody fusion tlif transforaminal through or across the foramina foramina a hole or opening in bone or a membranous structure interbody material inserted between two vertebral bodies to reestablish and maintain disc height fusion surgically induce union or healing of bone basic anatomical landmarks. Abstracttransforaminal lumbar interbody fusion tlif surgeries have nowadays became popular for treatment of degenerated spinal disorders. Transforaminal interbody fusion tlif basic anatomical landmarks the posterior elements of the spine lie under these muscles. Transforaminal lumbar interbody fusion tlif back surgery. Posterior lumbar interbody fusion and transforaminal. This surgery is used to treat serious spinal diseases that cause chronic low back pain and radiculopathy. Jan 26, 2005 the unilateral transforaminal approach for lumbar interbody fusion as an alternative to the anterior alif and traditional posterior lumbar interbody fusion plif combined with pedicle screw instrumentation is gaining in popularity. Transforaminal lumbar interbody fusion is a safe and effective method for achieving circumferential spinal fusion via a singlestage procedure. Surgeons perform lumbar fusion using several techniques.
A transforaminal lumbar interbody fusion tlif is an effective procedure for replacing a damaged disc. 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. An interbody fusion can be performed using a variety of different approaches. Pedicle screws are used for mistlif but must be inserted correctly because misplacement can lead to devastating complications. Nineteen patients presented with low back pain and associated radiculopathy.
Jan 08, 2018 presented by paul park, md, faans, of the university of michigan. Posterior lumbar interbody fusion and transforaminal lumbar. Spine surgeons use this procedure to restore structural integrity to the vertebrae of the lumbar spine. Anterior lumbar interbody fusion represents another alternative to a 360degree spinal fusion but requires a separate anterior approach. A posterior transforaminal lumbar interbody fusion tlif is a spine surgery performed to treat disabling back or leg pain. Approachbased complications of lumbar interbody fusion. It is performed through a midline incision by way of palpation. In recent years, many surgeons have begun to use a tlif procedure transforaminal lumbar interbody fusion in preference to a plif. Transforaminal lumbar interbody fusion, also called tlif, is surgery to correct problems with your spine backbone. Evolution of minimally invasive transforaminal lumbar. Minimally invasive transforaminal lumbar interbody fusion mitlif was devised to reduce the approachrelated morbidity of open tlif and has flourished in the last decade.
This procedure is particularly useful in restoring disc space height and lumbar lordosis. 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 bone graft and interbody spacer stabilize the anterior portion while the posterior is locked in place with pedicle screws, rods and bone graft. In posterior lumbar interbody fusion plif, your surgeon inserts the spacer or cage from the back of the spine. Disorders it treats spondylolisthesis, spondylolysis, spinal stenosis, segmental instability, ddd, disc. Posterior lumbar interbody fusion plif and transforaminal. Recombinant human bone morphogenetic protein2augmented. Evolution of minimally invasive transforaminal lumbar interbody fusion. Original article comparison between transforaminal lumbar interbody fusion and posterior lumbar interbody fusion in treatment of lumbar spondylolisthesis shaoyu han1, quan xiao2, guotai zhu 3, jian dai, xiaoming tang3, hailang sun3 1third department of orthopedics, huaiyin hospital, huaian 223300, jiangsu, china. A transforaminal interbody lumbar fusion treats spinal instability or weakness by permanently uniting bones of the lumbar lower spine.
This is a metaanalysis of randomized and nonrandomized studies comparing the clinical and radiological efficacy of minimally invasive mi and conventional open transforaminal lumbar interbody fusion opentlif for degenerative lumbar diseases. It refers to the placement of an interbody spacer, or cage, into the disc space. Presented by paul park, md, faans, of the university of michigan. This helps to improve spinal alignment and enhances spinal fusion. 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.
This approach requires a small incision on the back and can be done as a minimally invasive procedure through a 1 inch portal. The five primary interbody fusion approaches are shown here schematically. The posterior approach is indicated for spine fusion, intervertebral disc excision, nerve root exploration, and tumor resection. Perioperative complications in transforaminal lumbar. A transforaminal lumbar interbody fusion tlif is performed to remove a portion of a disc that is the source of back or leg pain. Minimally invasive transforaminal lumbar interbody fusion mistlif has been well described in the literature 1,2,3,4 and is widely performed in patients with lumbar spinal disease. Fusions in the lumbar spine can be achieved with or without the aid of instrumentation, and can be performed through various anatomic approaches.
Although the plif technique from a bilateral approach is wellknown in the clinical and academic literature, the development of the unilateral transforaminal lumbar interbody fusion tlif technique has allowed the surgeon to approach the interbody disc space posteriorly in a more efficient and isolated fashion, thereby diminishing the overall. Developed by harms in approximately 1997 20harms 1998, it uses a posterior approach to the spine, but accesses the disc space using a unilateral facetectomy via a. Transforaminal lumbar interbody fusion tlif the spine journal. During a tlif, your surgeon will make a series of incisions to access the spine through a posterior approach. Minimally invasive transforaminal lumbar interbody fusion. Transforaminal lumbar interbody fusion tlif spine surgery. Multiple anterior and posterior approaches to the thoracic disc space have been reported. The unilateral transforaminal approach for lumbar interbody fusion as an alternative to the anterior alif and traditional posterior lumbar interbody fusion plif combined with pedicle screw instrumentation is gaining in popularity. Transforaminal and posterior lumbar interbody fusion tlif and plif several fusion techniques are available for lumbar arthrodesis. There are two common types of posterior lumbar fusion. In addition, spinal instrumentation such as screws and rods are used to hold the spine in position and help promote successful fusion. Pdf the unilateral transforaminal approach for lumbar interbody fusion as an alternative to the anterior alif and traditional posterior lumbar. Mpro full text journal articles by author joong won.
Original article comparison between transforaminal lumbar. The interbody fusion technique like tlif maintains load bearing capacity of the spine and a suitable disc. The spine is made up of bones called vertebrae that are like blocks placed on top of each other. Pdf transforaminal lumbar interbody fusion todd albert.
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. 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. Oct 18, 2015 a surgical approaches to the lumbar spine for interbody fusion techniques. Motion is achieved through the intervertebral disc and the two facet joints. I or ii spondylolisthesis who underwent transforaminal lumbar interbody fusion. 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 decision to have a lumbar interbody spinal fusion operation to treat lower back pain caused by degenerative disc disease is a very personal one. Abstract transforaminal lumbar interbody fusion tlif surgeries have nowadays became popular for treatment of degenerated spinal disorders. With this technique, surgeons remove damaged vertebral bone, allowing access to remove the disc and replace it with a spacer and bone graft material. The motion segment outlined in black is the functional unit of the spinal column. Concept of transforaminal lumbar interbody fusion cage. The innovative transforaminal lumbar interbody fusion tlif procedure allows surgeons to reduce nerve exposure by approaching the spine from the side, with only a single incision in the back. It may also be recommended for leg weakness or numbness.
Transforaminal lumbar interbody fusion tlif a transforaminal lumbar interbody fusion tlif is an effective procedure for replacing a damaged disc. Transforaminal lumbar interbody fusion tlif mischer. The plif and tlif are the more commonly implemented 812. Usually, the spine is straight when seen from the back and like a letter s from the side. Jan 15, 2015 the tlif is defined as transforaminal lumbar interbody fusion. However, we are not aware of any previous reports describing a transforaminal approach for thoracic disc release and interbody cage placement. Minimal access surgery has revolutionized most surgical disciplines and spine surgery is no exception. Accuracy of pedicle screw insertion for unilateral open. Transforaminal lumbar interbody fusion tlif is a procedure that fuses the anterior and posterior columns of the spine through a posterior approach. 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.
The lumbar fascia and skin incisions are closed with dissolvable sutures. Developed by harms in approximately 1997 20harms 1998, it uses a posterior approach to the spine, but accesses the disc space using a unilateral facetectomy via a path that runs through the far lateral portion of. Transforaminal lumbar interbody fusion tlif technique. During this procedure, your surgeon will remove pressure on the nerve and fuse two or more of the vertebra. This article describes the transforaminal lumbar interbody fusion tlif fusion technique. A comparison of posterior lumbar interbody fusion and. Improving patient safety and outcomes s pinal instability, spondylolisthesis, and degenerative disc disease have long been recognized as surgically treat able causes of lower back and radicular leg pain. Minimally invasive versus open transforaminal lumbar. The bone graft is inserted into the disc space from the back posterior.
Transforaminal and posterior lumbar interbody fusion tlif. Percutaneous transforaminal lumbar interbody fusion ptlif. 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. Tlif spinal fusion transforaminal lumbar interbody fusion. Mitlif, a modern method for lumbar interbody arthrodesis, has allowed for a minimally invasive method to treat degenerative spinal pathologies.
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