As they accumulate, the disc eventually begins to suffer from the wear and tear. Posterior lumbar interbody fusion plif and transforaminal lumbar interbody fusion tlif. During a tlif, your surgeon will make a series of incisions to access the spine through a posterior approach. This is a problem that can be fixed with a new approach. To determine the clinical and radiological outcomes of mistlif for treatment of singlelevel spinal stenosis lowgrade isthmic or degenerative spondylolisthesis at l5s1. Transforaminal lumbar interbody fusion tlif back surgery. A posterior lumbar interbody fusion, called a plif, is a surgery designed to stop the motion at the targeted segment of the spine.
Transforaminal lumbar interbody fusion tlif is performed for conditions, including spinal stenosis, degenerative scoliosis, and spondylolisthesis of the lumbar spine. Lateral lumbar interbody fusion xlif the polyclinic. Comparison of posterior and transforaminal approaches to. Alif is a procedure used to treat problems such as disc degeneration, spine instability, and deformities in the curve of the spine. Lumbar fusion surgery is designed to create solid bone between the adjoining vertebra, eliminating any movement between the bones. In an anterior lumbar interbody fusion alif, the surgeon accesses the spine through an incision in the front, rather than the back. Transforaminal lumbar interbody fusion how is transforaminal lumbar interbody fusion abbreviated.
Usually, the spine is straight when seen from the back and like a letter s from the side. Numerous research studies in medical journals demonstrate greater than 9096% good or excellent results from plif and tlif surgery. Transforaminal lumbar interbody fusion tlif a transforaminal lumbar interbody fusion tlif is a type of spine surgery that involves approaching the spine from the back, or posterior, of the body to place bone graft between two vertebrae. Tlif transforaminal lumbar interbody fusion a transforaminal lumbar interbody fusion tlif is a type of spine surgery that involves approaching the spine from the back, or posterior, of the body to place bone graft between two vertebrae.
The plif and tlif are the more commonly implemented 812. The results of posterior lumbar interbody fusion plif and transforaminal lumbar interbody fusion tlif surgery in the treatment of symptomatic spondylolisthesis and degenerative disc disease are generally excellent. Transforaminal lumbar discectomy is the removal or partial removal of a damaged disc or discs, from a herniated, bulging or degenerated disc. Data from the swedish national spine register suggest that 25% of patients experience unimproved pain and up to 40% are not satisfied with the outcome of lumbar fusion surgery.
The downside is that this approach also requires significant disruption to the muscles, bones, and ligaments of the back, which can lead to pain and desensitization after surgery. A bone graft and interbody spacer stabilize the anterior portion while the posterior is locked in place with pedicle screws, rods and bone. A transforaminal lumbar interbody fusion tlif is performed to remove a portion of a disc that is the source of back or leg pain. This avoids nerve retraction injuries that are seen often with the plif and bilateral posterior interbody fusion techniques. The transforaminal lumbar interbody fusion technique is carried out in the lumbar region of the spine, commonly known as the lower back. However, the tlif procedure places a single bone graft between. Tlif transforaminal lumbar interbody fusion when the spines discs wear our there is often associated pain and collapse of that disc causing nerves to become pinched. This surgery may be done to treat lumbar degenerative disc disease, in. Tlif transforaminal lumbar interbody fusion encino. Transforaminal lumbar interbody fusion advanced relief. Transforaminal lumbar interbody fusion tlif is used to treat spinal stenosis and other ailments of the back. In an interbody fusion, the damaged intervertebral disk is removed and replaced with bone graft material.
Over the last two decades, the economic costs and rates of lumbar fusion surgery for chronic low back pain has risen dramatically in western industrialized countries. Juratli et al, mortality wcafter lumbar fusion surgery, spine 2009. Background context transforaminal lumbar interbody fusion tlif and posterior lumbar interbody fusion plif are both frequently used as surgical treatment for lumbar spondylolisthesis. Presented by paul park, md, faans, of the university of michigan. This helps to improve spinal alignment and enhances spinal fusion. The spine is made up of bones called vertebrae that are like blocks placed on top of each other. Extreme lateral interbody fusion xlif has been widely used for minimally invasive anterior lumbar interbody fusion alif, but an approach to l5s1 is difficult because of the iliac crest. Transforaminal lumbar interbody fusion tlif is a procedure that fuses the anterior and posterior columns of the spine through a posterior approach. Minimally invasive transforaminal lumber interbody fusion. A comparative study of lateral lumbar interbody fusion and. There is also the added biological advantage of an interbody fusion technique with compression across a structural fusion cage or apparatus, which will add to the success of a lumbar arthrodesis procedure.
It begins to degenerate and may cause discogenic low back pain. Transforaminal lumbar interbody fusion tlif is a surgical technique to stabilize the spinal vertebra and the disc or shock absorber between the vertebrae. It is an operation performed on the lower back to remove an intervertebral disc and join two or more spinal bones vertebrae together using screws and a cage. Posterior lumbar interbody fusion and transforaminal. Everything you do during the day, once you stand upright, tests the spines ability to support your body weight. A number of conditions can give rise to severe pain in the lower back, including a slipped, or herniated, disc, and spondylolisthesis, where a vertebra slips forward over the one beneath. Pdf transforaminal lumbar interbody fusion tlif versus. What is an anterior lumbar interbody fusion alif procedure. Like the plif posterior lumbar interbody fusion procedure, bone graft is used to fuse the spinal vertebrae after the disc is removed. Most commonly it is performed on the l4l5 or l5s1 segment at the bottom of the lumbar spine. Transforaminal lumbar interbody fusion tlif youtube. Minimally invasive spinal transforaminal lumbar interbody fusion mistlif at l5s1 is technically more demanding than it is at other levels because of the anatomical and biomechanical traits. Oblique lumbar interbody fusion olif the olif that has been recommended will be performed at.
There are several advantages distinct and to the tlif approach. Llif allows the surgeon to access the intervertebral space via a minimally invasive direct lateral approach through the psoas muscle. Transforaminal lumbar interbody fusion a transforaminal lumbar interbody fusion tlif is a type of spine surgery that involves approaching the spine from the back, or posterior, of the body to place bone graft between two vertebrae. Pain from pinched nerves or arthritis to the disc can be severe and disabling. Lateral lumbar interbody fusion llif is a relatively new technique and was first described by ozgur et al. Transforaminal lumbar interbody fusion tlif mesfin a. It refers to the placement of an interbody spacer, or cage, into the disc space. A transforaminal lumbar interbody fusion tlif is an effective procedure for replacing a damaged disc. Transforaminal lumbar interbody fusion tlif technique. Over time, these repeated daily stresses and minor injuries could add up and begin to affect the discs in your spine. This procedure is performed through the middle back, which allows direct access to the area being treated. Transforaminal lumbar interbody fusion tlif allows, as part of the dissection, a far lateral access to the neural foramina to decompress both the traversing and exiting upper nerve root without neural manipulation.
Theoretical advantages of tlif include increased fusion success, more complete foraminal decompression, better correction of deformity, and more effective treatment of discogenic pain. Transforaminal lumbar interbody fusion roush spine. Lemma, md minimally invasive spine surgery, scoliosis surgery, baltimore, md overview tlif is an adjunct to posterior spinal fusion. According to the agency for health care research and quality, the annual number of spinal fusion operations rose by 77% between 1996 and 2001. Spinal fusion is a surgery used to correct problems with the small bones in the spine. Page 2 following your discography investigation and consultation with your spinal surgeon, the possibility of undergoing lumbar spinal interbody fusion has been discussed with you. Accepted manuscript minimally invasive transforaminal lumbar interbody fusion versus percutaneous endoscopic lumbar discectomy. In addition, transforaminal lumbar interbody fusion tlif was introduced in the early 1980s, 1 and it has been extensively used since the late 1990s because of its better biomechanical stability. Spinal fusion may be recommended for conditions such as spondylolisthesis, degenerative disc disease or recurrent disc herniations. Minimally invasive transforaminal lumbar interbody fusion. Transforaminal lumbar interbody fusion, also called tlif, is surgery to correct problems with your spine backbone. Oblique lumbar interbody fusion minimally invasive. Transforaminal lumbar interbody fusion blausen medical. Anterior lumbar interbody fusion versus transfor aminal lumbar interbody fusion systematic re view and metaanalysis, british journal of neurosur gery, 29.
In the current study, we present 2 cases using minimally invasive oblique lateral interbody fusion olif of l5s1. Transforaminal lumbar interbody fusion listed as tlif. This article describes the transforaminal lumbar interbody fusion tlif fusion technique. The optimal treatment for degenerative lumbar diseases remains controversial 1,2. A comparison of posterior lumbar interbody fusion and. Perioperative complications in transforaminal lumbar. Transforaminal lumbar interbody fusion burak ozgur, md. Spine surgeons use this procedure to restore structural integrity to the vertebrae of the lumbar spine. Posterior lumbar and transforaminal lumbar are types of interbody fusion. Transforaminal lumbar interbody fusion complex spine.
Lumbar transforaminal lumbar interbody fusion tlif. Surgeons perform lumbar fusion using several techniques. The optimal treatment for degenerative lumbar diseases remains controversial 1, 2. It involves placing an interbody cage in an oblique direction and a strong pedicle screw posterior construct that temporarily stabilizes the spine until bony fusion takes place via sentinel and interbody bone.
Tlif is a contemporary approach to spinal fusion surgery. In an interbody spinal fusion, the damaged intervertebral disk is removed and replaced with bone graft material. 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. L 12 3 4 5 s during the procedure, if mr choi believes from what he sees that your outcome may be improved, he may involve an extra level or levels in the olif.
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