Transforaminal Lumbar Interbody Fusion (TLIF)
What is TLIF?
Transforaminal Lumbar Interbody Fusion (TLIF) is a minimally invasive lumbar stabilization surgery performed on the lumbar or thoracic spine to relieve symptoms such as pain or muscle weakness in the lower back and extremities. The procedure treats a span of diseases, including lumbar stenosis, disc herniations, and disc degeneration. This procedure is considered minimally invasive because the surgery is completed through a small incision and by pushing aside muscle tissue rather than by opening the entire back and cutting through muscle tissue as in traditional back surgery.
Symptoms of lumbar spine disease can manifest as either local or radiating symptoms. Localized symptoms include lower back pain, lower back stiffness, and decreased range of motion. Radiating symptoms are typical on only one side of the body or the other, but can occur on both sides simultaneously. Radiating symptoms typically occur unilaterally (on one side of the body), but can occur on both sides and will generally follow the nerves in the lower back, branching into the buttocks, hips, legs, and feet. Radiating pain can be described as sharp, shooting, throbbing, electrical, burning, numbness, or tingling and there may be weakness with specific muscle actions.
Lumbar Disc Herniation: Intervertebral discs provide shock absorption in the spine and are made of a fibrous outer ring, the annulus fibrosis, surrounding a jelly-like inner section, the nucleus pulposus. As repetitive tasks and aging create wear on the annulus fibrosis, small tears create weak spots in the disc and the nucleus pulposus squeezes through, creating a herniated disc and potentially compressing the spinal cord and/or nerve roots.
Lumbar Spinal Stenosis: Spinal stenosis is narrowing of the spine around neural elements, like the spinal cord and nerve roots. Narrowing may occur from a variety of causes, including disc herniation or arthritis. Arthritis and aging can cause intervertebral discs to shrink, narrowing the space through which nerves branch out from the spine; they can initiate bone spur formation, which are bony growths meant to prevent movement at a joint, but can compress a nerve; and they can cause ligaments to grow, which can also compress a nerve.
Lumbar Pinched Nerves: Pinched nerves include the spinal nerve roots that are being compressed because of diseases, such as disc herniation or spinal stenosis.
Lumbar Facet Joint Syndrome: The facet joints connect spinal vertebrae, enabling motion in the spine while also preventing extreme motions. As wear accumulates, the surrounding cartilage begins to thin and the lubricating synovial fluid runs low, allowing bone on bone rubbing. To prevent motion at these areas of friction, the spine starts forming bone spurs, or bony growths, that may press on a nerve directly or cause inflammation of the joint.
Spondylolisthesis: Spondylolisthesis is the shift or slip of a vertebra either forwards or backwards relative to the vertebra above and below. This disrupts the structure and stability of the spine, affecting its ability to stabilize the body. Spondylolisthesis can be caused by a variety of condition, but all of them can cause compression on the nerve roots because an abnormally positioned vertebrae can change the size of the spinal canal, the space that the spinal cord runs through, or of the foramen, the vertebral space through which nerves branch off of the spinal cord and into the body.
Scoliosis: Scoliosis is a sideways curvature of the spine, which can place uneven amount of stress, such as weight or pressure when standing or walking, on other body joints (e.g. hips, shoulders) and certain vertebra, leading to unevenness in these joints. Scoliosis can lend to more progressive degenerative changes as there is more pressure on the vertebrae in the curve, as well as more stress on the intervertebral discs.
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