Transforaminal lumbar interbody fusion (TLIF), is a technique for fusing the lower portion of the spinal cord. This surgery is performed to decrease the irritation to nerves that results in back pain. A spine fusion does not cure back pain. According to the Texas Spine and Joint Hospital (see References), most studies indicate that a majority of patients report a 60 percent improvement in their back and leg pain as a result of the surgery. There are also risks to having this surgery, including those associated with anesthesia as well as the possibility of additional nerve damage and the need for future surgeries.
Incomplete Fusion
The goal of any spinal fusion surgery is to fuse two or more vertebrae together into a solid bony union to stabilize the bones and stop movement between the bones that are causing nerve inflammation and pain. The TLIF approach offers advantages including access to both the anterior (top side of the vertebrae toward the head) and posterior (bottom side of the vertebrae toward the tail) portion of the spine, according to the doctors at the Texas Spine and Joint Hospital.
Because the bone grafts can be placed behind and to the sides of the vertebrae, the TLIF procedure has a good success rate with up to 89 percent of patients experiencing complete fusion, according to research published in the August 2005 "European Spine Journal." There is, however, still a risk of incomplete fusion, where the vertebrae are not fully fused allowing the nerves to be irritated and continue to cause pain. In these cases additional surgery may be necessary to obtain a complete fusion.
Nerve Damage
TLIF surgery is usually performed on the side of the spine where pain is being experienced due to irritated nerves. During the procedure, the skin, muscles and soft tissues are moved aside to provide access to the vertebrae. To provide room for a transforaminal procedure, the foramen (the opening around the nerves), must be enlarged. To do this, the nerve root must be moved and kept aside for the remainder of the surgery. The nerves must be handled very gently to avoid damage. Damage can result in debilitating and chronic back and/or leg pain according to the Spine Institute of San Diego (see References).
Anesthesia
General anesthesia, medication given to block the pain signals from being delivered to the brain through the nerves, is used during this surgery which means the patient will be asleep. General anesthesia is generally safe to use, but there are side effects and complications that might arise.
Side effects of general anesthesia include nausea, vomiting, shivering, sore throat, headache and confusion. More severe complications such as nerve damage, cardiac problems or allergic reactions are rare but can be critical.
Medical
Any surgery that involves cutting open the body holds a risk of medical complications. The most prominent complications include infection at or near the surgical site, and blood loss. The average blood loss for TLIF surgery, according to research conducted by the University Hospital Munster (see References), is approximately 485ml for a single fusion and 560ml for multiple fusions.
