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Minimally Invasive Lumbar Fusion (MIS-TLIF)

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The image illustration of the minimally invasive lumbar fusion surgery.
Source : https://orthoinfo.aaos.org

Understanding Minimally Invasive Lumbar Fusion (MIS-TLIF)

Fusion serves as a method to stabilise the spine by uniting two vertebrae. In contemporary practice, the standard for achieving lumbar fusion is Transforaminal Lumbar Interbody Fusion (TLIF), performed from the back. The transforaminal approach accesses the disc through the space between the vertebrae.

In the conventional technique, the spine is approached posteriorly, with the paraspinal muscles separated and retracted from their attachment. This is followed by a partial or complete removal of facets (small joints in the back), discectomy, and the insertion of a cage (artificial spacer and bone). Importantly, minimal retraction of the nerve root and dural sac is ensured.

Minimally invasive surgery relies on a profound understanding of anatomy and utilises radiographic imaging to address spinal conditions without causing undue injury to surrounding soft tissues. This technique allows for gently separating the muscles surrounding the spine rather than cutting through them. The potential benefits include smaller scars, reduced pain, and a quicker recovery.

When to Opt for MIS-TLIF

Our specialists may recommend this minimally invasive surgery under the following medical circumstances:
Advanced degenerative disc disease
Lumbar spinal deformity – Degenerative/ Adult deformity
Disc space infection
Spinal trauma
Adjacent segment disease after previous lumbar fusion

Surgical Options We Offer at Spine 360

Pre-Surgery Care: Points to Remember
During the Surgery: What to Expect
Post-Surgery Recovery Process
  • Our doctors will collect information on the medicines you are taking and ask you to stop them before surgery (such as blood thinners, etc).
  • Your doctor will review your condition with you and explain what all of your possible choices are, including physical therapy and other surgeries such as removal of the diseased disc, fusion, etc.
  • Do not eat or drink anything after dinner the night before the surgery (after 10 pm)
  • The surgery will be performed under General Anesthesia.
  • The entire procedure, including anaesthesia time, positioning, skin preparation, and the surgery itself, is expected to last a few hours.
  • Following the surgery, you will be awakened and monitored in the recovery room for approximately 1 hour before being transferred to a ward.
  • Postoperative pain, if present, will be managed with adequate analgesics.
  • Early mobilisation is a key objective, overseen by a physiotherapist and typically initiated the following day.
  • The urinary catheter will be removed after mobilisation.
  • You may experience a mild sore feeling/ stiffness in the back or numbness in the leg. These side effects are generally temporary and tend to gradually subside.
  • Individual recovery times may vary, but patients are typically discharged the next day after surgery.
  • A waterproof dressing will be applied to the wound and should be changed every alternate day, with instructions provided before discharge.
  • Regular follow-up appointments are essential and are scheduled at 1 week, 6 weeks, and 6 months following the surgery.
  • To facilitate life after surgery, it is advisable to prepare the home environment by placing essential items, such as medication and personal hygiene products, within easy reach.
  • As a precaution, remove safety hazards like floor clutter that may pose a tripping or balance risk. I
  • It is recommended to arrange for assistance at home and around the house during the postoperative period.

FAQs on Minimally Invasive Lumbar Fusion (MIS-TLIF)

The Minimally Invasive Transforaminal Lumbar Interbody Fusion (MIS TLIF) procedure offers several advantages when compared to traditional spine surgery:

  • Smaller incisions, leading to reduced postoperative pain.
  • Minimised muscle disruption during the surgery.
  • Decreased blood loss, often eliminating the necessity for blood transfusions.
  • Lower rates of postoperative complications
  • Reduced risk of infection.
  • Reduced need for pain medication post-surgery.
  • Quicker recovery, with some patients able to stand by themselves and walk as early as the day following the procedure.
Yes, physical therapy (PT) is generally recommended after TLIF surgery. It plays a crucial role in pain and inflammation reduction, strengthening the back, and facilitating a gradual post-surgery recovery process.
TLIF surgery is performed using general anaesthesia, and after the pain-blocking effects of anaesthesia wear off, patients may receive prescription pain medication to manage any postoperative discomfort. Minimally invasive TLIF further minimises postoperative pain due to smaller incisions and reduced muscle dissection.
TLIF back surgery generally leads to significant improvements in leg pain, back pain, physical function, and disability. Research conducted at HSS has indicated that 85% to 90% of patients who undergo TLIF experience enhanced well-being after the procedure and report high levels of satisfaction with the outcomes.
A happy doctor with a stethoscope.

Reclaim Your Life

Regain your vitality and embrace a joyful, wholesome daily routine! Book an appointment for the Minimally Invasive Lumbar Fusion (MIS-TLIF) procedure at Spine 360.
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