MINIMALLY INVASIVE SURGERY TRANSFORAMINAL LUMBAR INTERBODY FUSION
WHAT IS IT?
In response to wear and tear sustained over the course of a lifetime, the joints in your spine can become unstable and overgrown. The instability can lead to the vertebra that make up your spinal column to slip out of place causing back pain and pain going down the leg. In some cases the best way to treat this instability is to fuse the two vertebra that are slipping together. A minimally-invasive Transforaminal Lumbar Interbody Fusion (TLIF) is a type of spine surgery that enables the surgeon to fuse the vertebrae together through two small incisions in the back and treat the symptoms caused by the instability. The most common symptoms are: leg pain (one or both), numbness, weakness, bowel or bladder disturbance and back pain. Surgery is indicated in patients whose symptoms are persistent or becoming intolerable. Generally, surgery is only offered after most conservative options have failed e.g. medication, physical therapy, spinal injections. Early surgery may be performed in patients who have worsening weakness or symptoms suggestive of spinal cord compression.
HOW IS THE PROCEDURE PERFORMED?
The surgery will involve a general anesthetic so that you are asleep throughout the procedure. Two small incisions are made in the lower portion of the back each a little off the midline. Surgical navigation technology is used to guide the screws into the correct vertebral bodies. Then, the disc material is removed from the unstable level so that a graft may be placed to correct the alignment of your spine and promote fusion between the two vertebral bodies. Two small rods are then placed to connect the screws on each side and lock them into the correct alignment for your back. We then take X-rays to confirm correct placement of each screw and rod, and to ensure we have perfectly corrected the alignment of your spinal column. Once the surgery is complete, the anesthetic is reversed and you are taken to the recovery room.
WHY WOULD FULL ENDOSCOPIC FORAMINOTOMIES BE PREFERRED?
All surgery involves risk and this must be outweighed by the benefits of the procedure. The risks of surgery are related to the anesthetic, operation or hospital stay. Generally, surgery is safe and the risk of a major complication is 1 or 2%. The risks involved with a MIS TLIF include: infection, bleeding, failure to improve symptoms, temporary or permanent nerve damage, spinal fluid leak, need for further surgery.
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