Transforaminal lumbar interbody fusion (TLIF) is a surgical technique that involves removing a disc from between two vertebrae and fusing the vertebrae together. This is done through a single incision in the back.
It is similar to a posterior lumbar interbody fusion (PLIF). The difference is that in a transforaminal lumbar interbody fusion, the disc is removed from the side. In the posterior version, the disc is removed from the back.
A transforaminal lumbar interbody fusion involves cutting into the middle of the layer of muscle and ligament that sits on either side of the spine. Using a special instrument that takes small bites off bone, the lamina is gradually removed to expose the nerves. The disc is removed through the right and left sides of the spinal canal (although sometimes all this can be done through one side only). The space between the two vertebrae is cleared. It is then packed with bone graft and either a bone block or cage implant.
Devices such as pedicle screws are then placed in the vertebrae to secure the fusion. Additional bone graft will often be placed to help ensure a solid fusion.