Dr. Kremer is an advocate of restoring the natural dynamics of the spine. The less hardware, the better.


What is Transforaminal Lumbar Interbody Fusion?

A Minimally Invasive Transforaminal Lumbar Interbody Fusion (MIS TLIF) is an innovative surgical procedure used for stabilizing your lumbar vertebrae – the spinal bones of your low back. Over the last decade, surgeons have increasingly used MIS TLIF over traditional open TLIF surgery to help relieve back pain from degenerative disk disease, lower spine misalignments, and resolve symptoms of lumbar disk herniation like numbness and tingling in the buttocks and legs.

How does MIS TLIF work?

How does MIS TLIF work?

Using a very small incision, often only 1 inch in size, your surgeon will use x-ray guided tools to locate the area of concern. The surgeon then retracts the muscles in this area by cutting them, removes part of the damaged vertebrae, and inserts small spacer hardware to secure the area and provide better alignment of the spine. The small pieces of hardware allow your surgeon to fuse two or more vertebrae, providing stability and pain relief. The entire procedure can be done in a matter of hours.

Transforaminal Benefits

What are the benefits of MIS TLIF?

Some of the benefits of choosing Transforaminal Lumbar Interbody Fusion over traditional open spinal fusion surgery include:

  • Smaller incision and smaller resulting scars
  • No surgical cutting of muscle
  • Less blood loss and tissue damage
  • Shorter procedure time
  • Shorter recovery time
  • Briefer hospital stay
  • More stable spine immediately after surgery
  • Better spinal alignment immediately after surgery

MIS TLIF Surgery

Who Qualifies for Transforaminal Lumbar Interbody Fusion?

Only you and your doctor can decide if MIS TLIF is the correct surgical procedure for your individual needs. Often you will need to undergo testing like X-ray, CT scan, and/or MRI to correctly identify the cause of your pain and establish a plan for managing that pain.

Good candidates for the procedure will typically first need to try conservative measures like physical therapy, medication, and injections to relieve their symptoms. Also, some medical conditions such as bleeding problems, heart issues, certain cancers, and systemic disorders may preclude you from undergoing a MIS TLIF procedure.

TLIF Recovery

What is the Recovery Time from a MIS TLIF?

Patients will generally spend 24 hours to four days in the hospital after their MIS TLIF. If you have an office job, you will typically be back at work within three to six weeks after the procedure. You will need to refrain from lifting heavy objects for a while as instructed by your surgeon. You will also need to participate in postoperative physical therapy sessions for Transforaminal Lumbar Interbody Fusion patients.

TLIF Risks

Are there risks associated with MIS TLIF?

Every surgical procedure, no matter how minor, carries inherent risks. These risks include uncontrolled bleeding, unintentional damage to nearby structures, infection, and others. However, MIS Transforaminal Lumbar Interbody Fusion is considered a safe operation, and minimally invasive procedures tend to be associated with fewer complications than traditional open procedures.


MIS TLIF Research

Are There Any Studies on the Effectiveness of MIS TLIF?

Yes. Doctors and researchers have published many studies concerning the clinical outcomes of a minimally-invasive approach to Transforaminal Lumbar Interbody Fusion surgery. For example, a study appearing in the Journal of the Korean Neurosurgical Society looked at 20 patients who underwent MIS TLIF. The vast majority of these patients had excellent fusion outcomes when examined 12 months after surgery.

A more recent study in World Neurosurgery comparing 50 open TLIF and 50 MIS TLIF patients concluded that MIS TLIF resulted in reduced operative blood loss, hospital stay and 2-year cost, and accelerated return to work. Finally, a paper in the American Journal of Orthopedics demonstrated that MIS TLIF patients had less pain.

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