Transverse / Posterior Lumbar Interbody Fusion
(TLIF) / ( PLIF)
Operation
Also known as Lumbar spinal stabilization
Indication
Low back pain, spinal instability, leg pain with spinal instability and spinal fractures, revision lumbar spinal surgery
Pre-assessment
yes. Blood tests, general health assessment and X-rays.
Special preparation for surgery
stop all blood thinning medications including aspirin, warfarin, clopidogrel.
Stop HRT and oral contraceptives. Stop some herbal medicines.
You will be advised when to stop these medications.
Admission to hospital
On day of surgery or night before.
General anesthetic
Yes
Operation position
Prone (lying on front)
Details of operation
An incision is made 8 – 10cm long per level to be fused. The muscle and ligaments are dissected to allow the exposure of the bone. Under image intensification (mobile x-ray) the tracks for the spinal screws are prepared. The spinal pedicle screws are inserted (one each side per level). A rod is pre-shaped and attached to the screws by special clamps. The disc space is cleared and either a single large metal cage (Tantalum) for the TLIF procedure or two smaller cages are inserted into the disc space, to promote fusion across the disc space. Bone graft from the patient and occasionally bone substitutes are applied to the prepared bony surfaces
Length of surgery
3-5 hours
Urinary catheter required
Yes
Post-operative drain required
Yes
Post-operative antibiotics
Yes
Post-operative iv fluids ( drip)
Yes Intravenous fluids and patient controlled analgesia
DVT prophylaxis
Yes
Mobilization after surgery
After 24 – 48 hours
Length of stay in hospital
3-7 days
Post hospital recovery
2 weeks resting while wound heals followed by 2-6 weeks of gentle increase in daily activities
Sutures removed
Dissolvable
Dressing
Remove at 14 days
Review appointment
6 weeks, 12 weeks , 6 months and 1 year.
Physiotherapy
Yes , details will be recommended depending individual patient’s needs.
Return to driving
4 – 6 weeks
Return to work
6 – 12 weeks
