TLIF Spinal Fusion Surgery: 9 Must-Know Tips Before You Decide

If you’ve been advised to undergo a TLIF (Transforaminal Lumbar Interbody Fusion) surgery, here are some steps you can take:

1. Understand the Procedure

ㆍLearn about what TLIF surgery entails, including the reasons it’s recommended, the benefits, and the risks involved.

2.Ask Questions

ㆍDiscuss any concerns with your surgeon. Questions might include:

 – What are the expected outcomes?
– What are the potential risks and complications?
– What can you expect in terms of recovery time?
– if surgery is open or  minimally invasive
 – if hospital is you are undergoing is infrastructured to undergo procedure and all necessary equipments are there.  

3. Prepare for Surgery

ㆍ Follow any pre-surgery instructions given by your doctor, such as:
ㆍ Avoiding certain medications (like blood thinners).
Dietary changes or fasting before the procedure.

4. Plan for Recovery

ㆍArrange for help at home after the surgery, as you may have restrictions on movement.
ㆍPrepare your living space for comfort and safety during recovery.

5. Follow Post-operative Care Instructions

ㆍAdhere to your doctor’s guidelines for post-surgery care, including physical therapy if recommended, pain management, and activity restrictions.

6.Stay Informed

Keep up with follow-up appointments and any recommended imaging or tests to monitor your recovery. 

7. Get a Second Opinion 

 If you feel uncertain, consider consulting another spine specialist to confirm the need for surgery and explore all treatment options. 

Insurance – usually all insurances are not covered by all hospitals- If your surgery is covered by insurence,  usually service line managers ( Neuro SLM ) will give information regarding this.  

8. Consider Lifestyle Changes

 Discuss long-term strategies for maintaining spine health with your healthcare provider, including exercise, weight management, and ergonomics in daily activities.

Always prioritize communication with your Neurosurgery team and make informed decisions that align with your health needs and goals.

Dr. Ganesh Veerabhadraiah

Consultant – Neurosurgeon, Neurointerventional Surgery, Spine Surgeon (Neuro)
23+ Years Experience Overall (17+ years as Neuro Specialist)

Available for Consultation: Jayanagar 9th Block & Kauvery Hospital, Electronic City 

FAQs

1. What is the success rate of TLIF surgery?

TLIF surgery has a success rate of around 80%–90% for relieving chronic lower back pain caused by degenerative disc disease or spinal instability.

2. Is TLIF surgery safe?

Yes, TLIF surgery is generally safe when performed by an experienced spine surgeon. Like all surgeries, it carries some risks, but major complications are rare.

3. How long is the recovery after TLIF surgery?

Most patients can return to light activities in 4–6 weeks. Full recovery may take up to 3–6 months depending on overall health and rehabilitation.

Why spinal stenosis causes back problems and what are the possible reasons?

Spinal stenosis is a narrowing of the gaps within your spine that can cause strain on the nerves that run through it. Spinal stenosis affects the lower back and neck.

Some patients with spinal stenosis may not experience any symptoms. Others could feel discomfort, tingling, numbness, or muscular weakness. Symptoms might increase with time.

Spinal stenosis is most typically caused by osteoarthritis wear-and-tear alterations in the spine. In severe forms of spinal stenosis, doctors may advise surgery to provide extra space for the spinal cord or nerves.

Spinal stenosis can develop anywhere on the spine, although it is most frequent in two places:

1. The lower back (lumbar canal stenosis).

2. The neck (cervical spinal stenosis).

In this blog, we will discuss why spinal stenosis causes back problems and what are the possible reasons.

Causes 

1. Bone Overgrowth

Osteoarthritis is a “wear and tear” condition that causes the cartilage in your joints, especially your spine, to break down. Cartilage is the joint’s protective covering. Your body reacts by producing new bones. Bone spurs, or bone overgrowth, are a common occurrence. Vertebral bone spurs expand into the spinal canal, limiting the space and compressing nerves in the spine.

2. Bulging Disks

A flat, spherical cushioning pad (vertebral disc) sits between each vertebra like a sandwich and works as a shock absorber along the spine. The gel-like core of these discs breaks through a weak or torn outer layer due to age-related drying out and flattening of the discs and breaking in the outer border of the discs. The nerves around the disc are then pressed by the bulging disc.

3. Thickened Ligaments

The tight fibers that help keep your spine’s bones together might stiffen and grow over time. These swollen ligaments have the potential to extend into the spinal canal(ligament flavum

4. Tumours

Abnormal growths can arise inside the spinal cord, the membranes that surround it, or the space between the spinal cord and the vertebrae. These are infrequent and can be seen on spine imaging using an MRI or CT scan.

5. Injuries on the spine

Dislocations or fractures of one or more vertebrae can result from car accidents or other injuries. Displaced bone from a spinal fracture might cause injury to the spinal canal’s contents.

6. Achondroplasia

This hereditary disorder disrupts bone growth in the spine and other regions of the body. Achondroplasia is a bone-building disorder in which cartilage does not convert to the bone. It is distinguished by dwarfism, limited elbow range of motion, a big head size, short fingers, and normal IQ.

7. Ankylosing spondylitis (AS)

This kind of arthritis produces persistent inflammation in the spine, which can result in the formation of bone spurs. Ankylosing spondylitis (AS) is an uncommon form of arthritis that causes back pain and stiffness.

8.Congenital spinal stenosis

This is a congenital condition in which the spinal canal is inherently small. This is a birth defect in which a person is born with a narrow spinal canal. Scoliosis is another congenital spinal condition that might put a person at risk for spinal stenosis (an abnormally shaped spine)

9. Posterior longitudinal ligament ossification (OPLL)

Calcium deposits occur on the ligament that passes through the spinal canal in this disorder. Ossification of the posterior longitudinal ligament (OPLL) is a problem in which a soft tissue, the posterior longitudinal ligament, becomes less flexible and gets thick. The posterior longitudinal ligament links and stabilizes the spinal column’s bones.

10. Paget’s disease of the bone

Paget’s disease of the bone disrupts your body’s regular recycling mechanism, in which new bone tissue progressively replaces old bone tissue. Bones can become weak and deformed over time. The most usually afflicted areas are the pelvis, skull, spine, and legs.

11. Rheumatoid arthritis

Rheumatoid arthritis, or RA, is an immune-mediated inflammatory disease in which your immune system mistakenly assaults healthy cells in your body, producing inflammation (painful swelling) in the afflicted areas. RA typically affects many joints at once. This kind of arthritis is characterized by persistent inflammation, which can result in bone destruction and the formation of bone spurs.

12. Scoliosis

Scoliosis is a lateral curvature of the spine that is most commonly detected in teens. While scoliosis can arise in persons with diseases such as cerebral palsy and muscular dystrophy, the majority of infantile scoliosis is caused by unknown factors. The majority of scoliosis occurrences are moderate, although some curvature increases as children grow. This aberrant spine curvature might be caused by hereditary problems, neurological issues, or unexplained factors.

13. Osteoarthritis 

Osteoarthritis is the most common kind of arthritis, affecting millions of people. It happens when the protective cartilage that cushions the ends of the bones deteriorates over time. Although osteoarthritis may affect any joint, it most usually affects the hands, knees, hips, and spine.

Summary

The spine (backbone) extends from your neck to your lower back. Your spine’s bones form a spinal canal, which protects your spinal cord (nerves). However, most cases of spinal stenosis arise when something narrows the free area within the spine.

Many people with spinal stenosis live active and complete lives. To assist manage the effects of spinal stenosis, you may need to modify your exercise program or other daily activities. To ease pain and other symptoms, your doctor may recommend medicines, physical therapy, or surgery.

What is spinal stenosis?

Spinal stenosis is narrowing of spinal  space and or  compression  your spinal cord and nerve roots as they depart each vertebra. Changes in your spine as you get old is a common cause.  Symptoms are –back pain and/or neck pain, as well as numbness, tingling and weakness in the arms and legs.

What is spinal stenosis?

The narrowing of one or more areas within your spine is known as spinal stenosis. The amount of space available for your spinal cord and nerves that branch off your spinal cord is reduced . The spinal cord or nerves might become inflamed or pinched as a result of a narrowed space, resulting in back discomfort and causing claudication pain called neurogenic claudication.

Spinal stenosis normally takes a long time to develop, especially after 50 years . Osteoarthritis, or “wear and tear” changes in the spine that develop naturally as you age, are the most common causes. As a result, if some alterations are seen on X-rays or other imaging tests conducted for another cause, you may not have any symptoms for a long period.

Where does spinal stenosis affect?

Spinal stenosis can affect any part of the spine, however it usually affects two areas:

  • Lower back (lumbar canal stenosis)
  • Neck (cervical spinal stenosis)

Who gets affected by spinal stenosis?

Spinal stenosis can affect anyone, but it is most frequent among men and women over 50 years of age. Spinal stenosis can also affect younger persons who were born with a narrow spinal canal. Spinal stenosis can be caused by a variety of disorders that affect the spine, such as scoliosis or a spinal injury.

Causes of spinal stenosis:

There are numerous reasons for spinal stenosis. What they all have in common is that they alter the shape of your spine, narrowing the area around your spinal cord and nerve roots that escape through it. Compression or pinching of the spinal cord or nerve roots causes symptoms such as low back pain and sciatica.

The causes are:

  • Bulging disks/ herniated disk: a flat, circular cushioning pad (vertebral disc) sits between each vertebra and works as a stress absorber along the spine. The gel-like centre of these discs breaks through a weak or torn outer layer due to age-related drying out and flattening of vertebral discs, as well as breaking in the outside border of the discs. The nerves near the disc are then compressed by the bulging disc.

Spinal stenosis is commonly caused by herniated discs and bone spurs causing narrowing of spinal and Neurol foramina.

  • Thickened ligaments: ligaments, the fibre bands that keep the spine together, have thickened. Ligaments can enlarge and bulge into the spinal canal space as a result of arthritis (and can cause lateral recess syndrome)
  • So many times both disc prolapse and ligaments and facets enlarge may cause spinal stenosis.
  • inflammation from damage along the spine, can narrow the canal space or exert pressure on the nerves
  • Bone overgrowth/ arthritic spurs: osteoarthritis is a “wear and tear” condition that causes cartilage to break down in your joints, including spine. The protective coating of joints is cartilage. The bones begin to rub against one another when cartilage goes down. Your body reacts by producing new bone tissue. Bone spurs or bone overgrowth are a common occurrence.

Bone spurs on vertebrae protrude into the spinal canal, limiting the space and squeezing nerves.

Dr. Ganesh Veerabhadraiah

Consultant – Neurosurgeon, Neurointerventional Surgery, Spine Surgeon (Neuro)
23+ Years Experience Overall (17+ years as Neuro Specialist)

Available for Consultation: Jayanagar 9th Block & Kauvery Hospital, Electronic City 

Symptoms of spinal stenosis

1. Lower back (lumbar) spinal stenosis:

  • Lower back pain is a common ailment. Pain can range from a subtle aching or discomfort to an electric or searing sensation. It’s normal for pain to come and go.
  • Sciatica: this pain is what starts in your buttocks and spreads down your leg, possibly into your foot.
  • Leg cramps in one or both legs due to heavy feeling in the legs , after walking for sometime in the beginning, later stages even few steps also pain in legs ( neurogenic claudication)
  • Numbness or tingling in the buttocks, leg or foot (sometimes known as “pins or needles”)

2. Neck (cervical) spinal stenosis:

  • Neck ache
  • Arm, hand, leg or foot numbness or tingling. (symptoms can occur anywhere below the nerve compression point)
  • Arm, hand, leg or foot weakness or clumsiness.
  • Problems with body balance.
  • Loss of hand functioning, such as difficulty in writing or buttoning clothes.
  • Bladder or bowel control problems (in severe cases)

3. Abdomen (thoracic) spinal stenosis:

  • At or below the level of the abdomen, there is pain, numbness, tingling or weakness.
  • Problems with equilibrium.

Diagnosis 

Neuro imaging – MRI  to see the disc hernation and degree of canal stenosis

X Rays  to see the slip vertebrae, spondylolysis

Conculsion

Our expert Neuro team at NeuroWellness a neuro hospital in Bangalore provides consultation and treatment to all neuro problems.

FAQs

1. What is spinal stenosis?

Spinal stenosis refers to the narrowing of spaces in the spine, which puts pressure on the spinal cord and nerves. It commonly affects the neck or lower back.

2. What causes spinal stenosis?

Spinal stenosis is often caused by age-related changes like herniated discs, thickened ligaments, bone spurs (from osteoarthritis), or spinal injuries.

3. What are the symptoms of spinal stenosis?

Symptoms include lower back or neck pain, numbness, tingling, weakness in the limbs, sciatica, and leg cramps. In severe cases, balance issues and bladder/bowel problems may occur.

4. Where in the spine does spinal stenosis occur?

Spinal stenosis commonly affects the lower back (lumbar region) and neck (cervical region), but can also impact the thoracic spine (mid-back) in rare cases.

5. How is spinal stenosis diagnosed?

Spinal stenosis is diagnosed using MRI scans to visualize disc herniation and nerve compression, and X-rays to assess structural issues like slipped vertebrae.

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