TLIF: transforaminal lumbar interbody fusion

Abstract

-Transforaminal lumbar interbody fusion (TLIF) is a relatively new technique of lumbar arthrodesis via posterior transforaminal approach to the disc, indicated mainly in cases of degenerative disc disease, low grade spondylolisthesis and reoperation for disc herniation, specially when there is indication for interbody fusion and posterior decompression. The main advantage of TLIF is that it allows the complete removal of the intervertebral disc through the vertebral foramen, decompression of the spinal canal and vertebral foramen with minimum risk of neural lesion, due to the access being lateral to the nerve roots. In this study, we describe the first 24 cases of TLIF that we have done, wich shows to be very safe and efficient in our serie, with an relief of pain in 83.3% of patients, great improvements in the life quality in 75% of cases and satisfaction with the surgery in 79.1% of patients.KEY WORDS: transforaminal lumbar interbody fusion, lumbar disc disease, transforaminal access. TLIF -artrodese intersomática lombar transforaminalRESUMO -Artrodese lombar intersomática transforaminal (TLIF) é uma técnica relativamente nova de artrodese lombar intersomática via transforaminal posterior, indicada principalmente nos casos de doença discal degenerativa, espondilolistese (grau I e II) e reoperação para hérnia discal, especialmente quando existe indicação para fusão intersomática e descompressão posterior. A maior vantagem do TLIF é que ele permite remoção completa do disco através do forame, descompressão do canal e neuroforame, com mínimo risco de lesão neural, uma vez que o acesso é lateral aos nervos. Em nosso estudo, descrevemos os primeiros 24 casos de TLIF que realizamos, que se mostrou como cirurgia segura e eficiente em nossa série, com alívio da dor em 83,3% dos pacientes, melhora na qualidade de vida em 75% dos casos e satisfação com a cirurgia em 79,1% dos pacientes. The classic work of Crock and colleagues was the pioneer in identifiying lumbar pain at the disc origin not due to mechanical compression 3 . Since then innumerable studies have contributed to better comprehension of disc degeneration as the source of lumbar pain in many patients. Its pathophysiology is probably due to degeneration, thus causing alteration of properties of the discs. These alterations result in biochemical and structural irrtation of the adjacent nerve endings, as well as of new nerve ingrowth into the interior portion of the disc, thus provoking lumbar and referred leg pain 4 PALAVRAS-CHAVE

Ipsilateral pedicle screw placement with contralateral percutaneous facet screws: Early results with an alternative in lumbar arthrodesis

“…[7][8][9][10] Traditional decompression and inter-body fusion with TLIF has been shown to be safe and may result in relief of pain in as many as eighty percent of patients. 5 Modern surgical practice has been in favor of minimally invasive techniques whenever possible.…”

Association between Asymptomatic Urinary Tract Infection and Postoperative Spine Infection in Elderly Women : A Retrospective Analysis Study

“…The subgroups were instrumentation (spinal fusion), and laminectomy and/or discectomy. The spinal fusion procedure was almost always a unilateral posterior transforaminal lumbar interbody fusion (TLIF) with artificial cage and pedicle screw fixation (PSF), with exposure of the lamina, facets, and transverse process 11) . In laminectomy and/or discectomy, the lamina was resected partially and/or a partial discectomy was done after retracting the nerve root medially.…”

Update on Imaging of Spinal Fixation Hardware

“…11c, d). 61 TLIF is an alternative to PLIF because it decreases the amount of thecal sac distraction necessary for exposure and thus decreases the potential of neural injury, dural tear, and epidural fibrosis. Given its unilateral dissection technique, TLIF also spares most of the posterior ligamentous complex, unlike PLIF.…”