Having Transforaminal Lumbar Interbody Fusion (TLIF)

A fusion is a surgery that joins 2 or more bones together. During a transforaminal lumbar interbody fusion (TLIF), this is done on the spine. Two of the bones of your lower back (vertebrae) are joined together. The spinal disk between the 2 vertebrae is removed.

What to tell your healthcare provider

Tell your healthcare provider about all the medicines you take. This includes over-the-counter medicines, such as ibuprofen. It also includes vitamins, herbs, and other supplements. Also tell your provider if you:

• Have had any recent changes in your health, such as an infection or fever

• Are sensitive or allergic to any medicines, latex, tape, or anesthesia (local and general)

• Are pregnant or think you may be pregnant

Tests before your surgery

Before your surgery, you may need imaging tests. These may include ultrasound, X-rays, or MRI.

Getting ready for your surgery

Talk with your healthcare provider about how to get ready for your surgery. You may need to stop taking some medicines, such as blood thinners and aspirin, before the procedure. If you smoke, you may need to stop before your surgery. Smoking can delay healing. Talk with your healthcare provider if you need help to stop smoking.

Also, make sure that you:

• Ask a family member or friend to take you home from the hospital. You can;t drive yourself.

• Plan some changes at home to help you heal. You may need help at home.

• Follow any directions you are given for not eating or drinking before your surgery.

• Follow all other instructions from your healthcare provider.

You will be asked to sign consent forms. These give your permission to do the surgery and get anesthesia. Read the forms carefully. Ask questions if something is not clear.

On the day of surgery

Your TLIF will be done by an orthopedic surgeon or neurosurgeon. They will work with a team of specialized providers, technicians, and nurses. The surgery can be done in several ways. Ask your healthcare provider about the details of your surgery. The whole procedure may take a couple of hours. In general, you can expect the following:

• You will have general anesthesia. This medicine lets you to sleep through the surgery. You won’t feel any pain.

• A healthcare provider will watch your vital signs, like your heart rate and blood pressure, during the surgery. You may have a breathing tube put down your throat to help you breathe.

• You may be given antibiotics during and after the surgery to help prevent infection.

• You will be positioned face-down on the operating table.

• The surgeon will make a small cut (incision) in the skin on your back.

• They will use special tools called retractors to push aside your back muscles. This lets the surgeon see the spine.

• The surgeon will take out the disk. Then they will put a bone graft into the space between your vertebrae. The graft may be bone, titanium, or a synthetic bone-like material.

• The surgeon may use special screws or other materials to anchor your bones in place.

• The surgeon will fix other areas as needed. They will then close the layers of muscle and skin on your back with stitches (sutures).

After your surgery

Right after surgery, you will be taken to a PACU (post anesthesia care unit). Nurses will watch your breathing, heart rate, blood pressure, and surgical site. You may stay in the hospital for a few days. During this time, you may have imaging tests, such as X-rays. These are done to see how your surgery went.

You may have some pain at the incision site after surgery. You can take pain medicines to help ease it. But only take pain medicine approved by your healthcare provider. Some over-the-counter pain medicines can slow bone healing. You might have a small amount of fluid leaking from your incision. This is normal. Let your healthcare provider know right away if you see an increase in redness, swelling, or fluid from your incision.

You can go back to your normal diet as soon as you feel able. Your healthcare provider may tell you to eat foods high in calcium and vitamin D as your bones heal.

Your original pain symptoms may go away quickly after your surgery. Or they may slowly get better over time.

Follow-up care

Make sure to follow all your surgeon’s instructions about medicines and wound care. This will help to make sure the fusion is a success. If you have any questions or concerns, call the surgeon’s office.

While you heal, it’s important to keep your spine in correct alignment. A healthcare provider will show you safe ways to move around. At first, you may only be able to do light activity, like walking. As you heal, you’ll be able to slowly increase your activity.

Make sure to keep all your follow-up appointments. You may need to have your stitches taken out a week or so after your surgery.

When to call your healthcare provider

Call your healthcare provider right away if you have any of these:

• Chest pain or trouble breathing (call 911)

• Fever of 100.4°F ( 38°C) or higher, or as directed by your provider

• Ongoing or severe pain, weakness, or numbness in your back or legs

• Redness, swelling, pain, bleeding, or fluid leaking from your incision that gets worse

• A severe headache or tiredness

• Problems controlling your bladder or bowels

• Other signs or symptoms as directed by your provider