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Transforaminal Lumbar Interbody Fusion (TLIF)

Overview

What is TLIF?

Transforaminal Lumbar Interbody Fusion (TLIF) is a surgical procedure that joins (fuses) two or more bones in the lower spine to relieve pain and instability caused by damaged discs, nerve compression, or degenerative conditions. TLIF is performed through a single incision in the back, using specialised techniques that minimise tissue trauma and help restore function.​

Who is it for?

TLIF is generally recommended for patients who have not found relief through non-surgical therapies. You may be considered for TLIF if you have:

  • Chronic lower back and leg pain from degenerative disc disease, spinal stenosis, or spondylolisthesis
  • Persistent nerve symptoms, such as tingling, numbness, or weakness, that do not respond to medications or physiotherapy
  • Disc collapse or instability seen on imaging (MRI/CT)
  • Difficulty performing daily activities or walking due to ongoing nerve compression

What the Procedure Involves

During TLIF surgery, you can expect:

  • The procedure is performed under general anaesthesia, with you lying face down
  • A single incision is made to access the side of the spinal canal
  • The surgeon removes part of the lamina and facet joint (unilateral) to reach the affected disc space
  • The injured disc is removed and replaced with a spacer (interbody cage) filled with bone graft
  • Screws and rods are placed to stabilise the vertebrae and encourage bone fusion
  • The incision is closed and you will recover under close observation
    TLIF can be performed using open or minimally invasive approaches, reducing impact on surrounding tissues and promoting faster recovery.​

Risks and Complications

TLIF is considered safe, but as with any surgical procedure, certain risks are possible. These include:

  • Infection (2–4% risk)​
  • Bleeding or blood clots
  • Nerve root injury, which may cause temporary pain, numbness, or weakness (<5%)​
  • Spinal fluid leak (dural tear)
  • Non-union (failure of bones to fuse, risk higher in smokers)
  • Hardware issues (loosening, breakage)​
  • Adjacent segment degeneration (increased wear above or below the fused area)​
  • Persistent or recurrent symptoms, or need for repeat surgery​
    Your surgeon will discuss the individual risks and measures taken to minimise complications before surgery.

Recovery Expectations and Duration

Recovery from TLIF varies based on individual factors, but you can typically expect:

  • Hospital stay of 2–4 days; minimally invasive procedures may allow shorter stays​
  • Early mobilisation; gentle walking often begins soon after surgery
  • Most patients notice substantial pain reduction and improved function within 4–6 weeks, with light activity or desk work often possible by this stage
  • Return to driving within 2 weeks (once comfortable and off strong painkillers)​
  • Full recovery, including vigorous activity or sport, is typical within 3–6 months; bone fusion continues to strengthen for up to a year
  • Follow-up visits to monitor the fusion and healing process are scheduled
    Physical therapy is often recommended to aid in recovery and restore movement.

FAQs

Will TLIF eliminate my back and leg pain?
Most patients experience significant relief of leg and nerve pain; relief of back pain varies and is linked to successful fusion and healing.

How much mobility will I lose after TLIF?
The fused spine segment will no longer move, but daily movement is generally preserved, particularly if only one level is treated. You may notice some reduction in flexibility.

Is TLIF minimally invasive?
TLIF can be performed using minimally invasive techniques, which use smaller incisions and promote quicker recovery and less postoperative pain.