Transforaminal Lumbar Interbody Fusion (TLIF)

TLIF is a posterior lumbar procedure that combines decompression with interbody fusion. Through a midline or paramedian incision, the nerve roots are decompressed, a cage filled with bone graft is placed in the disc space, and pedicle screws and rods are used to stabilize the segment.

TLIF may be appropriate when symptoms, imaging findings, and clinical instability align — for example, in degenerative spondylolisthesis with stenosis, recurrent disc herniation, or segmental instability that has not responded to conservative care.

The decision to perform a fusion depends on whether instability is truly part of the problem. Decompression alone is sometimes enough. When fusion is needed, TLIF offers the advantage of addressing both the compression and the structural issue from a single approach. The trade-off is a somewhat longer recovery and the creation of a stiff segment that shifts load to adjacent levels over time.

• Infection
• Nerve injury or neurologic complications
• Implant failure or loosening
• Nonunion
• Blood loss or dural tear
• Adjacent segment degeneration

Hospital stay is often one to three days. Patients are encouraged to walk early. Return to sedentary work is usually within a few weeks, with full activity over three to six months depending on the extent of surgery.