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Transforaminal Lumbar Interbody Fusion (TLIF)

Howard S. An, MD
The Morton International Endowed Chair
Professor, Orthopaedic Surgery
Rush University Medical Center
Chicago, IL
Dino Samartzis, DSc, PhD (C)
Transforaminal lumbar interbody fusion (TLIF) is a variation of the posterior lumbar interbody fusion (PLIF) approach for surgical treatment of spondylolisthesis and segmental instability. The TLIF approach is a unilateral PLIF, which provides 360-degree fusion, avoids anterior access and associated complications, decreases manipulation of neural structures, reduces damage to ligamentous elements, minimizes excessive bone removal, enhances biomechanical stability, and provides early mobilization.
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This video was produced at the Department of Orthopaedic Surgery at Rush-Presbyterian-St. Luke's Medical Center and illustrates surgical demonstration of a TLIF featuring treatment of a high-grade spondylolisthesis.

A case is reviewed including history, physical examination, radiographic findings, operative course, and postoperative outcome. Copious graphic illustrations and intraoperative footage are implemented. Discussion also entails historical focus, consideration for the chosen approach, and detailed methodology of pedicle screw and interbody cage insertion and placement.

Please be aware that this video contains video from surgical procedures. We recommend that you visit other parts of SpineUniverse before viewing the video, in order to understand the content.

References:

1. Cloward RB. The treatment of ruptured lumbar intervertebral discs by vertebral body fusion. I. Indications, operative technique, after care. J Neurosurgery 1953;10:154-68.

2. Blume HG, Rojas CH. Unilateral lumbar interbody fusion (posterior approach) utilizing dowel grafts: Experience in over 200 patients. J Neurol Orthop Surg 1981;2:171.

3. Blume HG, Rojas CH. Unilateral lumbar interbody fusion by posterior approach with dowel grafts. In: Lin PM, editor. Posterior Lumbar Interbody Fusion. Springfield: Charles C. Thomas; 1982. p. 252-75.

4. Blume HG. Unilateral posterior lumbar interbody fusion: simplified dowel technique. Clin Orthop 1985:75-84.

5. Harms J, Beele BA, Bohm H, Jeszenszky D, Stoltze D. Lumbosacral fusion with harms instrumentation. In: Margulies JY, al. e, editors. Lumbosacral and Spinopelvic Fixation. Philadelphia: Lippincott-Raven; 1996.

6. Harms J, Jeszenszky D, Stoltze D, Bohm H. True spondylolisthesis reduction and monosegmental fusion in spondylolisthesis. In: Bridwell KH, DeWald RL, editors. The Textbook of Spinal Surgery. 2 ed. Philadelphia: Lippincott-Raven; 1997. p. 1337-47.

7. Jenis LG, An HS. Posterior lumbar interbody fusion for spondylolisthesis. Seminars in Spine Surgery 1999;11:56-66.

8. Hee HT, Castro FP, Jr., Majd ME, Holt RT, Myers L. Anterior/posterior lumbar fusion versus transforaminal lumbar interbody fusion: analysis of complications and predictive factors. J Spinal Disord 2001;14:533-40.

9. Humphreys SC, Hodges SD, Patwardhan AG, Eck JC, Murphy RB, Covington LA. Comparison of posterior and transforaminal approaches to lumbar interbody fusion. Spine 2001;26:567-71.

10. Rosenberg WS, Mummaneni PV. Transforaminal lumbar interbody fusion: technique, complications, and early results. Neurosurgery 2001;48:569-74; discussion 74-5.

11. Whitecloud TS, 3rd, Roesch WW, Ricciardi JE. Transforaminal interbody fusion versus anterior-posterior interbody fusion of the lumbar spine: a financial analysis. J Spinal Disord 2001;14:100-3.

12. Brislin B, Vaccaro AR. Advances in posterior lumbar interbody fusion. Orthop Clin North Am 2002;33:367-74.

13. Lowe TG, Coe JD. Resorbable polymer implants in unilateral transforaminal lumbar interbody fusion. J Neurosurg 2002;97:464-7.

14. Lowe TG, Coe JD. Bioresorbable polymer implants in the unilateral transforaminal lumbar interbody fusion procedure. Orthopedics 2002;25:s1179-83; discussion s83.

15. Lowe TG, Tahernia AD, O'Brien MF, Smith DA. Unilateral transforaminal posterior lumbar interbody fusion (TLIF): indications, technique, and 2-year results. J Spinal Disord Tech 2002;15:31-8.

16. Lowe TG, Tahernia AD. Unilateral transforaminal posterior lumbar interbody fusion. Clin Orthop 2002:64-72.

17. Moskowitz A. Transforaminal lumbar interbody fusion. Orthop Clin North Am 2002;33:359-66.

Last Updated: 07/25/2006
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