A surgeon may use bone from the patient's hip or from a bone bank to stabilize two vertebrae after a discectomy. During a fusion surgery, the disc is removed, and the surgeon inserts a small wedge of bone in between the two vertebrae to restore the disc space. Over time, the two vertebrae "fuse" together into a solid structure. While this limits movement and flexibility, it can also help to ease pain.
The decision to fuse or not to fuse can be a complex one. It will probably be based on the surgeon's assessment of two factors: the amount of instability that a discectomy will cause and how much disc space is necessary to restore. If the surgeon opts not to do a fusion, a different follow-up surgery may be recommended.
Transforaminal Lumbar Interbody Fusion (TLIF) is typically used to remove a degenerative disc and relieve pressure on nerve roots in the lumbar spine.
Using the minimally invasive procedure involves a small incision in the back. Using a C-arm for X-ray imaging, the surgeon locates the vertebral level with the herniated disc.
Making the smallest incision possible, the surgeon uses a combination of dilators and tubular retractors to access the vertebra and remove the degenerative disc. An implant with bone graft is placed in the empty space, this realigns the vertebral bones and relieves pressure on the nerve roots.
Some advanced spine surgeons perform the TLIF procedure through a minimally invasive approach. Advantages of the minimally invasive TLIF procedure over traditional spine surgery include a smaller incision, less disruption to muscle tissue, less time in the hospital and less pain in recovery.