Addressing Chronic Lower Back Pain With Fusion Surgery
Millions of American adults will experience back pain. For over 8%, the issue can be chronic and severe, significantly impacting quality of life. There is often an underlying issue with the spine, particularly the intervertebral discs, that help with stability and shock absorption. A damaged or herniated disc presses on nearby nerves, causing pain, stiffness, sciatica, and muscle weakness. If initial treatment fails and the symptoms worsen, surgery is a recommended option. A doctor will suggest transforaminal lumbar interbody fusion (TLIF), a procedure that produces fantastic results.
Time to TLIF the scales on back pain
TLIF is a procedure that addresses damaged discs in the lumbar region of the spine. The surgeon removes the degenerated or herniated disc causing discomfort or nerve pain. A small cage containing a bone graft is placed in the space and held in place with screws, rods, and a metal plate. Over several months, the vertebrae grow and combine with the cage to form a single piece of bone. TLIF differs from other spinal fusion techniques in terms of approach and placement of the cage. The surgeon uses a posterior approach, accessing the spine from the lower back. The fusion cage is placed diagonally in the disc space to maintain the disc height. TLIF is only one part of a multi-step process to achieve long-term pain relief.
Preparing for TLIF surgery
Doctors and patients do not decide on TLIF surgery in a vacuum. A series of pre-operative assessments, such as X-rays, magnetic resonance imaging (MRI), and physical tests, determine whether this surgery is best. During consultations, the patient will then discuss if surgery will be more effective than all current treatments. The doctor will also discuss minimally invasive surgery (MIS) versus open surgery, as well as the risks and benefits. Once surgery is decided, the patient will prepare for the procedure. For instance, some may quit smoking, reduce weight, or perform exercises to support the lower back. These all lead up to the day of surgery. Doctors also recommend preparing for recovery, including adjustments at home or getting support from family members.
What happens in the operating room?
The patient is prepared for surgery and then introduced into the operating room. The procedure is performed with the patient lying face down so the surgeon can access the spine. Patients are then put to sleep with general anesthesia. The surgeon will make an incision in the lower back, moving muscles and tissue to access the spine. With minimally invasive surgery, a small incision is made to introduce an arthroscope. This device will project the spine to an external monitor. TLIF is then performed by the surgeon, who removes the disc, installs the cage, and supports the spine with metal components. Once the surgery goes well and there are no complications, the patient is moved to recovery.
The recovery timeline
After surgery, the patient may need to spend additional time in the hospital for recovery purposes. If the doctor performed MIS, the patient could leave the hospital the same day. At this point, the recovery timeline begins. A complete recovery can take 6-12 months and is broken into 3 stages. The first 4 weeks require pain management, rest, wound care, and limiting movement. Near the end of this period, the patient begins the second stage, which involves physical therapy. A series of exercises and stretches ensures the fusion is supported. During the 3–6-month stage, most patients can resume daily activities, including work. The last stage of recovery includes more exercise and monitoring for complications. At this time, from months 6-12 or longer, the bones will grow and fuse. The patient should be able to function normally without the symptoms previously caused by the damaged disc.
Your role in the long-term outlook
The success and long-term outlook depend on the type of surgery, patient age, health, and adherence to rehabilitation. The patient must be diligent during this time, following the doctor’s instructions and taking steps to optimize healing. Doctors recommend adopting healthy habits like a clean diet, exercise, sleep, and stress management. There are other strategies that are helpful after recovery. For instance, practicing good posture during sitting, standing, and lifting reduces stress on the fused vertebrae. Avoiding high-impact or extreme sports can protect the integrity of fusion. Doctors recommend continued practice of physical therapy movements daily to promote mobility and reduce pain. When all steps go as planned, statistics show TLIF has a high success rate.
Feel pain-free with TLIF
Chronic lumbar back pain can be distressing, impacting physical, mental, and even financial health. Severe cases often fail to respond to medication and other forms of pain management. Lumbar fusion is an effective treatment option. A doctor will explain all of the benefits and risks before proceeding. Following the expected steps before, during, and after surgery increases the chances of success. If pain, instability, weakness, and other symptoms cause distress, do not hesitate to try TLIF.
