Transforaminal Lumbar Interbody Fusion
The NuVasive MAS (Maximum Access Surgery) TLIF is a minimally invasive back surgery procedure. It is a San Antonio minimally disruptive, pedicle-based surgery accessing only one side of the back using a novel access retractor called MaXcess.
What is Transforaminal Lumbar Interbody Fusion (TLIF)?
In a TLIF, rather than starting from the center and stripping the back muscles outward, the surgical approach starts at an angle to the spine and bluntly separates (rather than cuts) back muscles on just one side. This procedure should reduce the approach-related muscle pain often seen in traditional back surgeries by minimizing the amount of muscle and tissue disruption.
The surgery offers the same advantages as traditional posterior interbody fusion, but with the added benefit of less tissue disruption and therefore less postoperative pain and quicker recovery.
MAS TLIF Surgical Procedure
The surgery is performed with the patient in the prone position. X-ray floroscopy demonstrate the disc space and pedicles. K-wires are placed in the adjacent pedicles, and pedicle screws with MaXcess® retractor blades are placed over the wires using the NeuroVision® System which assists with pedicle screw and implant placement by monitoring nerve activity throughout the surgical procedure. The MaXcess® retractor blades are attached to the pedicle screws then the MaXcess® retractor is applied to the blades and surgery is ready to begin. The MaXcess® retractor from NuVasive offers improved visualization, and increased angulation during positioning of instruments and implants. With the disc space visible and accessible, San Antonio spine surgeon Dr. Guy Fogel then removes the disc material and prepares the disc space for fusion.
With the disc space prepared, spine and back surgeon Guy Fogel, M.D. of San Antonio then places an intervertebral implant and bone graft materials into the empty space to restore the proper disc height and support the loads put on that spinal segment and create an interbody fusion. Once the intervertebral implant is in position, the retractor blades are exchanged for pedicle screw tops and a rod is secured for fixation support of the interbody implant. The retractor is removed and pedicle screws may implanted through a small incision on the opposite side, also using NeuroVision guidance.
The final result will be a combination of an intervertebral disc space where the fusion will occur, and the pedicle screw fixation posteriorly to stabilize the spine. The small skin incisions are closed with a closure beneath the skin.
Because this procedure is less disruptive than conventional posterior surgery, most patients are able to get up and walk around the evening after surgery. Most MAS TLIF patients are discharged from the hospital the next day, but your physician and health care team will determine the best postoperative course for you.
Spine Surgeon, Dr. Guy Fogel of San Antonio, TX is pleased to offer the MAS TLIFprocedure as a reasonable minimally invasive spine surgical option for you. We hope that you are able to enjoy the benefits of this minimally disruptive approach to back and spine pain relief.