TLIF back surgery indications and technique TLIF back surgery indications Lumbar spine fusion may be recommended for disabling low back and leg symptoms that have not improved with non-surgical forms of treatment. Conditions such as spondylolisthesis, degenerative disc disease or recurrent disc herniations are known to produce mechanical pain and may be indications for a spinal fusion. TLIF is designed to eliminate the disc as the source of mechanical back pain. TLIF back surgery technique TLIF procedure is performed through a posterior incision exposing the back of the spine. Pedicle screws are placed into the vertebra. Exposure of the disc space is done on one side by removing the facet joints and protecting the nerve roots. The disc space is entered and disc material is removed. Bone graft is obtained from the patient’s iliac crest (the hip). A spacer or interbody cage that is filled with bone graft is placed into the disc space to maintain the disc height. Additional bone is placed in the lateral (side) gutters of the vertebra and the disc space. Pedicle screws are attached to rods or plates. The wound is closed. Post-operative care after TLIF back surgery After TLIF spinal fusion surgery, patients are admitted to the hospital for an average of three to five days. Blood transfusion may be required. Physical therapy is begun the day after surgery, and patients are gradually mobilized. A spinal brace may be used. Patients are discharged to be at limited activity on oral pain medicine and will follow up with the surgeon in several weeks. Patients can generally return to office work in four to six weeks, or longer if the patient’s occupation is heavier.