TLIF / PLIF (Lumbar Fusion)

TLIF (transforaminal lumbar interbody fusion) and PLIF (posterior lumbar interbody fusion) are closely related operations. Both decompress the nerves and stabilize the segment in a single procedure: the disc is removed, an interbody cage with bone graft is placed between the vertebrae, and pedicle screws and rods hold the segment while bone fusion completes over months.

TLIF approaches the disc from one side through the neural foramen; PLIF approaches from both sides. The choice depends on anatomy and what we need to accomplish. In practice, TLIF is more common today because it requires less retraction of the nerve roots.

When the problem isn't just stenosis but also instability — a spondylolisthesis that moves on flexion-extension films, a degenerative scoliosis at the affected level, or revision surgery where prior decompression destabilized the segment — fusion is the more durable answer.

Combining decompression and fusion in one operation handles both the nerve compression causing your leg symptoms and the structural problem causing your back pain. It's a bigger operation than decompression alone, but for the right patient it provides a more reliable long-term result.

Surgery typically takes 2.5–4 hours.

Most patients stay 1–2 nights in the hospital.

Walking begins the same day with physical therapy support.

Return to desk work in 4–6 weeks; driving in 2–4 weeks when off narcotics.

Activity restrictions for 3 months while fusion matures.

Bony fusion is typically solid by 6 months; we confirm with imaging.