Neurosurgeon
Neurosurgeon
Treatment / Procedures / TLIF
The workhorse lumbar fusion. Combines posterior decompression with cage placement through a single approach, addressing both nerve compression and instability. Niceville, Florida.
TLIF fuses the lumbar spine by placing an interbody cage through the foramen while securing pedicle screws from behind, all through a single posterior incision.
Transforaminal lumbar interbody fusion, or TLIF, is one of the most common lumbar fusion procedures. It achieves a full fusion of both the front disc space and the back of the spine through a single posterior incision, which makes it more efficient than approaches that require separate front and back surgeries.
During TLIF, pedicle screws are placed on both sides at the levels to be fused. On one side, the facet joint and part of the lamina are removed to reach the disc space through the foramen. The disc is removed, the endplates are prepared, and a large cage packed with bone graft is placed. This front-column support combined with the screws creates a very stable construct with strong fusion rates.
TLIF is used for degenerative disc disease with instability, spondylolisthesis, recurrent disc herniation, adjacent segment disease, and deformity needing fusion. Dr. Enguidanos performs both open and minimally invasive TLIF at HCA Florida Twin Cities Hospital in Niceville, Florida.
TLIF is recommended only after appropriate non-surgical care has not resolved the problem, or when there is instability or progressive weakness. Physical therapy, medication, activity changes, and injections are evaluated first.
Many patients improve without surgery. When instability or persistent nerve compression remains despite conservative care, TLIF becomes the appropriate next step.
The patient is positioned face down. For minimally invasive TLIF, tubular retractors limit the exposure to the affected level. Pedicle screws are placed on both sides under imaging guidance. On one side, the facet and part of the lamina are removed to reach the disc through the foramen, protecting the nearby nerve roots.
The disc is removed through this corridor and the endplates are prepared. A large cage packed with bone graft is placed to restore height and the natural curve. Rods connect the screws on each side and are tightened, and bone graft is applied. Minimally invasive cases may go home the same day or the next morning.
TLIF is one of several ways to fuse the lumbar spine. The right approach depends on the level, your anatomy, and the goals of surgery.
Reaches the disc from the front of the abdomen, allowing a larger cage and the best height restoration, especially at L5-S1.
Reaches the disc from the side through the flank with minimal disruption to the back muscles, useful for multilevel disease.
Relieves stenosis without fusion when the spine is stable and the main problem is nerve crowding.
Every patient who walks through our door follows the same path. It starts with listening and ends only at surgery if nothing else works.
Dr. Enguidanos meets with you personally. He reviews your imaging, takes your full history, and listens carefully to your lifestyle, your goals, and what has and has not worked so far.
In-person with Dr. EnguidanosSurgery is never the first answer. Before any procedure is considered, every appropriate non-surgical option is explored — physical therapy, medication management, injections, and regenerative medicine.
Physical therapy, injections, regenerative medicineWhen conservative care has been exhausted and surgery is the right answer, Dr. Enguidanos applies thirty years of surgical depth. From minimally invasive procedures to complex deformity reconstruction, every level is handled.
Only when everything else has been consideredDR. STEPHEN T. ENGUIDANOS MD | SPINE SURGERY | NICEVILLE, FL
Your information is private and will never be shared.
DR. STEPHEN T. ENGUIDANOS MD | SPINE SURGERY | NICEVILLE, FL
Your information is private and will never be shared.