Lumbar Fusion (TLIF)

What it is and why we do it

A lumbar fusion joins two (or more) vertebrae into one solid bone to stop painful or unstable motion. In a TLIF, I also place a spacer in the disc space from the back to restore height and support the fusion, along with screws and rods. I recommend a fusion when there is genuine instability, a slip (spondylolisthesis), excess movement, or a deformity, not for ordinary wear alone.

What happens during surgery

Through an incision in the low back, I relieve pressure on the nerves, remove the worn disc, and place a spacer with bone graft in the disc space. Screws and rods hold everything steady while the bone graft grows the vertebrae together over the following months into a solid fusion.

Your recovery

A hospital stay of a couple of days is typical. This is a bigger recovery than a decompression alone: the fusion solidifies over several months, sometimes longer. Walking starts early and is encouraged. I may have you use a brace, and not using nicotine during healing meaningfully improves the chance of a solid fusion.

Activity and restrictions

For a period of weeks to months, avoid heavy lifting, repeated bending, and twisting to protect the healing fusion. We progress your activity in stages, and physical therapy later helps rebuild strength. I will give you a specific timeline for work and exercise.

The science: for the curious

A fusion earns its place when instability is the problem: there, stopping the abnormal motion is what relieves pain and protects the nerves. The trade-off is real: a fused level no longer moves and adds stress to its neighbors over the years, which is why I fuse only the levels that truly need it and prefer a decompression alone whenever the spine is stable enough to allow it. Matching the size of the operation to the actual problem is the whole philosophy.

Learn more

OrthoInfo, Adult Spondylolisthesis in the Low Back: orthoinfo.aaos.org (opens in a new tab)

OrthoInfo, Spondylolysis and Spondylolisthesis: orthoinfo.aaos.org (opens in a new tab)

This handout is general education about this procedure and does not replace the specific plan, risks, and consent discussion we have together. Your own situation may differ: if anything here does not match what we talked about, what we talked about wins, so please ask me.