About the Procedure

Lumbar Laminectomy and Transforaminal Lumbar Interbody Fusion (TLIF)

A lumbar laminectomy, or lumbar decompression, is performed to treat spinal stenosis, a narrowing of the spinal canal that puts pressure on the nerves in the lower back, which causes symptoms in nearly 500,000 Americans over the age of 50. Used to manage related conditions involving deformities of the vertebrae, such as spondylolisthesis or scoliosis, a transforaminal lumbar interbody fusion (TLIF) is an innovative, sometimes safer, more efficient alternative to other anterior and posterior-approach fusion procedures. Both conditions cause pain and weakness in the lower back and legs, leading to walking difficulty in many patients. The conditions occur as people age because ligaments around the spine thicken and the discs, or cushions, between the vertebrae start to deteriorate.

During the surgery, an incision will be made in the patient’s back, but surgeons will approach the spine from the side, minimizing the nerve manipulation required to access the vertebrae, discs and nerves. They will remove bone and ligament from the spine to open the spinal canal and relieve pressure on the nerve roots which has been caused by stenosis.

Next, the surgeons will perform a TLIF to fuse the spine where one vertebra has slipped forward onto the vertebra below it. (This generally occurs with spondylolisthesis, but in the case of the webcast patient it has been caused by complications from scoliosis.) Some vertebral bone will be removed to reduce nerve exposure, and then the pain-causing disc will be taken out. A spacer and bone from the patient’s extracted vertebra will then be manipulated to fuse the two surrounding vertebrae together. Finally, rods and screws will be put in place to support the spine over the next several months as bone generates and connects to the vertebra.

Most patients are out of bed and walking the morning after surgery, and typically spend three to five days in the hospital. After discharge, they require three to six months of outpatient rehabilitation, but are able to care for themselves at home with the exception of heavy lifting. Generally after six months, patients are able to do any type of activity excluding those that pose high physical risk.

Thomas Jefferson University Hospital has major programs for heart disease, cancer treatment, neuroscience, high-risk childbirth, genetics, radiology, orthopedics, digestive diseases and many other areas of medicine and surgery. It is one of only a few hospitals in the United States that is both a Level I Trauma Center and a federally designated regional spinal cord injury center. Jefferson’s Kimmel Cancer Center is designated as a clinical cancer center by the National Cancer Institute.

For more information or to make an appointment, please call 1-800-JEFF-NOW