Dr. Fred Geisler

Board Certified Neurosurgeon

Tel: 650.631.4515

The TLIF (Transforaminal Lumbar Interbody Fusion) is a method of Minimally Invasive Spinal Fusion in which the affected disc is accessed posteriorly , as opposed to posteriorly (from the back) or anteriorly (from the front).  The surgical approaches used will depend on the location of the spinal condition as well as severity.  TLIF procedures are often used to treat conditions such as Degenerative Disc Disease, Spondylosis and Spondylolisthesis.


This procedure involves the utilization of fluoroscopic visualization and guidance to ensure the precise location of instruments as well as enhanced visualization of the surgical area.


How It Is Performed

First, an incision of a few centimeters is made, using a posterior approach (from behind), to the affected spinal level.  Once the incision is made, small endoscopes or microscopes are placed between muscle fibers to allow for increased visualization of the area.  Next, the intervertebral disc is removed to relieve the pressure on the spinal nerve.


Second, in the empty space where the disc was removed, a bone graft is implanted to allow for fusion.  This bone graft will fuse with the bones above and below creating one stable bone.   The use of a stabilizing plate and/or small interbody screws may be used to increase stability. This process also restores height to the disc and prevents the nerve from become entrapped again.


Traditionally, Spinal Fusion surgeries required a very long incision and the dissection of muscles, tissue and nerve fibers.  This “traditional” approach made for a very lengthy recovery period as well as visible scarring/ However, using this pioneering Minimally Invasive approach, Dr. Geisler is able to perform this procedure in a “muscle sparing” fashion.  This technique utilizes the usage of a smaller incision, decreased dissection and the use of small instrumentation to achieve spinal fusions.  The recovery profile is significantly expedited and visible scarring is dramatically reduced.


Dr. Fred GeislerBoard Certified Neurosurgeon
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