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

OrthoInfo — Spondylolysis and Spondylolisthesis: orthoinfo.aaos.org

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.