Our Summary

This research examines the impact of a specific type of back surgery, transforaminal lumbar interbody fusion (TLIF), on the curve of the lower spine (lumbar lordosis or LL). The study used a digital model based on CT scan images from a healthy 30-year-old man.

The researchers experimented with different degrees of spinal curvature after the simulated surgery. They applied a certain amount of force and movement to the model to mimic normal activities like bending and twisting.

The results showed that the movement range and the pressure inside the spinal discs increased after the simulated surgery. This increase was even more pronounced when the spinal curve was reduced.

These findings suggest that a decrease in the curve of the spine could lead to extra stress on the surrounding spinal segments. This could in turn increase the risk of damage to these areas. Therefore, the potential for this kind of damage should be taken into account when planning this type of spinal fusion surgery.

FAQs

  1. What is transforaminal lumbar interbody fusion (TLIF) and how does it affect the curvature of the spine?
  2. What were the main findings of the research on the impact of TLIF on spinal curvature?
  3. How might the decrease in spinal curve after TLIF surgery increase the risk of damage to surrounding spinal segments?

Doctor’s Tip

A doctor may advise a patient undergoing lumbar fusion surgery to be mindful of their posture and movements post-surgery to prevent additional stress on the spine. They may recommend maintaining a healthy weight, practicing good body mechanics, and engaging in regular exercise to support the spine and reduce the risk of complications. It is important for the patient to follow their doctor’s post-operative instructions and attend all follow-up appointments to ensure proper healing and recovery.

Suitable For

Patients who are typically recommended lumbar fusion are those who have severe low back pain and/or leg pain due to conditions such as degenerative disc disease, spondylolisthesis, spinal stenosis, or spinal fractures. These patients may have tried non-surgical treatments such as physical therapy, medications, and injections without success. Lumbar fusion may be recommended when conservative treatments have failed to provide relief and the patient’s pain and functional limitations are significantly impacting their quality of life.

Timeline

Before lumbar fusion:

  • Patient experiences chronic lower back pain, leg pain, numbness, and weakness due to conditions such as degenerative disc disease, spinal stenosis, or spondylolisthesis.
  • Patient undergoes diagnostic tests such as X-rays, MRI, and CT scans to determine the extent of the spinal damage.
  • Patient receives conservative treatments such as physical therapy, medications, and injections to manage symptoms.
  • If conservative treatments are ineffective, patient and surgeon decide to proceed with lumbar fusion surgery.

After lumbar fusion:

  • Patient undergoes pre-operative preparation including medical evaluations and clearance.
  • Patient undergoes the lumbar fusion surgery, which involves removing damaged disc tissue, inserting bone graft material, and stabilizing the spine with hardware such as screws and rods.
  • Patient stays in the hospital for a few days post-surgery for monitoring and pain management.
  • Patient begins physical therapy and rehabilitation to regain strength and mobility in the spine.
  • Patient follows a recovery plan that includes restrictions on activities, follow-up appointments with the surgeon, and gradual return to normal activities.
  • Over time, patient experiences reduced pain and improved function as the spine heals and fuses together.

What to Ask Your Doctor

  1. Can you explain the potential risks and complications associated with lumbar fusion surgery, specifically TLIF?
  2. How will the surgery impact the natural curvature of my lower spine (lumbar lordosis)?
  3. What are the expected outcomes and recovery timeline following TLIF surgery?
  4. Will I need physical therapy or rehabilitation after the surgery?
  5. How will the surgery affect my ability to perform daily activities and participate in physical exercise?
  6. Are there alternative treatment options to consider before proceeding with lumbar fusion surgery?
  7. What is your experience and success rate with performing TLIF surgery?
  8. How long will I need to take off work or restrict my activities after the surgery?
  9. Will I need to undergo any additional imaging or tests before the surgery?
  10. What steps can I take to optimize my recovery and ensure the best possible outcome from the surgery?

Reference

Authors: Zhao X, Du L, Xie Y, Zhao J. Journal: World Neurosurg. 2018 Jun;114:e114-e120. doi: 10.1016/j.wneu.2018.02.073. Epub 2018 Feb 21. PMID: 29477002