What is MIS TLIF?

In cases of spinal instability, a spinal fusion of one or more vertebral levels may be the best way to relieve symptoms and prevent further damage.


For many patients, a minimally invasive procedure may be an option. The most common minimally invasive fusion method is an MIS TLIF, or Minimally Invasive (Surgery) Transforaminal Interbody Fusion


Using x-ray, the level to be fused is identified, and a small incision is made on one side of the spine, about 1 to 2 inches in length. This is often done through a small "endoscopic tube" or specialized retractor to move the spinal muscles aside and avoid cutting through them. A small amount of bone is removed, so that a "cage" may be inserted between the vertebrae. This also clears up room for the nerve root that may also be causing problems. 

Special neuromonitoring wires are used to ensure that the nerves are avoided during the operation.

The recovery involves immobilization in a back brace for typically 6 weeks, followed by physical therapy. Patients are asked not to bend or twist at the back, and to avoid lifting over 10 pounds - no "BLT." Light duty working is allowed after 1 to 2 weeks, after pain medicine is no longer needed.

This surgery involves less blood loss and less muscle dissection than an traditional "open" surgery. Most patients can be discharged home the same day or the next day. Whenever possible, Dr. Bjerke offers his patients this option to allow for a faster recovery.

Right: xrays after an L4/L5 MIS TLIF procedure performed by Dr. Bjerke. Screws are see in the L4 and L5 vertebrae, and markers can be see in the "interbody cage" between the vertebral bodies.