Specialties
Minimally-Invasive TLIF (Transforaminal Lumbar Interbody Fusion)
Our Goal for You:
- Identify the cause of your pain.
- Minimize your down time with non-surgical or minimally invasive procedures if possible.
- Get back to living the life you want.
Overview
This minimally invasive procedure is used to remove a degenerated disc to relieve the compression of nerve roots in the lumbar spine. It is performed through a small incision on the back.
Preparation
After anesthesia has been administered and the patient is positioned face down, the surgeon uses a portable x-ray machine to identify the diseased vertebral level or levels. Then, the surgeon makes the smallest possible incision in the skin directly above the target level.
Accessing the Vertebra
A series of dilators of increasing size are carefully passed through muscles and soft tissue using the guidance of the portable x-ray machine. The surgeon slides a tubular retractor over the dilators and removes the dilators, creating a working channel that leaves muscle tissue intact. This working channel allows the surgeon to access the target vertebra and painful nerve root in a way that minimizes incisional pain and scarring of the muscles.
Disc Removed
The surgeon may use a microscope or endoscope to direct surgical instruments through the working channel. First, the surgeon removes bone at the rear of the vertebrae to create an opening. This opening will provide a clear route to the degenerated disc. The surgeon works through this opening to carefully remove the disc. Some of the disc wall is left behind to help contain the bone graft.
Bone Graft Inserted
An implant filled with bone graft is placed in the empty disc space. This lifts the vertebrae to the proper height, realigning the vertebral bones and relieving painful pressure from pinched nerve roots.
Additional Support
The surgeon will also place fusion instrumentation for additional support, most commonly screws and rods. In some cases, these may be implanted on both sides of the spine. Bone graft may also be placed along the hardware. Over time, the bone graft will grow through and around the implants, forming a bone bridge that connects the vertebral bodies above and below. This solid bone bridge is called a fusion.
End of Procedure
The instruments are removed, and the incision is closed and bandaged. Most patients are discharged from the hospital the following day and can return to their usual activity level within a few weeks of surgery. The patient may take pain medication to relieve incisional pain, but usually this is needed for less than one to two weeks.
Why Choose Advanced Spine Centers
Board Certified & Fellowship Trained.
Voted 2019’s Best Spine Surgeon.
Internationally Recognized Trainer to Spine Surgeons.
Pioneer in Non-Surgical & Micro-Surgical Procedures.
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Common Patient Questions
ExcellentBased on 147 reviewsRobert AliceaThe doctor and his staff were very welcoming and kind ..explained my issues in detail . Will highly recommendGerman CisnerosEvery visit to Dr. Courtney's office is educational and most beneficial. Dr. Courtney and ALL of his staff are the best!Jamey DerryberryMy wife and I both go to Dr Courtney for back issues. Great care. Great staff. Great surgical facility and smooth process. LOVE THEM!!!Mark CotterDr Courtney and his staff truly care about my well being. They are the only ones I have found that have been able to help me with my workman's comp claimJ “JAFO”Does your back hurt? Has your back been hurting, yet no other surgeon can or won't help you; or worse tells you nothing is wrong? You're in the wrong place! I had 4 back operations with no improvement. I had an additional 6 other consultations with "there's nothing wrong with you". The truth was I was probably 2-3 months away from permanent leg and lower back paralysis. He fixed me. I can stand, I can walk. I threw away my crutches of 13 years. If you need back correction - GO SEE THIS DOCTOR! He will fix you, and fix you correctly, if it is humanly possible. Enough said! Go see him. He tells the truth and tells it like it is. 🙂Terri StewmanDr courtney and his staff are great! Dr courtney always takes his time with you and I feel he truly cares about his patients.Ross WigingtonGreat Dr and helped me multiple times over the years Would recommend to anyone that needs helpBridgette e MentesanaDr. Courtney is knowledgeable and takes the time to really explain what’s going on and explain why you’re in pain and the several options to correct the issue. I never felt rushed and he was on time to our appointment which is such a rare thing. The rest of the office staff was absolutely top notch. They were really down to earth and so nice, you could tell they liked their jobs and were treated well. It was a very welcoming atmosphere. I felt very comfortable and I knew I was in capable hands just by the way he treated his staff and listened to his patients. Highly recommend.Marie BentonDr Courtney did my neck surgery and my 360 back surgery. I would not go to another surgeon, he cares about his patients and it shows! His staff is great as well! I trust his opinion and skills 100%