Transforaminal Lumbar Interbody Fusion (TLIF)

Name: TLIF Surgery - Transforaminal Lumbar Interbody Fusion
Creator: Edward M. DelSole, MD

TLIF is one of the most versatile and commonly performed lumbar fusion procedures. It allows decompression of the nerves and placement of an interbody cage through a single posterior approach. Dr. DelSole performs TLIF using both minimally invasive (MIS) and midline cortical bone trajectory techniques, selecting the optimal approach based on each patient's anatomy and pathology.

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Is TLIF Right for You?

TLIF may be recommended if you have:

Lumbar spondylolisthesis (degenerative or isthmic) requiring fusion and decompression
Recurrent disc herniation with instability affecting adjacent levels
Lumbar stenosis with instability requiring both decompression and fusion
Failed prior decompression (laminectomy) with progressive symptoms
Degenerative disc disease with mechanical back pain and instability

What to Expect

Procedure Time

2–3 hours depending on the number of levels treated and surgical approach

Hospital Stay

1–2 nights observation with possible same-day discharge for select cases

MIS Approach Advantages

Smaller incision, less muscle damage, and faster recovery compared to open fusion

Cortical Trajectory Benefit

May provide stronger fixation in patients with compromised bone quality or osteoporosis

TLIF Surgical Approaches

Minimally Invasive TLIF

Performed through small tubular retractors, MIS TLIF minimizes muscle dissection and blood loss. Percutaneous pedicle screws are placed through separate small incisions. This approach is ideal for single-level disease and results in less postoperative pain and faster return to activity.

Midline Cortical Bone Trajectory TLIF

This technique uses a midline incision with cortical bone trajectory screws that engage the denser cortical bone of the pedicle. It provides strong fixation particularly in patients with osteoporosis and allows direct decompression through the same incision.

Dr. DelSole carefully evaluates each patient's anatomy, bone quality, and disease pattern to determine which approach—minimally invasive or cortical trajectory—will provide the best outcomes and fastest recovery.

Why Dr. DelSole

Edward M. DelSole, MD

Dr. DelSole is a fellowship-trained orthopaedic spine surgeon with extensive experience in both minimally invasive and open lumbar fusion procedures. He brings a commitment to patient-centered care and evidence-based surgical decision-making.

Fellowship-trained at Rothman Orthopaedic Institute (one of the nation's top spine programs)
Board-certified, American Board of Orthopaedic Surgery
Chief Resident, NYU Langone Orthopaedic Surgery
Active member, Lumbar Spine Research Society and North American Spine Society
Published researcher with 30+ peer-reviewed publications

Ready to discuss the best fusion approach for your condition?

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Keystone Spine & Pain Management

2607 Keiser Blvd, Suite 200

Wyomissing, PA 19610