TLIF for lumbar interbody fusion techniques

TLIF (Transforaminal lumbar interbody fusion, FIG. 1) is the mainstream operation in clinical practice.If you are a new spine surgeon, you may not have seen all the fancy LIF, but you must know TLIF.The TLIF technique enters the target disc through the posterior foraminal space and performs intervertebral space treatment, such as disc decompression, intervertebral space preparation, and bone graft fusion.

TLIF technique can be said to be the most clinically practical lumbar interbody fusion technique.

The introduction of TLIF technology must be inseparable from PLIF (posterior lumbar interbody fusion, FIG. 2). PLIF and TLIF are close to each other, and it is difficult to distinguish them completely.The PLIF technique was developed during World War II. It exposes the spinal canal by removing the lamina, spinous process, ligamenta flameum and other structures in the back to relieve nerve compression, and then implants bone in the vertebral space to achieve the purpose of intervertebral fusion.According to ancient literature, Mercer et al. proposed several surgical approaches for lumbar slip surgery in their 1936 literature report, including posterior interspinous fusion with large bone graft and anterior intervertebral space fusion, etc. At that time, the concept of posterior intervertebral fusion was not explicitly proposed.Ten years later, Jaslow first explicitly proposed the method of intervertebral bone graft fusion after discectomy, which is regarded as the first year of the birth of PLIF technology.Popularised by pioneering spinal surgeons such as Cloward, the technique has since become popular around the world.

As a widely used technique in clinical practice,TLIF has become a cornerstone technique for spinal surgery due to its good technical adaptability, safer neuroprotection, satisfactory intervertebral space management and fusion rate.Even in today's endless variety of LIFs, TLIF should continue to shine as one of the basic skills that spinal surgeons need to be skilled and reliable.