How Long Does Pain Last After TLIF (And Why)?

Exact Answer: 4-6 weeks

Transforaminal lumbar Interbody fusion or commonly called TLIF is spinal fusion surgery. It’s a surgery done on the lower back to join two or more vertebrae.

It is done to stabilize the vertebra to prevent dangerous movements of bones. The deteriorating of discs between the vertebra results in back pain which makes the spine unstable.

TLIF creates a strong bone between the vertebra which prevents dangerous movement between them. TLIF is also performed for other conditions like spinal stenosis, spondylolisthesis, spondylosis, spinal fractures, scoliosis, etc.

There are different types of spinal fusion. All spinal fusion is done bone grafting which is either taken from the patient itself or a donor or artificial bone substitutes.

How Long Does the Pain Last After TLIF?

The extreme pain due to the surgery lasts around a few weeks and the pain gradually decreases over time but some people face slight pain even for few months after the surgery. Since it is a complex surgery, it will take time for the pain to go completely.

The first three months after surgery is the crucial time where proper care should be given as the lumbar fusion mass is getting established. During this period heavy weightlifting exercises, bending forward and backward, twisting the upper body should all be avoided. This should be done for optimal recovery conditions to be satisfied.

The number of days spent in the hospital depends on the severity of the surgery 3-4 days. If it’s minor surgery like cervical spinal fusion the patient can go home the same day itself. Recovery is a crucial period when it comes to spinal fusion. This period should not be taken lightly. It takes time and proper training to get back to normal activities.

Proper training and restriction on certain activities are the two main aspects of recovering. It may be difficult to sit properly like before for almost one and a half months.

Once the patient finds it completely comfortable to sit, he/she can try driving which can start from 3-6 weeks after surgery. Lifting weights is not recommended for almost 3 months after the surgery. Sedentary works (works involving lifting more than 10 pounds at once) can be started from 3-6 weeks. Manual works can be started between 8-12 weeks.

Why Does the Pain last Long After TLIF?

TLIF is a crucial and high-risk surgery. There are a lot of steps in the surgery that should be carefully done otherwise it can lead to failed surgery. In some cases, the period of pain after surgery determines the recovery of the patient. Patients feeling a lot better within few days is a rare case.

TLIF is not a simple surgery. In this, the surgeons remove the disc, and the space between the vertebrae is filled with bone. The disc is removed by pulling the nerves apart and the bones which are at the back of the spine are removed. After removing the bone, the inside of the disc is scraped out and then the wall of the disc is removed. The posterior part of the disc is the difficult part to remove as it has the most nerve endings and should be very careful. After the removal of the disc, a small metal cage is squeezed and inserted between the vertebrae which once placed it releases and the cage pop opens.

The space from where the disc was removed is filled with some bone which is taken from the patient’s pelvis or a cadaver. The bone is then placed in the space between vertebrae with help of the cage. The bone grows eventually filling up space with living bone. The metal part helps in bone grafting. Then the screws are used to hold everything in place.

Another reason for the pain to last is the nerve. To remove the disc, the nerves are pulled aside which may later cause nerve pain. as the surgery involves moving nerves and removing the disc it takes time to heal as a result the pain may last for few months. But the important thing is the pain is different for everyone. the healing time is different for everyone. If the pain is getting worse, consulting a surgeon is a must.

Conclusion

Recovery of TLIF is completely variable, it differs from person to person, it differs from the type of surgery done. The time needed to get back to normal activities differs from person to person. The pain or any discomfort will decrease each day. TLIF is a high-risk surgery especially for older people considering their other medication, lifestyle, etc.

The result of TLIF is not as good for people who smoke or very overweight, so it is important to quit smoking and lose as much weight as possible before the surgery. Before having a TLIF all the risk factors should be considered, and also other treatments should be considered. Thus, TLIF should only be performed as the last option.

References

1. https://journals.lww.com/jspinaldisorders/Fulltext/2005/02001/Minimally_Invasive_Transforaminal_Lumbar_Interbody.1.aspx
2. https://journals.lww.com/jspinaldisorders/fulltext/2002/02000/unilateral_transforaminal_posterior_lumbar.5.aspx
3. https://link.springer.com/article/10.1007/s00586-008-0739-1