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  • aborb22
    Post count: 1

    Dear Dr Coremman

    I am a 51 year old active male who has been experiencing lower back pain for years and getting worse. I have been diagnosed with advanced degeneration for of the L5 S1 disc.I am currently treated with pain management injections to aleviate the pain.
    I am familiar with the TLIF surgery since this is the procedure that has been recommended as a best option for me , by the local physician spinal surgery who I recently visited.
    I rececntly watched your video of this operation and it appears that the insertion of a “cage” in the space where the disc was removed , was not used and that only the screws are used to create the fusion. Is this correct and what is the difference between using and not inserting a “cage” .

    Thank you

    Alex B

    Donald Corenman, MD, DC
    Post count: 8459

    The TLIF procedire can be used with or without a cage depending upon the situation. In 99% of cases, I use a cage. This acts just like a “spacer” to bring the disc space height up to “normal”. This increases the height of the foramen (the nerve exit zone) and returns the correct angulation of the vertebral segments (restores the lordosis).

    The cage occasionally cannot be placed if the disc is so degenerative and surrounded by osteophytes that prevent the distraction of the disc space but that condition is rare.

    Dr. Corenman

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