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  • biofreeze
    Participant
    April 16, 2014 at 9:07 am
    Post count: 99
    in reply to: MIS TLIF #10744

    Thank you for the detailed response. Much appreciated!

    1.) You did not explain how you insert the cage. Do you insert cage from the side or or do you retract spinal cord to the side like in a PLIF and slide cage in ?

    2.) If there is no spinal cord under L1 and my surgery is at L5,S1 then retracting the spinal cord side to side is not dangerous, is it ??

    THANK YOU AGAIN FOR ALL OF YOUR HELP!!

    biofreeze
    Participant
    April 14, 2014 at 11:33 pm
    Post count: 99
    in reply to: MIS TLIF #10737

    Thank you,

    The intricate details of the surgery are important to me, I apologize if some of my questions are redundant.

    1.) you are making an incision directly in the middle of the back, in the same place the incision is made for a PLIF ?

    Most surgeons describe TLIF as an incision off to one side and then tunneling to the disc space through one side of the facet, leaving the other facet in tact.

    2.) will you decompress the nerves by directly unroofing the lamina bone/pars like described in the PLIF through the direct incision in the middle ?

    3.) If so, you are then taking this bone, putting it in the cage and then also packing the disc space with BNP along with the later gutters?

    It sounds as though the difference between TLIF and PLIF as you describe it is that you are inserting one large cage through the side facet instead of moving the spinal cord side to side to insert two smaller cages, which could thereby aggravate the nerve root ?

    4.) Who is the manufacturer of the cage or instrumentation that you like to use ? Are you able to endorse ?

    Thank you kindly.

    biofreeze
    Participant
    April 14, 2014 at 2:21 pm
    Post count: 99
    in reply to: MIS TLIF #10732

    Thank you.

    I agree about the nerve root retraction. It concerns me.

    Inserting one large cage with TLIF sounds easier than two smaller cages with with PLIF. My neuro did say, however, that with the PLIF if one cage doesn’t fuse that the second cage is a good back up??

    1.) Is PLIF with the two cages a newer type of procedure ?

    2.) Do you perform a TLIF through one incision off to the side through a tube to dilate muscle or through two incisions on either side with retractor tubes ?

    3.) Do you insert BNP laterally as well as into the disc space to supplement cage ?

    4.) Can BNP cause inflammation/pain at a later date ?

    Sorry for all the questions!!! Thank you so much!

    biofreeze
    Participant
    April 14, 2014 at 1:14 pm
    Post count: 99
    in reply to: MIS TLIF #10727

    Thank you Dr. Corenman:

    1.) If TLIF only has one cage would that provide a strong enough fusion for a guy my size 6,1 – 225 going through the foramina.

    2.) Sounds like PLIF would provide better access to removing pars defect with 2 cages and still provide a stronger fusion. Is this accurate ?

    3.) It appears that PLIf is more invasive with greater risk of blood loss than a TLIF with the incisions on both sides ??

    Thank you !!

    biofreeze
    Participant
    April 11, 2014 at 2:31 pm
    Post count: 99
    in reply to: Back pain post tlif #10706

    Sorry! Hope my question didn’t sound rude.

    Sounds like you must have fused if your Dr. lifted activity restriction after first 3 months.

    I wish you the best of luck!!!

    biofreeze
    Participant
    April 10, 2014 at 2:16 pm
    Post count: 99
    in reply to: Back pain post tlif #10703

    why would you go to the gym and do squats so soon after a fusion procedure?

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