Who is a candidate?
MIS TLIF is considered for nerve compression combined with instability, most commonly spondylolisthesis, and sometimes stenosis with demonstrated movement at the level or recurrent disc herniation. The key requirement is evidence that the segment is genuinely unstable, usually on standing flexion and extension X-rays, rather than degeneration on a scan alone.
How the procedure works
Through small incisions on one or both sides, tubular retractors give access to the back of the spine without stripping muscle from the bone. The compressed nerve is decompressed, the disc is removed, and a spacer packed with graft material is placed into the disc space to restore height and support fusion. Screws and rods are placed through the same small openings to hold the segment while the bone heals.
Recovery
Walking begins the day of surgery, and most people go home within a day or two. Discomfort at the incision sites settles over a couple of weeks. Bending, lifting, and twisting are restricted while the fusion consolidates, with restrictions relaxed in stages. Physical therapy usually starts after the early healing phase, and full bone healing takes several months.
Benefits and alternatives
Compared with an open fusion, the muscle-sparing corridor is intended to reduce blood loss, post-operative pain, and hospital stay while achieving the same decompression and stabilization. Alternatives include non-operative care, injections, decompression alone where the segment is stable, and other fusion approaches (anterior, lateral, or prone lateral), depending on anatomy and alignment.
Risks
Risks include infection, bleeding, nerve injury, a tear in the lining around the nerves, hardware problems, and failure of the bone to fuse, which can require further surgery. Adjacent levels may degenerate over time under the altered mechanics. Dr. Adapa reviews these against your own anatomy and health before any decision.