How to choose your fusion type: ALIF vs. PLIF vs. TLIF vs. MIS

**Katie** · 01-19-2011, 10:42 PM

I've had both the XLIF and PLIF last March in Brazil with a wonderful surgeon, one who has worked on the original development of the XLIF. Both levels were successful and I would chose both in a heartbeat if I had to do it all again.

Can you tell me who is doing the DLIF in Canada? It wasn't around eight months ago, from the extensive research that I did. Just my opinion, but I wouldn't be comfortable having a surgeon doing that on me with minimal experience. The method of going through the psoas muscle is very delicate, not that the other parts of spine surgery isn't....

**Cindylou** · 01-20-2011, 01:15 PM

Originally Posted by Katie

I've had both the XLIF and PLIF last March in Brazil with a wonderful surgeon, one who has worked on the original development of the XLIF. Both levels were successful and I would chose both in a heartbeat if I had to do it all again.

Can you tell me who is doing the DLIF in Canada? It wasn't around eight months ago, from the extensive research that I did. Just my opinion, but I wouldn't be comfortable having a surgeon doing that on me with minimal experience. The method of going through the psoas muscle is very delicate, not that the other parts of spine surgery isn't....

Katie, NancyC is having the DLIF. Scott has decided on the MIS TLIF. Wasn't sure if you caught that or not. Scott, I'm happy for you that you made your final decision. I think you should find that to be a huge weight off your shoulders, just getting the decision made. That was true for me anyway. Do you have a surgery date yet? The MIS TLIF must certainly be a newer approach, as I have never heard of it....and you know how we spiney's tend to keep up with this kind of stuff. haha Does your surgeon have a lot of experience with this approach? I think, more than almost anything, that is what is critical in approaching any type of surgery, is your confidence in your surgeon. And you sound like you have that confidence in yours, so that is fantastic. Good luck and let us know as you get closer to your surgery date, ok? My best to you, Cindylou

**Scott** · 01-20-2011, 06:31 PM

Originally Posted by Cindylou

The MIS TLIF must certainly be a newer approach, as I have never heard of it....and you know how we spiney's tend to keep up with this kind of stuff.

Sorry that I was not more clear about my procedure. MIS is Minimally Invasive Surgery. TLIF is Transforaminal Lumbar Interbody Fusion.

A normal TLIF is an updated version of the PLIF. They both go in from the back, but the bone graft is inserted from the side. When done using MIS techniques, the surgeon inserts a needle into the spine and then puts increasingly larger spacers over it to stretch the back muscles and create a 1" hole where they do the surgery with endoscopes. This gives all of the benefits of going in from the back with no muscle cutting.

I originally did not want a back approach because of muscle damage. The ALIF sounded like a better alternative. But I also became worried about all of the important "stuff" in the front that has to be moved to get access to the spine. So the MIS TLIF seemed to be a win-win for me.

Scott

**Cindylou** · 01-21-2011, 01:32 PM

Good for you Scott.

All systems go, sounds like, and I believe I read on a different post of yours that surgery is scheduled for right around the corner, January 28th. Good luck! We'll be here for you as you land on the other side as well, and can hopefully help normalize the experience for you. Best of everything, Cindylou