Q. My neurosurgeon recommends a TLIF. Kindly review my report and say if it is necessary.

Answered by
Dr. Hitesh Kumar
and medically reviewed by Dr. Chithranjali Ravichandran
This is a premium question & answer published on May 01, 2021

Hi doctor,

My neurosurgeon recommends a TLIF, looking for more information and seeing if this is really needed.



Welcome to

I would like to know the description and history of your symptoms in detail.

Please sequentially tell your symptoms.

Do you have any other co-morbidity or medical history along with this?

Are you currently on any medications? If yes, please mention the name with dosage and timings in a day. And also, mention how much effect you feel on those medications.

As per your mentioned MRI (magnetic resonance imaging) report (attachments removed to protect the patient's identity), it seems you already underwent spinal surgery before.

And now your neurosurgeon is recommending TLIF, for which current query you have raised.

As a general approach, surgical treatment for spine problem is indicated in a few situations:

- If the patient is developing any neurological deficit like weakness or loss of power in any leg muscle, bladder, or bowel incontinence, persistent impairment of sensation in any leg part.

- If severe pain (causing disability in routine daily activity) is not improving after optimum medical management and physiotherapy and spinal precautions.

- Large and big disc protrusion with evident significant compression on the spinal cord.

Medical management is usually still required after surgical treatment.

Treatment plan:

It is not possible to decide about surgical treatment just by reading the MRI report.
For taking that decision, it will need to know
- Details clinical history and clinical examination and neurological assessment.
- Need to look effect of medical management.
- Need to look MRI images physically.
If you keen for medical management optimization, I suggest you to please give detailed history and send neurologist assessment sheet along with also upload MRI images from CD via icliniq DICOM viewer for better understanding.
For surgical treatment decision, it will be better to meet neurologist and neurosurgeon physically only.

Regarding follow up:

Revert with above mentioned information for better understanding and further judgement.

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