I had a special operation to fuse my low back called a TLIF. I was warned about all the possible complications but I never once thought anything bad would happen to me. I ended up with too much bone growth in the area of the fusion and mow my nerve pain is worse than before. What are my chances that this will all go away like a bad dream?

The transforaminal lumbar interbody fusion (TLIF) technique is used to avoid the problems that come with entering the spine from the front (anterior approach. Transforaminal means the surgeon gains access to the spine from the back and side. This allows the surgeon to avoid the major blood vessels present in the front (e.g., aorta, vena cava). The surgeon makes a posterolateral incision from the back and side and removes one of the facet (spinal) joints so the disc can be taken out.

Interbody describes how the fusion is circumferential (all the way around and from front-to-back). Once the disc is removed, the two vertebrae are distracted or pulled apart gently and a special device called an interbody spacer is slid into the disc space. The spacer helps restore normal disc height, which in turn, takes pressure off the spinal nerve roots as they leave the spinal cord and pass through the opening formed by the vertebral bones.

As you know, any time the area around the spinal cord and/or spinal nerves is disrupted, problems can occur. Irritation of the nerve tissue or pressure on the nerve tissue can set up an unrelenting pain response. Irritation or pressure can develop as a result of bleeding into the area, infection, or too much bone growth. The added bone is needed for the fusion but if it extends into the space for the spinal cord or spinal nerves, the same problems with persistent pain can develop.

Further surgery may be needed to remove anything from around the nerves. There's no guarantee that the pain will go away. For some people, it does but for others, the pain signals aren't as easily turned off once they get started. And scientists have yet to identify individual factors that might predict which way a person will respond.