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Written by Chaunie Brusie; Reviewed by Albert Telfeian, MD, PhD

While general endoscopic spinal surgery—the impressive feat of performing surgery through a tube the size of a pencil—has moved into the mainstream, the procedure of awake transforaminal lumbar interbody fusion (TLIF) has been slower to take hold in the U.S.

However, the awake TLIF surgery is becoming a more popular thanks to numerous benefits that include shorter recovery time and decreased complications for the patient, as well as fewer incisions and active nerve monitoring feedback for the surgical team. SpineUniverse spoke with Albert E. Telfeian, MD, PhD, Professor of Neurosurgery, Warren Alpert School of Medicine at Brown University, Director of Division of Minimally Invasive Endoscopic Spine Surgery to learn more about this innovative procedure and how surgeons can adopt the technique for their own practice. 

History of the Awake TLIF Procedure 

TLIF surgery is often indicated for conditions such as a pinched nerve, sciatica, herniated discs, or bone growth. Until fairly recently, open surgery was the standard—and for a long time, only—option. Endoscopic spinal surgery, minimally invasive and increasingly common, allows the procedure to be performed with smaller incisions and lower risk of complications. Awake endoscopic surgery takes minimally invasive surgery one step further, using only minimal sedation and local anesthetic to keep the patient fully awake. 

Endoscopic spine surgery in general has been evolving over the past 20 years to the point where it’s a very common procedure performed in Asia, but endoscopic fusion has been slower to gain acceptance. However, it is growing...(More)

For more info please read, Awake TLIF Can Be Worth the Investment, by SpineUniverse