1. < Spine Health
Profile picture for annie1

Concerned about fusion, have osteoporosis: What are TLIF, ALIF, XLIF?

Posted by annie1 @annie1, Oct 14, 2025

I have consulted many surgeons because I have serious concerns about having fusion since I have osteoporosis. I found out there are at least four types of fusion and I would like to understand them better and what would be the best for me. Can someone elucidate on TLIF, ALIF and XLIF ?

Interested in more discussions like this? Go to the Spine Health Support Group.

Profile picture for gilkesl
gilkesl | @gilkesl | Dec 18, 2025
In reply to @annie1 "@kdks99 Actually I live near many major teaching hospitals in New York City and I find..." + (show)
Profile picture for annie1 @annie1

@kdks99
Actually I live near many major teaching hospitals in New York City and I find the opposite is true they seem to not want to do anything very different all of them are saying fusion except one woman who said I should not have fusion she didn't think it would help me but you didn't have anything else to offer for me except physical therapy that has no effect on my symptoms and she told me to try acupuncture which also had no effect did not help I tried it with several different acupuncture. So I am at a loss for where to go that's why I thought maybe in Europe since they do less fusion that I have no clue as to where to go and what country they would speak English. I was in Spain and had a very rude wake up call that hardly anyone wanted to speak English to me and it was very difficult.

Jump to this post

@annie1 Believe the experts. My expert fixes other doctor's replacement disk problems and they are very serious with potential paralysis. During the surgery, he is obligated to do a fusion anyway.

REPLY
1 reply
Profile picture for annie1
annie1 | @annie1 | Dec 18, 2025
In reply to @gilkesl "@annie1 Believe the experts. My expert fixes other doctor's replacement disk problems and they are very..." + (show)
Profile picture for gilkesl @gilkesl

@annie1 Believe the experts. My expert fixes other doctor's replacement disk problems and they are very serious with potential paralysis. During the surgery, he is obligated to do a fusion anyway.

Jump to this post

@gilkesl
Ok so who is your Dr and you are saying that replacement disc is not very safe?

REPLY
Profile picture for annie1
annie1 | @annie1 | Dec 18, 2025
In reply to @htolan "Yes, I had scoliosis fusion at Northwestern and I am considered osteoporosis because I have had..." + (show)
Profile picture for htolan @htolan

Yes, I had scoliosis fusion at Northwestern and I am considered osteoporosis because I have had so many fractures. Following a CAT scan, my doctor said my spine looked good enough to do the surgery. I believe parts of my body are worse than others as far as my bones go.

Jump to this post

@htolan
Can you please resend me the name of the surgeon? I think you have to send it privately to me on the Mayo connect. Thank you so much

REPLY
1 reply
Profile picture for htolan
htolan | @htolan | Dec 19, 2025
In reply to @annie1 "@htolan Can you please resend me the name of the surgeon? I think you have to..." + (show)
Profile picture for annie1 @annie1

@htolan
Can you please resend me the name of the surgeon? I think you have to send it privately to me on the Mayo connect. Thank you so much

Jump to this post

@annie1 how do I send it privately?

REPLY
Profile picture for annie1
annie1 | @annie1 | Dec 19, 2025

Actually I found the old post and you sent me his name. Tyler is the first name. So you have osteoporosis or had it at the time of your fusion? And everything worked out okay? In terms of sending things privately I figured it out a while ago but right now I'm just getting up I'll try to coach you through it another time. Thanks

REPLY
Profile picture for millironk
millironk | @millironk | Dec 20, 2025
In reply to @annie1 "Has anyone had TLIF and is that done going into the back mainly ? My surgeon..." + (show)
Profile picture for annie1 @annie1

Has anyone had TLIF and is that done going into the back mainly ? My surgeon said it would involve putting cages in also. I only need one level he says/thinks. My pain is all in my legs. I have throbbing and twitching in my calf muscles after walking only a few steps. I already had a simple decompression with fusion and the symptoms came back after four months.Thanks

Jump to this post

Has anyone had TLIF surgery (severe spinal stenosis, tricompartmental) while also diagnosed with MGUS lambda and osteoporosis?

REPLY
Profile picture for annie1
annie1 | @annie1 | Jan 27 1:02am

A couple of the surgeons I spoke to said they would do a posterior incision and that doesn't fit with what your surgeon told you about how it would be better to do the side incision for someone with osteoporosis. I'll have to ask them about that. I am having injections once a month for the osteoporosis of evenity which has increase my bone density already but it's still osteoporosis I think. I need to have another bone scan. I've been flying all over the country literally to talk to different surgeons and none of them have been as detailed as what you describe from the doctor in Houston which bothers me. Maybe I should see him but that's adding another trip. Anyway I have an appointment with a specialist in Boston who works a lot with osteoporetic spine so I think he should be a good bet. But in the meantime I'm going to ask the other guys why they would do the posterior with my osteoporosis.

REPLY
Profile picture for htolan
htolan | @htolan | Sep 3 5:07pm
In reply to @htolan "@jenatsky I have osteoporosis and scoliosis and had back fusion 8 weeks ago. I went to..." + (show)
Profile picture for htolan @htolan

@jenatsky I have osteoporosis and scoliosis and had back fusion 8 weeks ago. I went to Northwestern and their neurosurgeon who specializes in deformed spines did a great job. I am 72 and doing well.
I trusted him completely. My pain is so much less than before surgery.

Jump to this post

@htolan At one year, my pain in my back is gone. Northwestern saved me!

REPLY
1 reply
Profile picture for annie1
annie1 | @annie1 | Sep 3 5:48pm
In reply to @htolan "@htolan At one year, my pain in my back is gone. Northwestern saved me!" + (show)
Profile picture for htolan @htolan

@htolan At one year, my pain in my back is gone. Northwestern saved me!

Jump to this post

@htolan
I remember your post from a while ago. What's the name of the doctor? I've been hitting the wall in New York even though they're supposedly the best doctors here it gets very confusing. I don't know if they're egos or what and they each tell me a different procedure some with less levels of fusion which others say would just result in me having to have another surgery very soon after. I don't want that. Let me get the name of that person. Thanks a lot

REPLY
1 reply
Profile picture for htolan
htolan | @htolan | Sep 3 8:05pm
In reply to @annie1 "@htolan I remember your post from a while ago. What's the name of the doctor? I've..." + (show)
Profile picture for annie1 @annie1

@htolan
I remember your post from a while ago. What's the name of the doctor? I've been hitting the wall in New York even though they're supposedly the best doctors here it gets very confusing. I don't know if they're egos or what and they each tell me a different procedure some with less levels of fusion which others say would just result in me having to have another surgery very soon after. I don't want that. Let me get the name of that person. Thanks a lot

Jump to this post

@annie1 My doctor was Dr. Tyler Koski at Northwestern in Chicago. He is their top neurosurgeon for deformed spines. He’s phenomenal!
I’m so grateful that they helped me.
They have a rebab facility right by the hospital where you could go after surgery. It’s a great program. Good luck.

REPLY
Please sign in or register to post a reply.