If you follow the PGA Tour at all, you know about the world’s most famous back fusion surgery patient — Tiger Woods. Woods had fusion on the L5 and S1 sections of his spine in 2017. This is the last of the five lumbar vertebrae and the first of the sacrum. In someone Woods’s age, the sacrum is a single piece encompassing our hips. But in people prior to their mid-20s or so, the sacrum is still five separate pieces. As we grow out of puberty, these begin to fuse naturally into a single piece.
In Woods’s case, his fusion surgery enabled him to fully return to professional golf, winning a series of tournaments, including the Masters in 2019. Since then, he was in a car crash and is rehabilitating his health again. It will be interesting to see the role his fusion assumes in his future.
This is a fusion procedure our four neurosurgeons at Texas Neurosurgery perform regularly.
Who gets this fusion?
Spinal fusion is recommended for conditions such as spondylolisthesis, degenerative disc disease, or recurrent disc herniations. The goal is to reduce nerve irritation or compression that is occurring in this section of the spine. The pain may be local, or it may radiate down into the legs.
How is it done?
In Woods’s case, this would be called transforaminal lumbar interbody fusion (TLIF) surgery. Our Texas Neurosurgery surgeons perform this surgery through the posterior part of the spine.
Surgical hardware is applied to the spine to help enhance the fusion rate and minimize any movement whatsoever. Pedicle screws and rods are attached to the back of the vertebra and an interbody fusion spacer is inserted into the disc space from one side of the spine.
Bone graft material is placed into the interbody space and alongside the back of the vertebrae to be fused. This bone graft material is obtained from the patient’s pelvis in most cases, although there are also substitutes available.
As the bone graft heals, it fuses the vertebrae above and below and forms one long bone. In Woods’s case, it fused the lumbar spine to the sacrum.
TLIF is known as a last alternative type of procedure. It is used only when other options, such as microdiscectomy or laminectomy, have been found to be ineffective. In Woods’s case, he was finding it difficult to perform simple daily tasks and the pain was affecting his entire life. He had three prior microdiscectomies that were unsuccessful at stemming his pain.
Studies of this procedure indicate that the patient’s pain is improved in from 60-70 percent of cases after TLIF surgery. Over 80 percent of patients undergoing TLIF are satisfied with the surgical result.