The NuVasive ® MAS (Maximum Access Surgery) TLIF procedure is a minimally invasive approach to traditional back surgery.

In a MAS TLIF, rather than starting from the center and spreading the muscles outward, the surgical approach starts at an angle to the spine and bluntly splits (rather than cuts) back muscles on just one side. This procedure attempts to reduce the approach-related muscle pain often seen in traditional back surgeries by minimizing the amount of muscle tissue disruption.

The surgery offers the same advantages as traditional TLIF, but with the added benefit of less tissue disruption and therefore less postoperative pain and quicker recovery.

How Does The MAS TLIF Surgical Procedure Work?

The surgery is performed with you positioned on your belly. An X-ray is taken of your spine to show the location of the operative disc space. An initial dilator is inserted and used to feel the bony target points on the spine. Once the target is reached and confirmed with an X-ray, sequentially larger tubes are advanced to widen the exposure. Once the tubes are in place, a tissue retractor (called the MaXcess ® retractor) is placed into position, locked to the surgical table, and held open to provide lighted visibility and instrument access to the disc space.

With the intervertebral disc now visible and accessible, the surgeon then removes the disc and prepares the disc space for fusion.

With the disc space prepared, the surgeon then places an intervertebral implant into the empty space to restore the proper disc height and support the loads put on that spinal segment. Once the intervertebral implant is in position, the retractor is widened to expose from the vertebra above to the vertebra below for the placement of fixation instrumentation (pedicle screws).

NuVasive's SpeRx ® pedicle screws may be places through the MaXcess retractor using the NeuroVision® System which assists with implant placement peby monitoring nerve activity throughout the surgical procedure.

Once the screw construct is completed on that side, the retractor is removed and SpheRx DBR® pedicle screws are implanted through a small incision on the opposite side, also using NeuroVision guidance.

The final result will be a construct with an interbody implant between the vertebral bodies, where the fusion will occur, and the pedicle screw fixation posteriorly to stabalize the spine. The small skin incisions are closed with a few stiches and adhesive bandages.

Treatment and Recovery process from Lumbar Fusion

Because this procedure is less disruptive than conventional posterior surgery, most patients are able to get up and walk around the evening after surgery. Most MAS TLIF patients are discharged from the hospital the next day, but your physician and health care team will determine the best postoperative course for you.

We are please that the MAS TLIF procedure might be a viable option for you. We hope that you are able to enjoy the benefits of this minimally disruptive approach.


Interested in learning more? Please fill out our contact form or call 281-469-0339 with any questions.