Concierge spinal surgery · United Kingdom
Minimally invasive lumbar fusion, by a UK BASS spinal surgeon.
MIS‑TLIF for one or two lumbar levels - a 2–3cm tubular approach, percutaneous pedicle screws and O‑arm navigation. Less muscle disruption than open TLIF, comparable long‑term fusion, one or two nights in hospital.
Why patients choose us
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A UK BASS spinal surgeon, in theatre
Not a general orthopaedic list. A named spinal surgeon on the British Association of Spine Surgeons roster, in a hospital equipped for navigation and O‑arm work.
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Fusion is not the only answer
For some backs a decompression alone, or an XLIF, or good rehab, will do. We say so before you commit to a fusion.
- 03
Independent, and free
We are paid by no hospital, so the recommendation is impartial and costs you nothing.
Indicative pricing
What a private MIS‑TLIF costs in the UK.
Indicative ranges across our partner hospitals. NHS‑funded pathways are available at BASS‑accredited units. Send your imaging and we quote firm figures across two or three options.
In short
Single‑level MIS‑TLIF in our network: £18,000–£30,000, home in 1–2 nights.
| Procedure | Indicative range | Theatre time | Hospital stay |
|---|---|---|---|
| MIS‑TLIF single‑level (self‑pay) | £18,000–£30,000 | 2–4 hr | 1–2 nights |
| MIS‑TLIF two‑level (self‑pay) | £28,000–£45,000 | 3–5 hr | 2–3 nights |
| Open TLIF (comparator) | £15,000–£26,000 | 2–4 hr | 3–5 nights |
| Lateral lumbar interbody fusion (XLIF) | £20,000–£32,000 | 2–3 hr | 1–2 nights |
| Anterior lumbar interbody fusion (ALIF) | £22,000–£35,000 | 2–4 hr | 2–3 nights |
| Consultant spinal opinion only | £250–£450 | 30–45 min | Same visit |
Prices vary by hospital, by surgeon, by the number of levels operated, by whether O‑arm navigation is used, and by implant choice (PEEK vs titanium vs expandable cage). We come back with a firm quote within one working day.
The problem
The right surgeon, the right approach, the right levels.
Lumbar fusion is one of the most over‑ and under‑done operations in the UK - some backs get a bigger fusion than they need, others struggle for years without one. We help you get the right operation, not the biggest.
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Not sure fusion is needed?
A decompression alone, an XLIF, or targeted rehab might do the job. We say so before you agree to a fusion.
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Worried about a big open scar?
MIS‑TLIF is done through a 2–3cm paramedian incision with percutaneous screws - less muscle damage, less pain, shorter stay.
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Want it done properly?
A named BASS spinal surgeon in a hospital equipped for O‑arm navigation - with a formal fusion check at twelve months.
The journey
From enquiry to fusion check - what happens, in order.
One surgeon from first message to twelve‑month fusion check - including the rehab in between.
Phase 1 · Before your procedure
Concierge, off‑stage for you
Phase 2 · On the day
One to two nights in hospital
Phase 3 · After
Concierge, back on
- 01
Before
You tell us what is going on
A short, confidential form. Leg pain, back pain, how long, what you have already tried, and any imaging you have.
- 02
Before
We come back with a recommendation
Within one working day: the right surgeon, whether MIS‑TLIF or a lesser operation fits, and an indicative price.
- 03
Before
Imaging and pre‑op work‑up
MRI lumbar spine, CT for bony detail, standing flexion‑extension X‑rays, and DEXA if osteoporosis is possible. Bloods and anaesthetic review.
- 04
On the day
Arrival at the hospital
Admission, consent and a chat with the spinal surgeon and anaesthetist. General anaesthetic, prone on a Jackson table.
- 05
On the day
The MIS‑TLIF itself
A 2–3cm paramedian incision through a tubular retractor, muscle‑splitting Wiltse approach, unilateral facetectomy, discectomy, cage, percutaneous pedicle screws and rods under fluoroscopy or O‑arm navigation. Two to four hours.
- 06
On the day
One to two nights in
Up and walking on day one with the physiotherapist. Home when pain, mobility and bladder function are all settled - usually the next morning.
- 07
After
Recovery, rehab and review
Office work at two to six weeks, no heavy lifting for twelve, sport at six months. Surgeon review at six weeks and a fusion check at twelve months.
Typical end‑to‑end: 3–6 weeks from enquiry to surgery. Fusion check: 12 months.
When it helps
When MIS‑TLIF is the right operation.
The classical indications we see, plus the one red flag that means an emergency rather than an outpatient appointment.
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Degenerative spondylolisthesis (grade I–II)
A slipped vertebra with mechanical back pain and leg symptoms that has failed conservative care.
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Isthmic spondylolisthesis
A pars defect causing slip and radiculopathy - MIS‑TLIF restores foraminal height and stabilises the segment.
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Recurrent disc herniation with instability
A second or third herniation at the same level, with dynamic instability on flex‑ex films.
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Adjacent segment disease
A degenerate level next to a previous fusion, now symptomatic and structurally failing.
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Low‑grade degenerative deformity
A short lumbar curve or rotatory subluxation causing pain - a targeted one‑ or two‑level MIS‑TLIF often does the job.
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Symptomatic instability post‑decompression
Persistent mechanical pain and slip progression after a previous laminectomy or discectomy.
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Revision fusion for pseudarthrosis
A failed prior fusion with a non‑united segment on CT - MIS‑TLIF revises the interbody and adds fixation.
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Red flag: cauda equina
Saddle numbness, bladder or bowel disturbance, or bilateral leg weakness is an emergency - same‑day A&E, not a clinic booking.
Procedure options
MIS‑TLIF is not the only fusion.
What each option on the table actually involves - and which fits which back.
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MIS‑TLIF single‑level
Tubular retractor, unilateral facetectomy, interbody cage and percutaneous pedicle screws at one lumbar level.
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MIS‑TLIF two‑level
The same technique across two adjacent levels - longer OR time, one anaesthetic, one recovery.
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Open TLIF (comparator)
Traditional midline approach with muscle stripping. Still the right call for complex revisions or severe deformity.
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XLIF / OLIF (lateral)
A cage placed from the side through psoas. Larger footprint, good indirect decompression - often paired with percutaneous screws.
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ALIF (anterior)
A cage placed through the abdomen. Best restoration of disc height and lordosis at L5/S1, usually with a vascular surgeon co‑operating.
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Decompression alone
A microdiscectomy or laminectomy without fusion - the right answer when the pain is nerve compression, not instability.
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Cage choice: PEEK, titanium, expandable
PEEK is the workhorse, titanium encourages bony on‑growth, expandable cages restore height through a small window.
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Consultation only
An honest opinion on whether fusion is needed at all, and which flavour fits - no obligation.
Our vetted UK network
A small panel of spinal surgeons, we picked them.
Consultant spinal surgeons on the UK BASS roster, across London, the South East, the Midlands and the North. Not listed publicly - introductions are made privately, once we understand your case.
Selection criteria
How we choose every spinal surgeon in our network.
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Consultant spinal surgeons on the UK BASS roster, not general orthopaedic locums
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O‑arm or intra‑operative CT navigation available for percutaneous screw placement
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Non‑operative alternatives (decompression, rehab, injection) discussed before fusion
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Formal twelve‑month fusion check with CT and standing X‑rays included in the pathway
Safety and recovery
The benefits and the honest risks.
MIS‑TLIF is a well‑studied operation with clear advantages over open TLIF - but it has a learning curve, a longer OR time in early cases, and radiation exposure from fluoroscopy. Here is the balanced picture.
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Less muscle disruption than open TLIF
The Wiltse muscle‑splitting corridor and percutaneous screws mean less blood loss, less post‑op pain and a shorter hospital stay than a midline open fusion.
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Comparable fusion rates
At two to five years, MIS‑TLIF matches open TLIF on fusion rates and patient‑reported outcomes in most published series.
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Dural tear (3–8%)
A small tear in the sac around the nerves. Usually repaired at the time, occasionally needing a day of bed rest afterwards.
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Nerve root injury (1–3%)
A dysaesthesia or weakness in the exiting root, usually the L5. Most recover; a minority leave a lasting numb patch.
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Pseudarthrosis (5–15% at 12 months)
Failure of the bones to fuse across the cage. Smoking, osteoporosis and multi‑level surgery all raise the risk.
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Cage subsidence and hardware issues
The cage can sink into the endplate, or a screw can be malpositioned - the latter is much less common with navigation.
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Adjacent segment disease
A fused segment shifts load onto its neighbours. Over ten to fifteen years, some patients develop symptoms at the level above.
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Infection, DVT and PE
Low‑single‑digit rates for wound infection and venous thromboembolism, mitigated by antibiotics, stockings and early mobilisation.
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Red flags after discharge
New leg weakness, saddle numbness, bladder trouble, spreading redness or a fever are all reasons to call the team or A&E the same day.
Reading your operation note
Your operation note in four parts. Read the last one first.
Whichever levels were fused, the note the spinal surgeon sends you keeps to the same shape.
A quiet reminder
Surgical language is precise and can read coldly - we translate it for you.
If you would like us to talk you through the note before your review, just ask.
- 01 Header
Indication and levels operated
Why the fusion was done - spondylolisthesis, adjacent segment disease, revision - and exactly which lumbar levels were addressed.
- 02 Technique
Approach, cage and instrumentation
Wiltse tubular approach, side of facetectomy, cage type (PEEK, titanium, expandable) and how the screws were placed (fluoroscopy or navigation).
- 03 Findings
Decompression, disc and blood loss
Notes on the discectomy, endplate preparation, any dural tear, estimated blood loss and screw accuracy on the post‑insertion scan.
- 04 Impression
Rehab plan, lifting limits, fusion check
Read this first: mobilisation plan, when you can drive, twelve‑week lifting limits, sport at six months, and when the fusion is checked.
Recognised by major UK insurers
Most UK insurers fund MIS‑TLIF when clinically indicated with prior authorisation. Implant caps vary by policy - we confirm cover, gaps and any co‑pays before booking.
Frequently asked
Everything we get asked about MIS‑TLIF.
Quick answers on candidacy, hospital stay, cost, risks, alternatives and getting back to work and sport.
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What is MIS‑TLIF and how is it different from open TLIF?
MIS‑TLIF is a minimally invasive transforaminal lumbar interbody fusion - the same operation as an open TLIF, but done through a 2–3cm paramedian tubular retractor with percutaneous pedicle screws instead of a long midline incision and muscle stripping. Fusion rates and long‑term outcomes are comparable; the trade is less blood loss, less pain and a shorter stay against a longer operating time and higher radiation dose.
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Am I a candidate for MIS‑TLIF?
The usual indications are grade I–II degenerative or isthmic spondylolisthesis, recurrent disc herniation with instability, adjacent segment disease, low‑grade deformity, symptomatic instability after a previous decompression, or revision of a failed fusion. Severe deformity, high‑grade slip or extensive multi‑level disease usually still favours an open approach.
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How long does the operation take and how long am I in hospital?
A single‑level MIS‑TLIF typically takes two to four hours. Most patients spend one to two nights in hospital, are walking with the physiotherapist on day one, and go home the following morning.
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How much does MIS‑TLIF cost privately in the UK?
Roughly £18,000–£30,000 for a single‑level self‑pay case and £28,000–£45,000 for two levels, inclusive of surgeon, anaesthetist, hospital, implants and standard follow‑up. NHS‑funded pathways are available at BASS‑accredited units. We confirm a firm figure within one working day.
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When can I go back to work and to sport?
Office and desk work usually resumes at two to six weeks. No heavy lifting (over 5–10kg) or repeated bending for twelve weeks. Running, gym and contact sport wait until about six months, once the fusion is confirmed on CT and standing X‑rays.
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What are the main risks and complications?
Dural tear (3–8%), transient nerve root injury (1–3%), pseudarthrosis or non‑union (5–15% at twelve months), cage subsidence, hardware malposition (reduced with O‑arm navigation), adjacent segment disease long‑term, infection, DVT or PE, incomplete decompression and chronic pain persistence.
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What are the alternatives to MIS‑TLIF?
A decompression alone if instability is not the issue, an XLIF or OLIF from the side, an ALIF from the front (especially at L5/S1), an open TLIF for complex cases, or continued non‑operative care with physiotherapy and targeted injections. A good spinal surgeon walks you through all of them.
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When should I go to A&E rather than book a clinic?
Saddle numbness, new bladder or bowel disturbance, bilateral leg weakness, a foot that will not lift, or a fever with spreading redness after surgery are all reasons for same‑day emergency assessment, not a clinic appointment.
Related treatments
Looking for something else?
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Minimally invasive spinal surgery
The full family of MIS spine procedures.
Learn more -
Lateral lumbar interbody fusion (XLIF)
A cage placed from the side through psoas.
Learn more -
Discectomy
Nerve decompression without fusion.
Learn more -
All tests & procedures
Every test and procedure we arrange.
Learn more