In patients with chronic severe pain arising from the  disc itself, or who have excessive movement or slippage at a disc segment, lumbar fusion may be indicated. Traditionally this was an extensive operation carried out through a midline approach. Mini-open lumbar interbody fusion via a paramedian route significantly reduces muscle trauma and systemic inflammatory reactions.

In the mini-open TLIF procedure bone graft and an interbody cage are placed in the disc space with a supplemental pedicle screw construct.