MAS TLIF in Elizabethtown, Kentucky
When a worn or slipped disc in the lower back causes pain that has outlasted therapy, injections and time, a fusion may be the operation that finally stabilizes the segment. MAS TLIF, a minimal access version of transforaminal lumbar interbody fusion, does that through small incisions with less muscle damage than a traditional open fusion. Dr. Michael Casnellie, a board-certified spine surgeon, evaluates Elizabethtown and Hardin County patients at Aptiva Health’s clinic at 529 Westport Road, Suite 2. Your decision-making, pre-operative planning, follow-up visits and physical therapy all stay in Elizabethtown.
Call 270-506-4888. Monday through Friday, 8 AM to 5 PM. Same-day appointments available.
Schedule your appointment today!
Is MAS TLIF right for you?
A lumbar fusion joins two vertebrae into one solid unit so a painful, unstable or collapsed segment can no longer move. It is a bigger step than a decompression alone, so it is reserved for specific problems:
Spondylolisthesis, where one vertebra has slipped forward on the one below it, often with nerve pain in the legs
Degenerative disc disease at one or two levels that has collapsed the disc space and narrowed the nerve openings
Recurrent disc herniation at a level that has already had surgery
Instability or deformity after a prior laminectomy
Spinal stenosis with instability, where decompression alone would leave the segment unstable
Candidates have usually completed at least six months of non-surgical care, have imaging that matches their symptoms, and are medically fit for surgery. Smokers are asked to stop before surgery because nicotine sharply lowers the chance of a solid fusion. Patients with widespread back pain, multiple painful levels, or pain that does not correlate with imaging are generally not candidates.
What we try first, in Elizabethtown
Fusion is never the first step. The Westport Road clinic provides the conservative pathway in full:
Physical therapy with Simon Hoehn, PT, DPT and Dovie Brown, PTA, concentrating on core stabilization, hip mobility and posture; Dovie works one on one with patients and has extensive experience with orthopedic injuries and conditions
Medication management and activity modification
Image-guided injections from our interventional pain team, including epidural steroid injections and facet or medial branch blocks, which can relieve pain and help confirm which level is the source
Your surgeon tracks your response at Elizabethtown follow-ups. Only when these measures have been exhausted, and when the problem is one that fusion treats well, is MAS TLIF recommended.
Your first visit at Westport Road
Where: 529 Westport Road, Suite 2, Elizabethtown, KY 42701.
When: Monday through Friday, 8 AM to 5 PM; same-day appointments at 270-506-4888.
What happens: history, neurological exam, and standing X-rays taken on site, including flexion and extension views that show whether a vertebra moves abnormally.
MRI and CT: scheduled at Aptiva Health Imaging, 3615 Newburg Road in Louisville, when needed, and reviewed with you at your next Elizabethtown visit. Bring any prior imaging on disc.
Bring: photo ID, insurance card, medication list, prior imaging and operative reports, and work or auto claim information if applicable.
Surgery day
MAS TLIF is performed under general anesthesia using X-ray guidance. Through one or two small incisions on one side of the lower back, the surgeon works between the muscle fibers rather than cutting them, removes the damaged disc through the opening where the nerve exits (the foramen), places a spacer filled with bone graft to restore disc height and relieve pressure on the nerves, and secures the segment with screws and rods placed through small stab incisions. A single-level MAS TLIF usually takes two to three hours.
Surgery for Elizabethtown patients is performed in the Louisville metro area. Depending on the number of levels and your overall health, your surgeon will schedule it either as an outpatient procedure or with a short hospital stay. That decision, and all pre-operative clearance, happens at your Elizabethtown pre-operative visit.
Recovery and physical therapy in Hardin County
Days 1 to 3: walking with assistance on the day of surgery; home when pain is controlled and you can walk, eat and use the bathroom independently.
Weeks 1 to 6: daily walking, no bending, lifting or twisting; a brace if your surgeon prescribes one. First follow-up and wound check at the Elizabethtown office.
Weeks 6 to 12: physical therapy begins at Westport Road, focused on core strength and safe movement patterns. Desk work typically resumes between two and six weeks.
Months 3 to 6: progressive return to lifting and physical work. X-rays at Elizabethtown follow-ups track the fusion.
Months 6 to 12: the bone graft matures into solid fusion. Heavy labor and impact activity are cleared once X-rays or CT confirm it.
Why Elizabethtown patients choose Aptiva Health for spine care
One spine team, one chart. From your first visit through injections, surgery and rehab, your surgeon, the Westport Road clinic team and your physical therapists share one record and one plan.
Conservative care first. Fusion is never the first step; therapy, medication management and image-guided injections are all delivered in Elizabethtown before any operation is considered.
Honest guidance. MAS TLIF is the right answer for some patients and the wrong answer for others. Your surgeon recommends fusion only when conservative care has been exhausted, imaging shows a clear structural cause, and you are a good candidate.
Follow-up close to home. Pre-operative planning, wound checks, follow-up X-rays and physical therapy with Simon Hoehn, PT, DPT and Dovie Brown, PTA all happen in Elizabethtown.
Risks and realistic expectations
Risks include infection, bleeding, nerve root irritation or injury, a dural tear, hardware problems, failure of the bone to fuse (more common in smokers and in diabetes), blood clots, and anesthesia complications. Adjacent-segment degeneration, extra wear on the levels above and below the fusion, can occur years later. Most well-selected patients get meaningful relief of leg pain and improvement in back pain, but fusion does not restore a normal back and it is not a treatment for pain that comes from several levels. Your surgeon will put these risks in the context of your imaging, your health and your goals.
Your Elizabethtown spine surgeon
Spine patients at Aptiva Health’s Elizabethtown clinic are evaluated and treated by Michael Casnellie, MD, a board-certified spine surgeon, with physical therapy on site from Simon Hoehn, PT, DPT and Dovie Brown, PTA. Your surgeon and therapy team share one chart, so your rehab follows your surgical protocol.
Dr. Michael Casnellie — Orthopedic Spine Surgeon
Dr. Casnellie has been treating spine patients in Kentucky since 2005 and is one of the most experienced motion-preservation spine surgeons in Kentucky. He performed Kentucky's first Prestige cervical artificial disc replacement — a procedure that preserves motion at the affected level of the cervical spine instead of fusing it — and remains one of the few surgeons in the state offering both cervical and lumbar disc replacement to appropriate candidates. He sees spine patients at Aptiva Health’s Elizabethtown clinic on Westport Road.
Insurance accepted
Aptiva Health accepts most major insurance plans, Medicare, Medicare Advantage, most Kentucky Medicaid plans, workers’ compensation, and auto injury coverage (PIP and MedPay). Lumbar fusion is covered by most plans when medically necessary; we verify your benefits before surgery and explain your expected costs. We offer self-pay where there is no insurance, it is a non-covered service, and on a case-by-case basis.
Call 270-506-4888 to verify your insurance.
Get evaluated in Elizabethtown
If chronic back pain, leg pain, numbness or weakness has not settled with conservative care, it is time to talk to a spine surgeon about whether fusion is right for you. Aptiva Health Orthopedics, Elizabethtown: 529 Westport Road, Suite 2, Elizabethtown, KY 42701. Phone 270-506-4888. Monday through Friday, 8 AM to 5 PM. On-site X-ray. Same-day appointments available.
Physical therapy at Westport Road is provided by Simon Hoehn, PT, DPT and Dovie Brown, PTA. Dovie works one on one with patients and has extensive experience treating orthopedic injuries and conditions. Image-guided injections are performed in Elizabethtown by our interventional pain team.
MRI or CT, when needed, is scheduled at Aptiva Health Imaging, 3615 Newburg Road, Louisville, KY 40218, and reviewed with you at your next Elizabethtown visit.
Frequently asked questions about MAS TLIF in Elizabethtown
Do I have to go to Louisville for MAS TLIF?
Your evaluation, injections, pre-operative visit, follow-ups and physical therapy are all at our Elizabethtown clinic on Westport Road. The fusion itself is performed in the Louisville metro area, either as an outpatient procedure or with a short hospital stay depending on your case, and you return to Elizabethtown for all follow-up care.
How is MAS TLIF different from a traditional fusion?
The goal is the same: a solid fusion of the painful segment. MAS TLIF reaches the spine through small incisions and between the muscles rather than through a long incision with the muscles stripped from the bone, which typically means less blood loss, less post-operative pain and a faster return to walking.
How long until I can work?
Desk work usually resumes between two and six weeks. Physical jobs generally wait three to six months, and heavy labor until the fusion is confirmed solid. Your surgeon sets the timeline at your Elizabethtown follow-ups.
Can I do physical therapy in Elizabethtown?
Yes. Simon Hoehn, PT, DPT and Dovie Brown, PTA provide post-fusion rehabilitation at the Westport Road clinic, one on one, following your surgeon’s protocol.
Will I need an MRI before my first visit?
No. You will be examined and X-rayed in Elizabethtown first. MRI or CT, if needed, is scheduled at our Newburg Road imaging center in Louisville.