MAS TLIF in Louisville, Kentucky

A minimally invasive lumbar fusion technique that uses smaller incisions, dilates muscles instead of cutting them, and offers outpatient capability for the right candidates. Dr. Michael Casnellie and Dr. David McConda lead Aptiva Health's lumbar fusion program, combining decades of experience with fellowship-trained expertise from AOSpine — the international foundation that sets clinical standards in spine fusion surgery. Medically reviewed by Michael Casnellie, MD, David McConda, MD, and Steven Ganzel, DO — May 2026.

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Minimally Invasive Lumbar Fusion — Big Procedure, Small Incision

If you've been suffering with chronic back pain, leg pain, or weakness from lumbar spondylolisthesis, severe disc degeneration, or lumbar instability — and conservative care hasn't worked — lumbar fusion may be the right next step.

At Aptiva Health in Louisville, we perform lumbar fusion using MAS TLIF — Minimal Access Surgery Transforaminal Lumbar Interbody Fusion. Instead of the four-to-six-inch incision and muscle-cutting approach used in traditional open lumbar fusion, MAS TLIF uses small incisions and specialized retractors that gently dilate the back muscles rather than cutting them.

The result for the patient: smaller scars, less blood loss, less post-operative pain, a shorter hospital stay (often outpatient for appropriately selected patients), and a faster return to active life. The result for the spine: the same proven, durable fusion that has been the gold standard for severe lumbar conditions for decades.

For patients with nerve compression from a single herniated disc — without instability — a microdiscectomy is often the better answer. For patients with structural instability, severe degeneration, or spondylolisthesis, MAS TLIF is the right tool. We'll help you understand which procedure fits your anatomy.

Conditions We Treat With MAS TLIF

MAS TLIF is the minimally invasive solution for structural lumbar conditions that require fusion. It is most commonly used for:

• Lumbar spondylolisthesis — when one vertebra slips forward on the one below it, causing instability, back pain, and often radiculopathy (degenerative or isthmic)

• Lumbar spinal stenosis with instability — narrowing of the spinal canal combined with abnormal vertebral motion

• Severe lumbar degenerative disc disease with mechanical back pain

• Recurrent disc herniation — when a herniated disc returns after a prior microdiscectomy

• Lumbar instability — abnormal motion between vertebrae, often after prior surgery or injury

• Failed back surgery syndrome with a clear mechanical cause on imaging

• Pseudarthrosis — revision MAS TLIF for failed prior lumbar fusion

Not sure if your back pain is a fusion issue? Compare options on our Microdiscectomy Louisville and Spine Surgery Louisville pages, or get evaluated by an Aptiva spine provider.

MAS TLIF vs. Traditional Open Lumbar Fusion — What's the Difference?

The goal of both procedures is the same: fuse two vertebrae together to relieve nerve compression and stabilize the spine. The difference is how the surgeon gets there.

Traditional Open Lumbar Fusion

• Single midline incision, typically four to six inches or longer

• Back muscles are cut and retracted away from the bone

• More blood loss

• More post-operative pain from muscle disruption

• Typical hospital stay of two to four days

• Recovery often delayed by post-operative muscle pain

MAS TLIF (Minimal Access Surgery TLIF)

• One to two small incisions, typically one inch or less per side

• Tubular retractors dilate the back muscles rather than cutting them

• Less blood loss

• Less post-operative pain

• Outpatient or single-night stay possible for appropriately selected patients

• Faster recovery and return to work

• Same proven, durable fusion result as traditional open fusion

The long-term fusion outcome is comparable between techniques when MAS TLIF is performed by an experienced fellowship-trained spine surgeon. What changes is the patient's experience getting there — and how quickly they get back to active life.

What to Expect From MAS TLIF Surgery

Before Surgery

• Lumbar MRI (and often CT) at Aptiva Health Imaging in Louisville to confirm the affected level and identify nerve compression

• Bone density assessment if osteoporosis is a concern

• Medical clearance and pre-operative consultation with your Aptiva spine provider

• Review of alignment, instability, and the levels involved

• Fasting instructions per anesthesia protocol

• Arrange a ride home — you cannot drive yourself the day of surgery

Day of Surgery

• Arrive 1-2 hours before surgery start time

• General anesthesia administered

• One or two small incisions (typically one inch or less per side) made in the back

• Tubular retractors dilate the back muscles

• Using fluoroscopic (X-ray) guidance, surgeon enters the disc space from the side (transforaminal approach)

• Damaged disc removed; nerve carefully decompressed

• Interbody cage packed with bone graft placed in the disc space to restore height and alignment

• Pedicle screws and rods placed through small incisions for stability

• Single-level procedure typically takes 2-4 hours; multi-level proportionally longer

• 2-3 hours in recovery, then discharge home the same day or overnight observation depending on the patient

After Surgery

• Walking encouraged within hours of surgery

• Pain medication tapered quickly as discomfort subsides

• Most patients report relief of leg pain almost immediately

• Back pain improves gradually as inflammation resolves and fusion progresses

• Desk work: typically 2-4 weeks

• Driving: typically 2-4 weeks (off narcotic pain medication)

• Light exercise: 4-6 weeks

• Physical labor and high-impact activity: 3-6 months

• Bony fusion completes over 6-12 months

• Post-operative follow-up at 2 weeks, 6 weeks, 3 months, 6 months, and 12 months

• X-rays at follow-up visits confirm fusion progress

Why Choose Aptiva Health for Your MAS TLIF

Minimally invasive technique, not traditional open fusion. Aptiva performs lumbar fusion using the MAS TLIF technique — smaller incisions, less muscle disruption, less blood loss, and faster recovery than traditional open lumbar fusion. Patients recover at home, not in a multi-day hospital stay.

Fellowship-trained fusion surgeons. Dr. McConda completed his fellowship at OrthoCarolina Spine Center through the AOSpine North America Spine Surgery Fellowship — the program of AOSpine, the international foundation that sets the clinical standards for spine fusion worldwide. Dr. Casnellie has been performing lumbar surgery in Louisville since 2005.

A dedicated spine team. Spine surgery isn't a side specialty at Aptiva — it's a focus. Our Louisville team includes board-certified spine and orthopedic surgeons, an interventional pain physician, and dedicated PAs and an NP who care for spine patients every day.

Honest guidance — fusion is a big procedure. MAS TLIF is the right answer for some patients and the wrong answer for others. We don't recommend fusion unless conservative care has been exhausted, imaging shows a clear structural cause, and the patient is a good candidate. Our interventional pain specialist, Dr. Steven Ganzel, performs epidural steroid injections, facet joint injections, medial branch blocks, and radiofrequency ablation — non-surgical options that provide lasting relief for many patients and may avoid the need for surgery entirely.

Multiple lumbar surgical options. For patients with a single herniated disc and no instability, lumbar microdiscectomy is often the better choice. We evaluate every patient individually to recommend the right procedure — not the biggest one.

Fast access. Stop waiting weeks for an answer. Most patients see an Aptiva spine provider within days of calling.

One team, start to finish. From your first call to your final post-op visit, you'll work with the same Aptiva team. We handle insurance verification, scheduling, and post-op care in-house.

Cash-pay options available. For patients without insurance — or with high deductibles — we offer transparent, all-inclusive cash-pay pricing for MAS TLIF that includes the surgeon, facility, anesthesia, implants, and post-operative visits. No surprise hospital bills.

Schedule your appointment today!

Your Louisville Spine Care Team

At Aptiva Health, your spine care is delivered by a team of board-certified surgeons and advanced practice providers who focus on the diagnosis, treatment, and follow-up of conditions of the cervical and lumbar spine — including herniated discs, sciatica, spinal stenosis, and degenerative spine conditions.

Insurances Accepted

Aptiva Health accepts most major insurance plans, Medicare, Medicaid Managed Care, workers' compensation, and auto insurance (PIP and Medpay). We verify benefits and provide a clear cost estimate before surgery.

MAS TLIF is a well-established procedure covered by Medicare and most major commercial insurance plans when medically necessary. One-level and two-level lumbar fusion are both routinely covered when imaging and clinical criteria are met.

For patients paying out of pocket, we offer transparent, bundled cash-pay pricing for MAS TLIF that includes the surgeon, facility, anesthesia, implants (interbody cage, pedicle screws, rods), and post-operative visits — no surprise itemized hospital bills.

Call 502-414-0036 to verify your insurance or request a cash-pay quote.

Ready for Relief From Chronic Back Pain?

If you've been suffering with chronic back pain, leg pain, numbness, or weakness — and conservative care hasn't worked — it's time to talk to Aptiva's spine team about whether MAS TLIF is right for you.

Schedule a Consultation in Louisville — Schedule Now

Aptiva Health — Spine Center of Excellence 3615 Newburg Road, Suite 101, Louisville, KY 40218 Phone: 1-866-439-6696 | Direct: 502-414-0036

Additional Louisville locations also serving spine patients:

• Louisville East — 10100 Linn Station Road, Suite 1A, Louisville, KY 40223 — Tel: 502-465-8254

• Louisville Downtown — 300 South 13th Street, Louisville, KY 40203 — Tel: 502-583-1011

• Louisville Imaging — 3615 Newburg Road, Suite 106, Louisville, KY 40218 — Tel: 502-465-8254

• Louisville Middletown — 401 N English Station Road, Suite 1A, Louisville, KY 40223 — Tel: 502-465-8254

• Concussion & Sports Medicine Institute (on-site MRI) — 3611 Newburg Road, Louisville, KY 40218 — Tel: 502-465-8254

Elizabethtown location serving spine patients:

• Aptiva Health Orthopedics — Elizabethtown — 529 Westport Road, Suite 2, Elizabethtown, KY 42701 — Tel: 270-512-5480

Mt. Washington location serving spine patients:

• Aptiva Health Orthopedics — Mt. Washington — 737 N Hwy 31e Bypass, Suite 2, Mt. Washington, KY 40047 — Tel: 502-465-8254

MAS TLIF: Frequently Asked Questions

What is MAS TLIF (minimally invasive lumbar fusion)?

MAS TLIF stands for Minimal Access Surgery Transforaminal Lumbar Interbody Fusion. It is a minimally invasive technique for fusing two vertebrae in the lower back. Through small incisions (typically one inch or less), specialized retractors dilate the back muscles instead of cutting them. The surgeon enters the disc space from the side, removes the damaged disc, decompresses the affected nerve, and places an interbody cage with bone graft to restore disc height. Pedicle screws and rods are then placed for stability. Compared with traditional open lumbar fusion, MAS TLIF generally results in smaller incisions, less blood loss, less post-operative pain, and faster recovery.

How is MAS TLIF different from traditional open lumbar fusion?

The goal of both procedures is identical — fuse two vertebrae together to relieve nerve compression and stabilize the spine. The difference is how the surgeon accesses the spine. Traditional open lumbar fusion uses a four-to-six-inch midline incision, with the back muscles cut and pulled away from the bone. MAS TLIF uses one or two small incisions (typically one inch or less), with tubular retractors that dilate the muscles rather than cutting them. The result is generally less blood loss, less post-operative pain, shorter hospital stay (often outpatient or one night), and a faster return to work. The fusion result and long-term outcome are comparable between techniques when performed by an experienced surgeon.

Is MAS TLIF an outpatient procedure?

MAS TLIF can be performed as an outpatient procedure for appropriately selected patients at Aptiva Health in Louisville. Many patients are discharged the same day or after a brief overnight observation, depending on the number of levels treated, overall health, and post-operative recovery. This is a meaningful difference from traditional open lumbar fusion, which typically requires a multi-day hospital stay.

What conditions does MAS TLIF treat?

MAS TLIF is most commonly used to treat lumbar spondylolisthesis (when one vertebra slips forward on another), lumbar spinal stenosis with instability, severe lumbar degenerative disc disease causing mechanical back pain, recurrent disc herniation, and lumbar instability. It can also be used as a revision procedure for failed prior fusion (pseudarthrosis) or failed back surgery syndrome with mechanical pain.

Am I a candidate for MAS TLIF?

MAS TLIF is generally considered when patients have chronic back pain and/or leg pain from a structural lumbar problem such as spondylolisthesis, severe disc degeneration, or instability — and have not improved after at least six months of conservative care such as physical therapy, anti-inflammatory medications, epidural steroid injections, and activity modification. A consultation and review of lumbar imaging with Dr. Casnellie or Dr. McConda determines whether MAS TLIF is appropriate. Some patients may be better served by a less invasive procedure such as microdiscectomy, by interventional pain procedures, or by continued non-surgical care.

How long does MAS TLIF surgery take?

A single-level MAS TLIF typically takes two to four hours of surgical time. Two-level procedures take proportionally longer. Including pre-operative preparation, anesthesia, and post-anesthesia recovery, patients are generally at the surgical facility for six to eight hours before being discharged home or admitted overnight for observation.

How long is the recovery after MAS TLIF?

Walking is encouraged within hours of surgery. Patients typically return to desk-based work within two to four weeks. Light exercise resumes around four to six weeks. Physical labor and high-impact activity typically resume at three to six months once early fusion is confirmed on imaging. Solid bony fusion generally completes within six to twelve months. Recovery from MAS TLIF is generally faster than recovery from traditional open lumbar fusion because of the smaller incisions and reduced muscle disruption.

Will I lose flexibility in my lower back after MAS TLIF?

Motion is permanently eliminated at the level that is fused — that is how the surgery works. However, most patients do not notice a meaningful loss in overall lower back range of motion after a single-level fusion, because the remaining lumbar levels compensate naturally. Multi-level fusion results in more noticeable motion loss. Many patients gain functional motion overall because the chronic pain that limited their movement is gone.

What is the success rate of MAS TLIF?

Published clinical studies of MAS TLIF generally report fusion rates above 90 percent and significant improvement in back and leg pain in approximately 80 to 90 percent of appropriately selected patients. Outcomes are most predictable when surgery is performed by a fellowship-trained spine surgeon on patients who have failed conservative care and have a clear structural cause of their pain on imaging.

Will my insurance cover MAS TLIF?

Yes. MAS TLIF is a well-established procedure covered by Medicare and most major commercial insurance plans when medically necessary. Aptiva Health accepts most major insurance plans, Medicare, Medicaid Managed Care, workers' compensation, and auto insurance (PIP and Medpay). Our team verifies benefits and provides a clear cost estimate before surgery. We also offer transparent, bundled cash-pay pricing for MAS TLIF that includes the surgeon, facility, anesthesia, implants, and post-operative visits.

Who performs MAS TLIF at Aptiva Health in Louisville?

MAS TLIF at Aptiva Health Spine in Louisville, Kentucky is performed by Dr. Michael Casnellie and Dr. David McConda — both board-certified spine surgeons. Dr. Casnellie has been treating spine patients in Louisville since 2005. Dr. McConda is fellowship-trained at OrthoCarolina Spine Center through the AOSpine North America Spine Surgery Fellowship, the international foundation that sets clinical standards in spine fusion surgery. The full Aptiva spine team — including Dr. Steven Ganzel for interventional pain procedures, Kayla Troutman, PA-C, David Koonce, DNP, and Michael Gilbert, PA-C — supports evaluation, surgical care, and post-operative follow-up.

Should I try non-surgical options before considering MAS TLIF?

Yes. MAS TLIF is generally considered only after at least six months of well-documented conservative care has failed. Non-surgical options include physical therapy, anti-inflammatory medications, activity modification, and interventional pain procedures such as epidural steroid injections, facet joint injections, medial branch blocks, and radiofrequency ablation. Many patients experience lasting relief from these treatments and never require surgery. Dr. Steven Ganzel performs these interventional pain procedures as part of the Aptiva Health Spine Team.

Questions? Call us today! 502-414-0036