What is Posterior Lumbar Interbody Fusion?

Posterior Lumbar Interbody Fusion (PLIF) is a surgical procedure performed on the lower back to alleviate symptoms caused by spinal instability or compression. During the procedure, a surgeon accesses the spine from the back (posterior approach) and removes the damaged disc or bone material causing pressure on the spinal nerves. The space created by removing the disc is then filled with a bone graft or a cage filled with bone graft material to promote fusion between the adjacent vertebrae.

Why is PLIF performed?

PLIF is indicated for conditions such as:

• Degenerative disc disease
• Spondylolisthesis (a condition where one vertebra slips forward over the one below it)
• Lumbar spinal stenosis (narrowing of the spinal canal in the lower back)
• Recurrent disc herniation
• Trauma or injury to the lumbar spine
• Failed previous spinal fusion

Procedure

1. Preparation: Before surgery, you'll undergo several preoperative tests to ensure you're fit for surgery. These may include blood tests, imaging scans (like MRI or CT scans), and possibly a physical exam.
2. Anesthesia: You'll receive general anesthesia to ensure you're unconscious and pain-free during the procedure.
3. Surgical Approach: The surgeon makes an incision in your lower back, exposing the affected vertebrae.
4. Disc Removal: The surgeon removes the damaged disc material and any bone spurs that are pressing on spinal nerves, relieving pressure on the nerves.
5. Bone Grafting: A bone graft or a cage filled with bone graft material is placed into the empty disc space. This promotes bone growth between the vertebrae, stabilizing the spine.
6. Instrumentation: In some cases, the surgeon may use screws, rods, or other instrumentation to stabilize the spine while the fusion heals.
7. Closure: The incision is closed with sutures or staples, and a sterile dressing is applied.

Recovery

• You'll typically spend a few days in the hospital after surgery for monitoring and pain management.
• Physical therapy and rehabilitation will be initiated to help you regain strength and mobility.
• Full recovery may take several weeks to months, depending on individual factors such as overall health and the extent of the surgery.
• It's important to follow your surgeon's postoperative instructions carefully to optimize healing and reduce the risk of complications.

Risks and Complications

• As with any surgical procedure, PLIF carries certain risks, including infection, bleeding, nerve damage, blood clots, and anesthesia complications.
• There's also a risk that the fusion may not be successful, leading to persistent symptoms or the need for additional surgery.

Outcomes

• Many patients experience significant relief from symptoms such as back pain, leg pain, and numbness following PLIF.
• Successful fusion results in improved spinal stability and may prevent further degeneration of the affected segment.

It's essential to have a detailed discussion with your surgeon to understand the risks, benefits, and expected outcomes of PLIF based on your specific condition and medical history.