Posterior Lumbar Interbody Fusion

A posterior lumbar interbody fusion (PLIF) is a surgical technique that involves correction of the spinal problems at the base of the spine by placing bone graft between two vertebrae.

Minimally invasive surgical techniques may be employed to perform the procedure.

Indications

PLIF is recommended when the non-surgical treatment measures such as rest, physical therapy or medications fail to reduce the symptoms (pain, numbness, and weakness).

Some of the common indications are:

  • Spinal instability
  • Degenerative disc disorder of lumbar spine (pain due to damaged disc)
  • Spondylolisthesis (slippage of one vertebra on another)
  • Spinal stenosis

Procedure for PLIF

The basic steps involved are as follows:

  • A incision is made in the skin on your back over the affected vertebrae, a separate incision over your hip may be used to harvest bone graft.
  • Muscles encircling the affected spine are retracted to gain accessibility to the spine Lamina covering the vertebra is removed to view the nerve roots.
  • Facet joints (structures that connect the vertebrae to one another) may be undercut or removed to provide more space for the nerve roots.
  • Nerve roots are moved away to remove the disc material from the anterior region of the spine.
  • A cage and bone graft is inserted between the vertebrae.
  • Screws and rods are fixed to stabilize the spine.
  • A drain is generally inserted to remove any haematoma.
  • Soft tissues are re-approximated and the incision is closed.

Recovery

Patients who undergo PLIF are generally in hospital for six days. Patients are discharged home when they are getting themselves in and out of bed, pain is controlled, going to the bathroom by them and eating and drinking. At ten to fourteen days post operatively the patients are advised to visit their GP for a wound check.

Follow up is at six weeks post operatively.

Risks and Complications

The complications associated with PLIF surgery include infection, nerve damage, blood clots or blood loss, bowel and bladder problems and problems associated with anaesthesia. The primary risk of spinal fusion surgery is failure of fusion of vertebral bone and bone graft which may require an additional surgery.

Talk to your surgeon if you have concerns regarding PLIF procedure.