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.
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
In this procedure the surgeon makes a small incision in the lower back over the vertebrae to be treated. The size of the incision depends on the bone graft to be used. The surgeon dilates the surrounding muscles of the spine to access the section of the spine to be stabilized. The lamina/roof of the vertebrae is removed to visualize the nerve roots. The facet joints that are directly over the nerve roots are trimmed to provide the nerve roots with more space.
To place the bone graft, the nerve roots are shifted to one side and disc material is removed from the front (anterior aspect) of the spine. Now the bone graft is implemented into the disc space. Screws and rods are used to stabilize the spine for better healing and fusion. After the completion of the procedure, the incision is closed leaving behind a minimal scar. The main goal of the procedure is to re-establish the spinal stability.
This minimally invasive procedure typically permits most of the patients to be discharged the day after surgery but some patients may require a longer hospitalization. Most of the patients observe immediate improvement of some or all of their symptoms but sometimes the improvement of the symptoms may be gradual. Contribution of a positive approach, realistic expectations and compliance with your doctor’s post-surgical instructions help bring a satisfactory outcome of the surgical procedure. Most patients can resume their regular activities within several weeks.
The complications associated with PLIF surgery include infection, nerve damage, blood clots or blood loss, bowel and bladder problems and problems associated with anesthesia. 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.