What is Posterior Lumbar Interbody Fusion?

Posterior lumbar interbody fusion (PLIF) is a type of spinal fusion surgery. Patients typically undergo this type of surgery to treat a number of back problems that cause them to have pain in their vertebrae. During this procedure, a surgeon usually fuses two adjoining vertebrae together with the use of a bone graft. This procedure has some potential risks, and may not be appropriate for all patients with back problems.

Physicians may recommend a posterior lumbar interbody fusion surgical procedure for some patients with spondylosisthesis, spinal stenosis, or degenerative disc disease. Individuals with scoliosis or a fractured bone in the spine may also receive this type of spinal treatment in some instances. Patients with some types of infections and tumors in the spine may also undergo a posterior lumbar interbody infusion.

In this surgery, the surgeon usually makes an incision 3 to 6 inches (7.62 to 15.24 cm) in length in the midline of a patient's back. Portions of the lower back muscles and other tissues are typically moved away from the spine in order to provide the surgeon with a clear view of the nerve roots in the spine. The surgeon removes the nerve roots and disc material from the disc space where the fusion will take place. Then the surgeon typically implants a graft of bone into the newly opened disc space. The grafted bone normally grows together and fuses with the adjoining bones of the spine after a posterior lumbar interbody fusion.

In some cases, patients may not experience an expected fusion of the vertebrae after surgery, but in most cases the spinal fusion occurs as planned. Patients who are obese, individuals who have had prior back surgeries, and people who received radiation treatment for cancer typically have an increased chance that a graft will not properly fuse with the adjacent vertebrae. Bleeding and infection have occurred after posterior lumbar interbody fusion surgery in some instances.

Most patients go home from the hospital within three to five days after surgery. Patients may receive instructions from a physical therapist to help them with everyday movements of the spine and the body while healing occurs. Individuals may be instructed to avoid twisting, bending at the waist or lifting for four to six weeks after they return home. In many cases, patients resume driving within seven to 14 days after surgery, and they can typically return to work within two to three weeks of surgery. Most back surgery patients return to their physicians for periodic follow up appointments in order to monitor the success of the posterior lumbar interbody fusion.