Posterior Lumbar Interbody Fusion Surgery

Posterior lumbar interbody fusion (PLIF) is a surgical technique used to remove a damaged disc in your spinal column and fill the resulting gap with material called a bone graft. This graft fuses to existing bone in your spinal column and helps keep your spine structurally sound.

Basics of the Procedure

PLIF is just one of several forms of interbody fusion used in the surgical treatment of certain back problems. Like all other interbody procedures, it gets its name from the fact that bone graft material is placed in between the main bodies of the spinal bones (vertebrae) that sit above and below the surgical site. Through a natural healing reaction in your body, this graft—which can be made from a variety of substances, including bone from your hip, bone from a preserved cadaver or manmade materials—will gradually encourage the formation of new bone that will ultimately fuse to your vertebrae and take the place of your damaged spinal disc.

As the name of the procedure suggests, in posterior lumbar interbody fusion, your surgeon will approach your spinal column from the rear (posterior) portion of your body. After making a three- to six-inch incision down the middle of your back, he will access the vertebra associated with your damaged spinal disc by pulling aside the muscles that cover this segment of your spine. In order to reach the disc, he will then cut out a portion of the targeted bone called the lamina, which helps form the rear wall of your spinal canal. He will also shave back joints on the rear section of your vertebra called facet joints.

Next, your surgeon will remove the damaged disc, then use specialized instruments to temporarily keep the resulting space in your spinal column open. After carefully measuring this space, he will fill this space with just enough bone graft material to maintain the overall height of your spinal column. In most cases, your surgeon will then temporarily support the graft with small metal rods anchored in the vertebrae above and below the surgical site.

Uses and Benefits of the Procedure

Your surgeon may recommend posterior lumbar interbody fusion to address a variety of serious back problems, including a condition called degenerative disc disease, significant spinal deformity or instability, a form of spinal bone slippage called spondylolisthesis and prior unsuccessful spinal fusion. When compared to fusion procedures that place bone grafts at the rear of the spinal column, PLIF produces more consistently positive results. In part, these results stem from the wide surface area that interbody fusion provides for successful bone grafting. In addition, compression of the graft material by the rest of your spinal column promotes fusion by increasing your body’s natural healing response.

Risks of the Procedure

Potential risks associated with posterior lumbar interbody fusion include damage to nearby blood vessels or nerves, damage to nearby muscles or ligaments, uncontrolled bleeding, infection, loss of normal sensation in your legs, unwanted shifting of the bone graft into your spinal canal, lack of adequate bone graft fusion, unusual weakness in the muscles of your feet and damage to the membrane that protects your spinal cord. When compared to another form of posterior fusion, known as transforaminal lumbar interbody fusion (TLIF), has a higher rate of significant surgical complications.