Posterior Lumbar Interbody Fusion, abbreviated PLIF, is a type of lumbar spine surgery that combines one or more interbody devices (such as a cage) with bone graft to stimulate bony fusion. The term bony fusion means new bone grows to join two or more vertebrae together. While interbody devices are used to fill the disc space after discectomy (or microdiscectomy), other spinal instrumentation may be included to increase spinal stability. Spinal instrumentation generally refers to different types of plates, rods, and screws that secure or fix the spine in position.

Depending on your spinal disorder, the number of levels to be treated and other factors, surgery may be performed as an open approach or minimally invasive surgery (MIS). An open approach requires a long(er) incision and cutting through muscle and other soft tissues to gain access to the intervertebral disc(s). Minimally invasive surgery uses smaller incisions (some puncture-like) and specialized equipment to gently separate muscle and soft tissue. Your surgeon will explain what your surgical procedure may involve and the intended benefits and possible risks and complications.

PLIF Procedure

The procedure is performed using image guidance and involves a laminotomy or laminectomy. The laminae are two flat bony plates on the posterior portion of the spine that forms part of the ring of bone surrounding the spinal cord. Laminotomy is a partial removal of the spine's laminae. Laminectomy is the complete removal of the lamina.

Laminotomy or laminectomy is performed to access the spinal cord, nerve roots, ligament, and disc. Both procedures decompress or remove pressure from the spinal cord and/or nerve roots. During laminectomy and discectomy, the facet joints may be removed to further decompress the spine and to create space for the interbody device(s).

After discectomy, one or two interbody devices (such as cages) are filled with bone graft and implanted in the empty disc space. More bone graft is packed around the interbody device. PLIF involves posterior fusion, rods and pedicle screws to provide spinal support and stability.

Potential benefits, risks, and complications

• PLIF is the preferred approach when performed in conjunction with a laminectomy.
• PLIF can be performed as a minimally invasive procedure using two or more (depending on the number of levels to be treated) small incisions.
• In an open procedure, spinal muscles and ligaments are cut. It takes longer to recover and heal from open surgery.
• PLIF requires retraction of the nerve roots, which increases the risk of nerve damage.

We Can Help You Make Informed Decisions

Spine surgery is an important decision. While the final decision is yours, the benefits, potential risks and complications require careful consideration. We look forward to answering your questions and helping you to resolve your concerns about any treatment offered by Piedmont Spine Center.