A Visual Guide to Posterior Lumbar Interbody Fusion (PLIF)

A PLIF is a type of fusion surgery that may be done with the goal of reducing or stopping pain from degenerative disc disease or from lumbar spondylolisthesis. In a PLIF, implants and bone graft are used to set up the conditions for two vertebral segments to fuse together, stopping the motion of the segment.

See Posterior Lumbar Interbody Fusion (PLIF) Surgery

Posterior Lumbar Interbody Fusion (PLIF) VideoThe goal of a PLIF is to reduce pain from DDD or lumbar spondylolisthesis. Watch: Posterior Lumbar Interbody Fusion (PLIF) Video

The following visual walk-through and video present an illustrated overview of how a PLIF is done.

PLIF visual walkthrough

The the lumbar, or lower, spine is the area shown here in purple. A PLIF is most commonly done in the L4-L5 or L5-S1 segment in this area of the lumbar spine.

See Lumbar Spine Anatomy and Pain

To start the procedure, your surgeon will make a 3 to 6 inch long incision in the midline of your back, shown here as a thin purple line.

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Next, your surgeon will lift the muscles (depicted here in purple) off of the lamina, or roof of your spinal canal.

The nerve roots are exposed by removing the lamina. At this time, your surgeon may trim the facet joints, which are directly over the nerve root, to reduce pressure on the nerve roots.

Next, your surgeon will retract the nerve roots to one side, and clear the disc space of disc material.

See Spinal Discs

Once the disc space is cleared, your surgeon will insert an implant into the disc space. The purpose of the implant is to restore normal spacing between the vertebrae, which will alleviate pressure on the nerve roots.

See Interbody Cages for Spine Fusion

Next, bone graft is placed inside of, and alongside, the implant the sides of the spine and in the cage.

If your own bone is used in the bone graft, your surgeon will perform an additional surgical procedure to harvest bone from your iliac crest, along the back of your hip. It's also possible to use bone synthetic bone graft and/or other sources.

See Bone Graft Options for Spine Fusion

To add additional support, your surgeon may add a series of rods and screws to the back of the spine.

A simultaneous posterolateral spine fusion surgery may be done to supplement the PLIF.

A PLIF may be done as an open surgery, described here, or it may sometimes be done through a tube in a minimally invasive

Learn more:

Postoperative Care for Spinal Fusion Surgery

Spine Fusion Risks and Complications

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