A posterior lumbar interbody fusion surgery (PLIF) may reduce your pain from degenerative disc disease or lumbar spondylolisthesis. Our video walk-through can help you visualize how this procedure is performed:
To begin the procedure, your surgeon will make a 3-to 6-inch incision in the midline of your back (shown above as a thin purple line).
Your surgeon will then lift the muscles off of your lamina (the roof of your spinal canal).
Your nerve roots are exposed as a result of removing the lamina. At this time, your surgeon may trim your facet joints to reduce any pressure on your nerve roots.
Next, your surgeon will retract your 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 (called a cage) into the disc space. The purpose of the implant is to restore normal spacing between your vertebrae, which will alleviate pressure on your nerve roots.
Beginning the fusion
Next, bone graft is placed in the cage and along the sides of your spine.
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 (located along the back of your hip). In some cases, synthetic bone graft options or bone removed from a laminectomy may also be used.
To add additional support, your surgeon may add a series of rods and screws to the back of your spine. And a simultaneous posterolateral spine fusion surgery may be done to supplement the PLIF.
PLIF risks and complications
PLIF fusions rates should be as high as 90% to 95%, but the following risks and complications are associated with the surgery:
- Nonunion. The main risk associated with a PLIF is that a solid fusion will not be obtained, which in turn requires an additional surgery. Nonunion rates are higher for people who smoke, are obese, or have been treated with radiation for cancer.
- Infection and/or bleeding. Roughly 1% to 3% of people will experience infection and/or bleeding as a result of PLIF surgery.
More on the dangers of smoking after surgery
Nicotine is a bone toxin, which inhibits bone-growing cells (osteoblasts). If you have any form of nicotine after spine fusion surgery—especially right after surgery—it becomes more difficult for your body to grow the bone needed for a fusion.
The risk of a non-healing fusion is 3 times more likely if nicotine is used after surgery, and it may make your pain medication less effective.