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Posterior Lumbar Interbody Fusion (PLIF)

What is a posterior lumbar interbody fusion (PLIF)?

Posterior lumbar interbody fusion (PLIF) is a surgical procedure available at NeuroSpine Plus that offers relief from lower back and leg pain. This technique involves removing a damaged spinal disc and fusing the pain-generating segment of the spine, which consists of two adjacent vertebrae and the disc space between them. Utilizing interbody spacers (cage), screws, and rods, the fused segment is stabilized.

At NeuroSpine Plus, our experienced surgeons can perform PLIF surgery using a single incision along the middle of the patient’s back or through two smaller, minimally invasive incisions. PLIF effectively relieves pressure on compressed nerves and eliminates unwanted spinal segment motion, resulting in significant pain reduction.

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What conditions are treated using a posterior lumbar interbody fusion (PLIF)?

Posterior Lumbar Interbody Fusion (PLIF) is an effective treatment option for various prevalent conditions causing low back pain and/or radiating leg pain. A posterior lumbar interbody fusion may be recommended if you have:

  • Debilitating spinal pain
  • Spinal nerve compression
  • Myelopathy
  • Spinal stenosis
  • Radiculopathy
  • Leg weakness
  • Leg pain
  • Sciatica
  • Herniated disc
  • Prior lumbar fusion
  • Neurogenic claudication 
  • Spondylolisthesis

 With our expertise, we prioritize delivering personalized care tailored to each patient’s unique needs.

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How is a posterior lumbar interbody fusion (PLIF) performed?

On the day of surgery, you will be given general anesthesia by a trained anesthesiologist. You will be completely asleep before the procedure begins. Exact surgical details may vary from what is outlined below depending on multiple factors including your past medical and surgical history, preoperative imaging findings, and the complexity of your individualized procedure. During PLIF surgery at NeuroSpine Plus, our neurosurgeons will perform the following steps to address your condition:

  1. An incision is made on the lumbar spine at the site of your planned surgery.
  2. With gentle surgical dissection and retraction, a pathway is created to expose the spine.
  3. The degenerated disc(s) are removed with specialized instrumentation and the affected nerve roots are freed from any bone spurs or compressing disc fragments.
  4. A surgical disc spacer (“interbody”/ “cage”) may be inserted into the space where your compromised disc used to be.
  5. Titanium screws are placed above and below the disc space(s) to provide stability.
  6. Titanium rods are then used to connect screw heads and locked into place.
  7. The incision(s) will be closed with multiple layers of dissolvable sutures and covered with a dry, sterile dressing
  8. You will likely have a small surgical drain exiting from below your incision. This is to empty any blood remaining from your procedure. It will be removed prior to your discharge.

 

If advised by your surgeon, you will wear a supportive lumbar brace following surgery. Over time, the levels operated on will ‘fuse’, or grow together, like one continuous bony structure. At NeuroSpine Plus, our team is committed to providing you with exceptional care and personalized surgical solutions.

What to expect following a posterior lumbar interbody fusion (PLIF)

Your postoperative healing progress will be closely overseen by our team of providers, ensuring a routine recovery. A member of our team will contact you within the first 48 hours of your procedure to monitor your progress. Your initial post operative appointment will be scheduled within two weeks of your surgical date. A member of our team is always available to answer questions or address your concerns during your recovery period. General postoperative recommendations include, but are not limited to the following:

  • Use of postoperative pain medications as prescribed

  • Over-the-counter Tylenol for pain

  • Advance your diet as tolerated as discussed with your team; ensure regular bowel movements.

  • Avoid bending/twisting/ lifting 

  • Do not lift greater than 10 pounds

  • Do not smoke

  • Do not drink alcohol

  • Attend all scheduled follow-up appointments

  • Do not use NSAIDs until cleared by your surgeon (Advil, Ibuprofen, Motrin, Aleve, etc)

  • Incision care includes washing your incision with gentle antibacterial soap 48 hours after your procedure. No scrubbing, submerging, or soaking the incision(s). No lotions, creams, oils, or ointments atop the incision(s).

You will likely stay at least one night in the hospital following your surgery. You may be fitted for a lumbar brace either before your surgery, or immediately following your surgery. You may begin walking with assistance the night of surgery. A representative of the surgical team will see you each day of your hospital stay to monitor your care ensuring your pain is well-controlled and you are healing properly. The drain exiting from below the incision will be removed once it has been determined safe to do so by the provider. Discharge is dependent on the clearances from either physical therapy, occupational therapy, internal medicine, neurosurgery, and consulted specialists and/or all of the above. At NeuroSpine Plus, we encourage an active recovery, with many patients walking up to two miles within the first two weeks following their procedure. It is common for patients to experience lower back soreness for two to four weeks after the procedure. Our specialized minimally invasive PLIF technique can help mitigate soreness and enable an earlier return to activities due to the reduced muscle dissection involved.

When to contact your doctor's office following a Posterior Lumbar Interbody Fusion surgery

If you have concerns during your postoperative period to include, but not limited to the following: 

  • High fever greater than 100.4F
  • Change in urinary or bowel habits
  • Swelling or discoloration of one or both calves
  • Shortness of breath
  • Chest pain
  • Palpitations
  • Lightheadedness
  • Incisional compromise
  • Loss of strength in your arms or legs

If you have a question regarding your initial postoperative period, a member of our team is always available to answer and address your concerns at 201-399-3388.

Posterior lumbar interbody fusion (PLIF) FAQs:

Depending on the complexity of your planned procedure, PLIF surgery performed by our team of specialists at NeuroSpine Plus typically takes two to three hours.

The timing for beginning postoperative physical therapy sessions will depend on your specific physical condition and the expert judgment of your neurosurgeon at NeuroSpine Plus. Your postoperative period is monitored closely by our team, ensuring a routine recovery and resolution of your discomfort. Physical therapy is often recommended several weeks following your PLIF surgery, as it aids in pain reduction, inflammation control, and strengthening of the back muscles, facilitating a progressive recovery. 

All surgical procedures have an inherent level of risk associated with them. With the PLIF procedure performed by our board-certified neurosurgeons, the risks are rare. All risks and benefits associated with undergoing any surgery at NeuroSpine Plus are discussed at length with our board-certified neurosurgeons prior to proceeding with your procedure. 

If you believe you may be a candidate for a PLIF procedure, call our office today to book your consultation at 201-399-3388.

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