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Posterior Lumbar Interbody Fusion (PLIF)


What’s Posterior Lumbar Interbody Fusion (PLIF)?

PLIF surgery aims to join two or more vertebrae together to stop movement between them. PLIF stands for Posterior Lumbar Interbody Fusion, which means that the surgery happens from the back (back) of the lower spine (lumbar spine), removes the intervertebral disc between the vertebrae (intervertebral body) and replaces it with an intervertebral disc filled with bone. PLIF surgery usually treats conditions such as chronic back pain, degenerative disc disease that causes nerve compression, spondylolisthesis, spinal stenosis, and scoliosis

What Conditions Does Posterior Lumbar Interbody Fusion (PLIF) Treat?

Neurosurgeons may recommend Posterior Lumbar Interbody Fusion (PLIF) for individuals with pain, weakness, or trauma from one of the aforementioned conditions. Neurosurgeons usually recommend spinal fusion surgery after when they can identify the source of the pain by performing several imaging tests such as X rays, computerized tomography (CT) scans, and magnetic resonance imaging (MRI) scans. Neurosurgeons also recommend spinal fusion for patients who have the following: Spinal instability, Spondylolisthesis, Scoliosis, Spondylosis, Spinal weakness, Discogenic pain, Vertebral fracture, Kyphosis Posterior rami syndrome, etc. 

How does a Neurosurgeon Perform a PLIF Procedure?

PLIF is a technique employed by the neurosurgeons, when the non-surgical treatment measures are applied. Such measures include; rest and physical therapy if medication fails to reduce the symptoms like pain, numbness and weakness. Or it is an approach used to spinal fusion surgery in which the neurosurgeon access lower spine from the back of the patient’s body. This is done after radiological investigations of the spine. It includes, when neurosurgeon visualizes distance between the spin discs, this can lead to bacterial infection between the spaces. If there is bone spurs or osteophytes bone growth form in the spine. When there is nerve bundles sclerosis occurs when the myelin is damaged. Facet hypertrophy when the cells of the facet proliferate abnormally and rapidly. Lastly, when there is instability of the flexion or extension of the limbs. Occurrence of all this leads to neurosurgeons to say the PLIF procedure is right to be used on the patients 

What are the Possible Risks and Complications of Posterior Lumbar Interbody Fusion (PLIF)?

The main complication that may arise after a Posterior Lumbar Interbody Fusion surgery remains the failure of the vertebral discs to fuse. In the case of an unsuccessful spinal fusion, neurosurgeons may recommend another back surgery to refuse the vertebrae. Failure of the vertebral discs to fuse occurs commonly among patients with a history of previous multiple spinal fusion surgeries or cancer. This complication may also occur among patients with obesity or who smoke. Successful fusion rates for Posterior Lumbar Interbody Fusion surgery reach a value of 90-95%. 

Other complications that may arise after this procedure may include damage to the spinal cord or peripheral nerves, loss of sensory functions, infection, bleeding, and increased back pain.

What Does Recovery from PLIF Surgery Look Like?

 After the procedure, PLIF patients can stay from 2 to 5 days in the hospital to manage their pain, using patient controlled analgesia pumps with opiates such as morphine, and monitor if there are any complications after the procedure such as blood loss. It is also important to inform the patient of how to move safely until the spinal fusion solidifies. For example, keeping the spine aligned to reduce disruption of the healing process. Some activity restrictions include no bending, lifting, twisting or driving. After a week, the patient would have to learn of certain complications that could arise from medication and the surgical site. One of the most important to be aware of is surgical site infection and its cardinal signs such as fever, redness of the incision site, an increasing back pain and an increase in the drainage and changes in its features. Returning to work could be done after 4 to 6 weeks if it does not involve strenuous physical activity or physical dependance. The patient can also start driving or going to school in this period. A physical therapy program targeting effective walking exercises is started typically after 3 months after surgery to enhance patient’s recovery and pain.


Mino, D. E., Munterich, J. E. & Castel, L. D. Lumbar fusion surgery for degenerative conditions is associated with significant resource and narcotic use 2 years postoperatively in the commercially insured: a medical and pharmacy claims study. J. Spine Surg. 3, 141–148 (2017).

Rushton, A. et al. Patient journey following lumbar spinal fusion surgery (FuJourn): A multicentre exploration of the immediate post-operative period using qualitative patient diaries. PLoS One 15, 1–19 (2020).

Park Y, Ha JW. Comparison of one-level posterior lumbar interbody fusion performed with a minimally invasive approach or a traditional open approach. Spine. 2007;32:537–543. doi: 10.1097/01.brs.0000256473.49791.f4.

 Yavin, D. et al. Lumbar fusion for degenerative disease: A systematic review and meta-analysis. Clin. Neurosurg.80, 701–715 (2017).

If You need a Fort Worth Neurosurgeon, Contact Longhorn Brain & Spine Immediately To Get a Consultation.