As with all spinal fusion surgery, a posterior lumbar interbody fusion (PLIF) involves adding bone graft to an area of the spine to set up a biological response that causes the bone to grow between the two vertebral elements and thereby stop the motion at that segment.
Unlike the posterolateral gutter fusion, the PLIF achieves spinal fusion in the low back by inserting a cage made of either allograft bone or synthetic material (PEEK or titanium) directly into the disc space. When the surgical approach for this type of procedure is from the back it is called a posterior lumbar interbody fusion (PLIF).
A PLIF fusion is often supplemented by a simultaneous posterolateral spine fusion surgery.
Posterior Lumbar Interbody Fusion Surgery Description
First, the spine is approached through a three-inch to six-inch long incision in the midline of the back and the left and right lower back muscles (erector spinae) are stripped off the lamina on both sides and at multiple levels.
After the spine is approached, the lamina is removed (laminectomy) which allows visualization of the nerve roots. The facet joints, which are directly over the nerve roots may then be undercut (trimmed) to give the nerve roots more room.
The nerve roots are then retracted to one side and the disc space is cleaned of the disc material.
A cage made of allograft bone, or posterior lumbar interbody cages with bone graft, is then inserted into the disc space and the bone grows from vertebral body to vertebral body.