Posterior Lumbar Fusion (PLIF)

A posterior lumbar fusion (PLIF) is a technique used in spinal fusion surgery. As with all spinal fusion surgery, the procedure involves inserting bone graft to a damaged area of the spine to set up a biological response that causes bone to grow between two vertebral segments. 

To begin the procedure, the spine is first approached through a three-inch to six-inch long incision in the midline of the back. The left and right lower back muscles are retracted from the lamina, and the lamina is removed (when performed individually, this procedure is called a laminectomy) to allow for visualization of the nerve roots. The facet joints, which are located directly over the nerve roots, may be trimmed slightly to give the nerve roots more to heal. The disc space is then cleaned of all disc material. A cage made of allograft bone is inserted into the disc space and the bone will fuse and grow from vertebral body to vertebral body. 

The advantage of PLIF surgery is the one singular incision needed to reach the disc space; an anterior/posterior spinal fusion requires a second incision. This technique also has higher potential for a solid fusion. Bone in the anterior portion fuses better because there is more surface area in the posterolateral gutter. The bone is also under compression, and bone in compression generally heals more quickly as the bone responds to stress.