What is PLIF ?

PLIF or Posterior Lumbar Interbody Fusion is a Posterior Approach based Spinal Fusion Surgery . PLIF is a time tested technique and has proven excellent results in various indications of spinal fusion . Indication of Posterior Lumbar Interbody Fusion;-

• Symptomatic Mechanical instability due to
• Spondylolisthesis (isthmus, degenerative, or postlaminectomy spondylolisthesis)
• Degenerative disc disease, Slip Disc ,
Herniated Disc , Prolapse Intervertebral Disc (PID)
• Complex Spinal Stenosis
• Spinal Trauma/ Spinal Tumor / Spinal Metastasis
• Spinal infection eg Tuberculosis
• Spinal Deformity- Scoliosis or Kyphosis .

Procedure of PLIF :

• Posterior surgical approach – midline incision
• Exposure of Posterolateral Inter transverse Gutter
• Discectomy , Preparation of End Plates with various instruments
• Preparation of Fusion Bed (Bleeding Bone surface is achieved ) – Interbody End plates, Transverse Process , Facet Joints , Laminae are prepared and made raw
• Harvested (Local graft ) bone graftis laid in the inter body area between the bleeding surface of end plates of vertebral bone and in posterolateral portion of the spine.
• INterbody Bony strut or Metallic or PEEK Cage (Spacer filled with graft) is inserted
• Spinal Instrumentation is a part of this surgery
• Closure over drain

Advantages of PLIF :

▪ Simpler, quicker, Easier
▪ High Fusion Rates
▪ Better mechanical alignment and lordosis
▪ Reconstruction is better .
▪ Helps to achieve reduction of Listhesis of vertebrae

Disadvantages Of PLIF :

▪ Nerve root irritation post op due to

► neural oedema
► Epidural Fibrosis
► Arachnoiditis

▪ Bleeding is more
▪ Not possible in higher levels of disc / spine
▪ Difficult in revision surgery cases