Jason E. Smith MD
Spine Surgeon with Baton Rouge Orthopaedic Clinic
Call Us: 225-924-2424
Posterior lumbar interbody fusion (PLIF) is a type of spine surgery that involves approaching the spine from the back (posterior) of the body to place bone graft material between two adjacent vertebrae (interbody) to promote bone growth that joins together, or “fuses,” the two structures. The bone graft material acts as a bridge, or scaffold, on which new bone can grow. The ultimate goal of the procedure is to restore spinal stability.
Why Do I Need This Procedure?
A spinal fusion procedure such as a PLIF may be recommended as a surgical treatment option for patients with a condition causing spinal instability in their lower back, such as degenerative disc disease, spondylolisthesis or spinal stenosis, that has not responded to conservative treatment measures (rest, physical therapy or medication). The symptoms of lumbar spinal instability may include pain, numbness and/or muscle weakness in the low back, hips, legs, and feet.
Your surgeon will take a number of factors into consideration before recommending a PLIF, including the condition to be treated, your age, health and lifestyle and your anticipated level of activity following surgery.
How is this procedure Performed?
First, a small incision in the skin of your back over the vertebra(e) to be treated.
The muscles surrounding the spine will then be dissected to allow access to the section of spine to be stabilized. After the spine is accessed, the lamina (the “roof” of the vertebra) is removed to allow visualization of the nerve roots. The facet joints, which are directly over the nerve roots, may be trimmed to give the nerve roots more room.
Bone Graft Placement
The nerve roots are then moved to one side and disc material is removed from the intervertebral space. Bone graft is then inserted into the disc space. Screws and rods are inserted to stabilize the spine while the treated area heals and fusion occurs.
The incision is then closed which typically leaves behind only a small scar.
How Long Will It Take Me To Recover?
After this surgery usually a 2 to 3 day hospitalization is required. Many patients will notice immediate improvement of some or all of their symptoms; other symptoms may improve more gradually.
Many patients are able to return to their regular activities within 12 weeks.
A typical post-op course consists of walking only for the first 6 weeks. No bending/twisting/lifting over 10 lbs.
Once Xrays are obtained at the 6 week appointment, physical therapy for passive range of motion is started.
At your 3 month appointment Xrays are obtained and core strengthening with physical therapy is begun. This therapy varies in time anywhere from 4 weeks to a few months. The determining factor has a lot to do with your pre-op physical condition. At this point all restrictions are usually lifted.
At 6 months Xrays are obtained.
Are There Any Potential Risks Or Complications?
All treatment and outcome results are specific to the individual patient. Results may vary. Complications such as infection, nerve damage, blood clots, blood loss and bowel and bladder problems, along with complications associated with anesthesia, are some of the potential risks of spinal surgery. A potential risk inherent to spinal fusion is failure of the vertebral bone and graft to properly fuse, a condition that may require additional surgery.
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