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Posterior Lumbar Interbody Fusion Plif Surgery
Just like the regular spinal fusion surgery, a posterior lumbar interbody fusion follows an addition of bone graft to a spine area to establish a biological response that allows bone growth among two vertebral elements and hence prevents the movement in that part.
Unlike to posterolateral gutter fusion, the Posterior lumbar fusion (PLIF) receives the spinal fusion in the low back through placement of a cage made from allograft bone or prosthetic material in the disc space. When the surgical approach for this procedure is from the back it is named as posterior lumbar interbody fusion.
Posterior Lumbar Interbody Fusion Procedure
Initially an incision of 3 -6 inch length is made in the center of spine back and the left and right lower back muscles are removed from the lamina on both sides at various levels.
After interacting with spine, the lamina is eliminated to view the nerve roots. The facet joints that are over the nerve roots can be undercut to offer more place for the nerve roots. These roots are retracted to either side to clean the disc space. Then a cage of posterior lumbar interbody is kept into the disc space.
Benefits and drawbacks of PLIF
The posterior lumbar fusion surgery has its own benefits such as offering anterior fusion of the disc space without the need of second incision as performed in anterior/posterior spine fusion procedure. Although, it also comes with few drawbacks such as:
Posterior approach does not allow to remove much of the disc space
Anterior way (front side) allows sufficient area of the disc for increased space for fusion.
A large spinal implant can be placed by anterior method that offers higher stability
Posterior approach becomes more complicated to fix the deformation in case of spinal deformation.
There is a minor but certain risk while placing a cage in a posterior way that will cause retro pulse to back into the canal and develop neural compression.
The posterior lumbar interbody surgery has a major benefit for firm fusion rates as compare to posterolateral fusion rates as the bone is placed in anterior part of the spine. A better fusion occurs through bone insert in anterior portion as it offers larger place as compare to posterolateral gutter and therefore bone is more compressed. A compressed bone recovers more quickly due to its response to stress whilst bone under tension doesn’t recover soon.