POSTERIOR LUMBAR INTERBODY FUSION (PLIF) and TRANSFORAMINAL LUMBAR INTERBODY FUSION (TLIF)
Spinal fusion is a surgical procedure used to correct problems with the small bones in the spine (vertebrae). It is essentially a “welding” process. The basic idea is to fuse together the painful vertebrae so that they heal into a single, solid bone.
One method of fusing the lumbar spine involves removing the intervertebral disc. When the disc space has been cleared out, a metal, plastic, or bone spacer is implanted between the two adjoining vertebrae.
These spacers, or “cages”, usually contain bone graft material. This promotes bone healing and facilitates the fusion. After the cage is inserted, surgeons often use metal screws, plates, and rods to further stabilize the spine.
An interbody fusion can be performed using a variety of different approaches:
Posterior lumbar interbody fusion (PLIF). A spacer may be inserted from the back of the spine. With this approach, your surgeon gains access to your spine by removing the bone (lamina) and retracting the nerves. Then the back of the disc can be removed and a spacer inserted.
Transforaminal lumbar interbody fusion (TLIF). With this technique, the surgeon approaches the spine a little bit from the side. This requires less movement of the nerve roots. More recently, it has even been possible to take a direct side approach and center the incision over the patient’s flank. With this approach, the surgeon can reach the disc without moving the nerves and opening the back muscles (AAOS, 2015).