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Posterior Lumbar Interbody Fusion (PLIF)

Overview

What is PLIF?

Posterior Lumbar Interbody Fusion (PLIF) is a surgical procedure designed to treat chronic lower back and leg pain caused by spinal instability or nerve compression. By removing the damaged disc and fusing the affected vertebrae, PLIF provides stability, relieves symptoms, and can help restore mobility.

Who is it for?

PLIF is usually recommended for people with:

  • Chronic leg and lower back pain related to degenerative disc disease, spondylolisthesis, or spinal stenosis
  • Nerve compression not responding to medications, physiotherapy, or injections
  • MRI or CT evidence of disc damage or severe nerve root compression
  • Symptoms such as numbness, weakness, or reduced quality of life affecting daily activities

What the Procedure Involves

PLIF involves several key steps:

  • Under general anaesthesia, a vertical incision is made in the lower back
  • The vertebral bone (lamina) is removed to access the spinal canal and disc space
  • Nerve roots are gently moved aside to expose the damaged intervertebral disc
  • The disc material is removed and the space prepared for fusion
  • Spacers (cages) filled with bone graft are inserted into the disc space to restore height and promote bone healing
  • Screws and rods are attached to stabilise the spine during the fusion process
  • The incision is closed and the patient is monitored in recovery
    Most surgeries take 2–3 hours and may be performed as open or minimally invasive procedures, depending on patient needs.​

Risks and Complications

Important risks to be aware of include:

  • Infection (risk below 1–4%)​
  • Bleeding or blood transfusion
  • Nerve or spinal cord injury (can lead to weakness or numbness)
  • Dural tear (spinal fluid leak)
  • Nonunion (failure of bones to fuse, may require additional surgery)
  • Blood clots in the legs
  • Adjacent segment degeneration (increased wear and tear above or below fused area over time)
  • Persistent pain or neuropathic pain
  • Bowel or bladder problems (rare)
    Your spine surgeon will discuss individual risks and steps to minimise them, tailored to your medical history.​

Recovery Expectations and Duration

Here is what most patients can expect during recovery:

  • Hospital stay is typically 1–4 days, or longer if more levels are treated​
  • Immediate pain control with medications; early walking is encouraged, often within 1–2 days
  • Soft tissues and muscles normally heal over 6–12 weeks​
  • Return to light or desk-based work in 4–8 weeks; heavier duties or sports can take 3–6 months
  • Full bone healing (fusion) can take 6–12 months, with regular follow-ups to monitor progress
  • Driving may be safe from 4–6 weeks after surgery, depending on comfort and pain medications
    It’s important to avoid lifting, twisting, and strenuous activity until cleared by your surgeon. Rehabilitation or physical therapy may be recommended for optimal recovery.​

FAQs

Will my pain be gone straight after surgery?
Many people notice relief from leg and nerve pain soon after PLIF, but back soreness and discomfort may persist for several weeks as tissues heal. Fusion takes several months.

Will my spine be less mobile after PLIF?
The fused spinal segment will not move, but most people retain good mobility in other parts of the back. Some reduction in flexibility is possible, especially if multiple levels are fused.