What is a Posterior Spinal Fusion (PLIF)?
As a spine doctor, Dr. Braxton offers posterior spinal fusion (PLIF) for patients suffering from spinal degenerative disease. The goal of this surgery is to improve stability of the vertebrae and spinal bones by creating a strong bone structure between two or more spinal vertebrae. It also increases degenerated disc space to a more anatomically correct structure to help reinforce spinal stability. A posterior lumbar interbody fusion utilizes a biological response to enable bone to grow between the treated area. This growth helps eliminate abnormal or degenerative movement at that segment. PLIF approaches the affected spinal segment from the back of the body, or posterior entry.
What is a Posterior Spinal Fusion Used to Treat?
Dr. Braxton recommends posterior spinal fusion surgery when degenerative conditions do not respond to non-surgical treatment options. Patients with the following conditions may be candidates for the surgery:
- Spinal deformity such as scoliosis or other curvature abnormalities
- Degenerative disc disease
- Spinal or foraminal stenosis
- Disc herniation or bulging
- Spinal instability
- Spinal stenosis
- Radiculopathy
Symptoms for these conditions are typically exacerbated with certain movements such as sitting, which can trigger pain. Twisting, lifting and bending may worsen the pain. In some cases, walking, and even running, can improve pain as can frequent change of body position. Lying down is often most comfortable. General non-motion related pain may also be present. This can include spinal stiffness and radiating pain to the buttocks, pelvis, and thighs.
How is PLIF Performed?
Dr. Braxton conducts the posterior lumbar interbody fusion (PLIF) under general anesthesia. The patient lies on the stomach and the surgery takes place through a back, or posterior, incision. Incision length is dependent on the spinal levels being treated. Access is gained to the spine and the lamina is extracted; this part of the procedure is called a laminectomy. Nerve roots are exposed and facets joints may be minimized to open up more space. Nerve roots are carefully identified to ensure that both sides of the spinal disc can be accessed. Surgical screws and rods are placed to provide further stability during the fusion healing process.
The disc removal, clean-up and repair is then completed so that the disc space has been optimized for the fusion process. Bone graft material and the necessary surgical components are placed in the open space to ensure optimal fusion. Dr. Braxton’s advanced surgical techniques ensure the goal of a vertebrae level that moves as a single unified segment.
What are the Advantages of Posterior Lumbar Interbody Fusion?
The posterior lumbar interbody fusion surgery has several advantages including:
- Decompression of the affected nerve passageways
- Restoration and long term maintenance of disc space
- Benefit of dynamic compression on healing bone
- Optimal bone graft surface area for maximum fusion strength
Posterior spinal fusion surgery generates a higher solid fusion rate because the bone is implanted into the anterior or front position of the spine. The bone placed in the anterior location creates the potential for a stronger fusion, in part due to the greater compression upon the healing bone. This is a unique advantage of the posterior spinal fusion surgery.
What is the Recovery After PLIF Surgery?
Dr. Braxton works closely with post-surgical patients for an optimal recovery. Immediate recovery includes pain management, restored basic functioning and the beginning of prescribed motion. The day after surgery a light walking program may be introduced and patients are taught how to sit, stand, lie down and get up safely. Patients benefit from at-home assistance initially as they regain motion and ability to perform normal daily activities. Pain management should continue as needed. Modified and limited activity should be monitored carefully ensuring no bending, lifting and twisting.
Practice of healthy habits such as adequate sleep, rest, nutrition, avoiding alcohol and nicotine and any activity that is too much, too soon, are important. Some patients may be prescribed to wear a brace; Dr. Braxton will recommend the duration. Driving can tax the back and should be avoided until full recovery. Returning to work will be determined by the progress and should include light duty initially. Attending all post-surgical appointments with Dr. Braxton helps to ensure an optimal recovery and a return to preferred activities and lifestyle as quickly as possible.