Overview and Indications
Posterior lumbar interbody fusion (PLIF) and transforaminal lumbar interbody fusion (TLIF) are two types of spinal fusion procedures that utilize a posterior approach to fuse the lumbar spine bones together using an interbody fusion technique. Interbody fusion means the intervertebral disc is removed and replaced with a bone spacer using a posterior approach in this case. The posterior technique is often favored when one or two spinal levels are being fused in conjunction with a posterior decompression (laminectomy) and use of metal screws/rods. There are two different types of posterior interbody fusion procedures. The traditional PLIF procedure involves placing two small bone graft spacers with gentle retraction of the spinal nerves and neurologic structures with one graft on each side of the interbody space. A newer technique, called a transforaminal lumbar inter body fusion (TLIF) involves placing only one bone graft spacer in the middle of the interbody space without retraction of the spinal nerves.
PLIF and TLIF procedures are commonly performed for a variety of painful spinal conditions, such as spondylolisthesis and degenerative disc disease, among others.
Most patients are usually able to go home three to five days after surgery. Before patients go home, physical therapists and occupational therapists work with patients and instruct them on proper techniques of getting in and out of bed and walking independently. Patients are instructed to avoid bending at the waist, lifting more than five pounds and twisting in the early postoperative period (first two to four weeks) to avoid a strain injury. Patients can gradually begin to bend, twist and lift after four to six weeks as the pain subsides and the back muscles get stronger.
Patients are generally not required to wear a back brace after surgery. Patients may be issued a soft or rigid lumbar corset that can provide additional lumbar support in the early postoperative period, if necessary.