Learn About PLIF Cage (Posterior Lumbar Interbody Fusion) Surgery And Its Process

A posterior lumbar interbody fusion called PLIF is a procedure that stops mobility in a specific region of the spine. The lumbar, or lower, spine is treated with a PLIF cage. The L4-L5 or L5-S1 region near the bottom of the lumbar spine is most typically used. This operation may be used to treat lumbar degenerative disc disease, which is characterised by a painful deteriorated disc. It can be done also for lumbar spondylolisthesis, a condition in which one vertebra slides forward over the vertebra below it. A PLIF begins with a three to a six-inch incision in the back’s midline. The erector spinae muscles in the lower back are then peeled off the lamina on both sides and at several levels. The lamina is removed, allowing the nerve roots to be seen.

Posterior Lumbar Interbody Fusion (PLIF) Cage

PLIF (posterior lumbar interbody fusion) is a surgical treatment that involves fusing one or more vertebral segments in the lower spine from behind. A prosthetic cage is frequently implanted to keep the disc space open and help the fusion process. The purpose of lumbar fusion surgery is to remove pressure on the nerve roots that may be causing sciatica discomfort. When all other measures of cautious treatment have failed, the operation is typically reserved. The discs between the vertebrae in the human spine are piled on top of each other. The vertebrae form a central channel that allows the spinal cord and its covering to pass through. The target region is supplied by spinal nerve roots that exit the spinal canal through intervertebral foramina at each level.

plif cage

Posterior Lumbar Interbody Fusion Surgery Description

The spine is first reached by a three- to a six-inch-long incision in the midline of the back, with the left and right lower back muscles on both sides and at numerous levels being peeled off the lamina. The lamina is removed once the spine is approached, allowing a view of the nerve roots. To give the nerve roots more room, the facet joints that are right over them might be undercut (trimmed). After that, the nerve roots are retracted to one side, and the disc area is cleared of the disc material. The disc gap is subsequently filled with an allograft bone cage or posterior lumbar interbody cages with bone graft, and the bone develops from the vertebral body.

PLIF Potential Advantages and Disadvantages

A pure PLIF procedure offers the benefit of providing anterior fusing of the disc space without the need for a second incision, which is required in an anterior/posterior spine fusion procedure. It does, however, have several drawbacks:

  • With a posterior approach, less of the disc space may be removed (from the back).
  • An anterior approach (also known as an ALIF, or anterior lumbar interbody fusion) allows for a significantly more thorough evacuation of the disc space, resulting in an increased surface area accessible for fusing.
  • An anterior technique allows for a bigger spinal implant to be implanted, which gives greater stability.
  • A posterior approach alone is more difficult to minimise the deformity in situations of spinal deformity (e.g. isthmic spondylolisthesis).
  • Inserting a cage posteriorly poses a modest but real danger of it retropulsing back into the canal and causing neurological compression.
Also Read - Know More About The Knee Arthroscopy Implants If You Are Getting The Surgery

PLIF Potential Risks and Complications

The main danger of a PLIF is that a firm fusion will not be achieved (nonunion), necessitating another back surgery to re-fuse the spine. The PLIF should have a fusion rate of 90-95 percent. The complications of a spinal fusion operation include infection and bleeding, in addition to nonunion. These problems are relatively rare (approximately 1 percent to 3 percent occurrence). Furthermore, there is a chance that a successful spine fusion may occur, but the patient’s discomfort would persist.


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