PLIF: Posterior Lumbar Interbody Fusion



PLIF is generally used to treat back or leg pain caused by degenerative disc disease. The surgeon will stabilize the spine by fusing vertebrae together with bone graft material. 


The procedure is performed through a three to six inch incision in the back.


Parts of the vertebral bone need to be removed to get access to the disc.


The damaged disc is partially removed. Some of the disc wall is left behind to help contain the bone graft material.


Bone grafts are placed in the empty disc space, realigning the vertebral bones. This also lifts pressure from pinched nerve roots. The area may also be filled with morselized bone.


The surgeon may implant a series of screws and rods to the back of the spine for additional support. Bone graft is also placed along the sides of the spine.


The morselized bone graft will grow through and around the implants, forming a bone bridge that connects the vertebral bodies above and below. This solid bone bridge is called a fusion.

PLIF spine surgery risks and complications


  • The principal risk of this type of low back surgery is that a solid fusion will not be obtained (nonunion) and further back surgery to re-fuse the spine may be necessary. Fusion rates for a PLIF should be as high as 90-95%. This does not necessarily equate to the “success” of the operation as this is sometimes different for surgeon and patient. It is always useful for both to define what they expect of the operation BEFORE it is done so that this is fully understood from both sides. This is true of any surgical procedure.
  • Nonunion rates are higher for patients who have had prior spine surgery, patients who smoke or are obese, patients who have multiple level fusion surgery, and for patients who have been treated with radiation for cancer.   Not all patients who have a nonunion will need to have another spine fusion procedure. As long as the joint is stable, and the patient's symptoms are better, more back surgery is not necessary.
  • Other than nonunion, the risks of a spinal fusion surgery include infection or bleeding. These complications are fairly uncommon (approximately 1% to 3% occurrence). In addition, there is a risk of achieving a successful spine fusion, but the patient's pain does not subside.