What Is Spinal Fusion?
Chronic lower back pain is often due to an underlying lumbar spine condition. Conditions like spinal stenosis, a herniated disc, or spondylolisthesis can cause severe nerve pain and discomfort. A spinal surgeon may suggest posterior lumbar interbody fusion if conservative treatment fails. Spinal surgery raises several questions and concerns. Understanding what happens can help patients be more prepared and have a smooth surgery.
Posterior lumbar interbody fusion (PLIF) aims to create one solid bone in the lower spine to eliminate pain and stiffness. The surgery removes a damaged disc and any nearby bone, then inserts material in the vacant space. The material triggers a biological response, allowing bone to grow between 2 vertebral elements. In addition, the new fused bone stops the motion, reducing nerve irritation. PLIF is done by inserting a cage made of allograft bone or synthetic material into the disc space.
How is it done?
With PLIF surgery, the surgeon makes minimally invasive incisions on the patient’s back to access the spine. Before then, the patient assumes a face-down position, and an anesthesiologist will administer general anesthesia. The surgeon will make 2 incisions and retract the paraspinal muscles, or the muscles access the spine. Afterward, the surgeon will remove any abnormal bone or disc material and install a disc cage between the vertebral bodies. The enclosure contains a bone graft or synthetic material. Screws and rods will then hold the cage and bones in place. The surgeon ends the procedure by repositioning any muscles and tissue before closing the incisions.
Prepping for surgery
A successful PLIF requires the patient to take added steps to prepare the body and mind for surgery. The surgeon will recommend additional tasks to limit complications and improve the outcomes. For instance, patients should stop smoking to improve postoperative healing. Discontinuing supplements and medication like aspirin can prevent excess blood loss. Doctors will also suggest a healthy diet and simple exercises several weeks before surgery to help with recovery. PLIF can limit movement, especially in the first 2 weeks post-surgery. Make sure to prepare the house and any facilities at home in advance for easier use.
Potential risks and complications
Studies show that PLIF rate as high success rates. However, there is still a risk that the spine will not obtain solid fusion, called non-union. Patients at higher risk for non-union include those with prior spine surgery, smokers, obesity, and previous radiation therapy for cancer. While rare, other possible complications of PLIF are infection, nerve damage, and bleeding.
Your recovery period
Because the surgical team uses minimally invasive techniques, the patient can leave the same day. Patients must combine rest, pain management, and physical therapy to get back to regular activity. This process can take up to 3 months. Patients should not drive, perform office or manual labor during the initial stages, or play sports. Only after the doctor confirms the fusion, which can take 3-6 months, can a patient return to everyday activities. However, the bone needs to mature and solidify for 12-18 months.
Information is power
PLIF is a type of spinal fusion surgery with a long recovery timeline that can seem complicated. Therefore, patients should get as much information about the surgery as possible before proceeding. The surgery removes damaged discs and bones, allowing the bones to fuse into one piece. Patients should be prepared before and after surgery. Asking the right questions can improve the chances of a smooth procedure.