A Laminectomy is performed to free up nerves and identify the degenerate disc. The disc is then removed and a cage inserted for stability followed by pedicle screws.
Posterior Lumbar Interbody Fusion is a surgical procedure aimed to treat back or leg pain originated by degenerative disc disease. Our surgeons at the Harley Street Hospital will make your spine stable by fusing vertebrae together with bone graft material.
Before this type of surgery, the doctor utilizes magnetic resonance imaging (MRI) and Computerized Axial Tomography (CAT) to determine what size of implant is required for the patient.
Lumbar Fusion can help to eradicate back pain caused by a degenerate disc or spinal instability. There are many ways of doing a lumbar fusion. The PLIF technique is one of the most traditional procedures. Our surgeons use minimally invasive techniques of lumbar fusion.
Preparation of disk space:
Taking into account the number of levels which will be merged, a 2 inch incision is performed in the patient´s back and then the spinal muscles are separated to be able to access to the vertebral disc. Right after that, the specialist patiently removes the lamina (this step is called laminectomy) so the surgeon is capable to see and get into the nerve roots. The facet joints, which are placed right on the nerve roots, may be cut in order to enable more space for the nerve roots.
The surgeon eliminates the damaged disc, the surrounding tissue and then disposes the bony surfaces of the contiguous vertebrae for fusion.
When the disc space is settled, a bone graft, allograft or BMP with a cage (which is a biomechanical spacer implant) is put into the disc space in order to foster fusion among the vertebrae.
The implant (cage) may be composed of bone, metal, carbon fiber or other material. Additional supplies (like rods or screws) will also be applied at this time to further stabilize the spine. We do not advise this procedure without applying fixation because of serious complications.
It is important to mention that the bone graft will grow through and around the implants, allowing the formation of a bone bridge that joins the vertebral bodies above and below. The solid bony bridge is what we know as a fusion.
Lumbar Fusion exercises
We recommend core strengthening exercises such as Pilates or the Alexander technique. Neural mobilisations are also useful to keep the nerve roots mobile.
You can usually start these exercises 2 weeks after surgery.
PLIF vs TLIF
Both techniques aim to stabilise the lumbar spine. We generally recommend using the TLIF technique as it avoids the need for a laminectomy which can cause unnecessary complications. A TLIF fusion (Transforaminal Interbody Fusion) is far less invasive.
Orthopedic spine surgeons at the Harley Street Hospital are well trained for posterior lumbar interbody fusion surgery and have performed this advanced surgical procedure to help many patients relieve long-term chronic and acute low back pain.
At Harley Street Hospital, we have the best doctors to perform PLIF. Book a consultation to get a specialist´s opinion.