PLIF

PLIF ( posterior lumbar interbody fusion ) is a surgical technique for fusing lumbar vertebrae by removing the intervertebral disc and replacing it with a (titanium) cage . Then the vertebrae are stabilized by an internal fixator (transpedicular instrumented dorsal WK fusion). PLIF is a stiffening operation on the spine (spinal fusion ).

In contrast to the ALIF ( anterior lumbar intervertebral fusion ), this operation is performed posteriorly , i.e. from behind. A surgical variant of the PLIF is the TLIF ("transforaminal lumbar interbody fusion").

principle

Interbody (= between the vertebral bodies) fusion through bone (autologous or homologous) or bone substitutes (e.g. tricalcium phosphate bones without "soft PLIF") or with cages (made of titanium, PEEK, carbon ...). Mostly with additional stabilization (pedicle screws, translaminar screws, facet screw connections or interference screws in the facets). The most common fusion technique around the turn of the 20th - 21st centuries.

Surgical technology

Posterior approach, nucleotomy and nuclectomy , laminectomy and facetectomy . Then insert the cage filled with autologous bone, 2 per segment. There is a risk of injury to the dural sac and the nerve root
As a special form TLIF, Transforaminal interbody lumbar fusion, in which the intervertebral disc is exposed from the side and only a partial facetectomy is performed. The disadvantage is the increased risk of nerve root injury.

Both methods show a high rate of pseudoarthrosis without additional dorsal instrumentation .

literature

Andreas B. Imhoff, René Baumgartner, Ralf D. Linke: Orthopedic checklist. Thieme, Stuttgart 2006, ISBN 3-13-142281-5 .