Lumbar interbody fusion
Lumbar interbody fusion is a common type of lower back surgery where your surgeon may choose to perform a fusion in the space at the front of the spinal column in between the spinal bones (vertebrae) called the interbody space. In these procedures, which can be done from a front (anterior), side (lateral), or back (posterior) approach to the spine, your surgeon will remove degenerated or herniated disc material and replace it with either a piece of donor bone or an implant made of metal or plastic and filled with natural bone material.*
Bone graft may come from your own bone (autograft) or from a donor (allograft). If taken from your own body, this bone is usually taken from the hip area. Your surgeon may also place fixation devices, such as plates, rods and/or screws, in order to help provide stability to the spinal bones until fusion occurs. If successful, spinal fusion typically takes place in the weeks and months following surgery.*
Anterior lumbar interbody fusion (ALIF)
An Anterior Lumbar Interbody Fusion (ALIF) procedure is a type of lumbar spine surgery that surgeons perform through an incision made on the front of the abdomen to remove a damaged, or degenerated intervertebral disc that may be the source of back or leg pain. This procedure is intended to restore or maintain space between the vertebral bodies, relieve pressure and create more room for the spinal nerves. It is called an anterior procedure because the spine is approached from the front of the abdomen and through the belly.
Lateral lumbar interbody fusion (LLIF)
A lateral lumbar interbody fusion, or LLIF, is a less invasive surgical technique that accesses the spine from incisions on the side of the body. This procedure allows the surgeon to avoid separating the low back muscles, cutting bone, or moving aside blood vessels as is required for other minimally invasive spine fusion procedures including posterior (from the back) and anterior (from the front) lumbar spine surgery.1,2 When treating this source of back and leg pain, surgeons remove disc material and replace it with either a piece of donor bone or an implant made of metal or plastic and filled with natural bone material. This is done to help restore proper disc height and help fuse the adjacent vertebrae, restoring stability.
The surgeon will then place fixation devices designed to provide stability to the vertebral segment until fusion occurs. If successful, spinal fusion will typically take place in the weeks and months following surgery and can be assessed by your surgeon on imaging studies (e.g., x-rays) taken during follow-up visits.*
Posterior lumbar interbody fusion (PLIF)
A posterior lumbar interbody fusion, or PLIF is performed through an incision made on the lower back (posterior spine) to remove a damaged or degenerated disc that may be the source of back or leg pain, and replace it with one or two pieces of donor bone or implants made of metal or plastic and filled with natural bone material. Accessing the spine from the back also allows the surgeon to perform a spinal decompression, or removal of bony structures that may be placing pressure on the spinal nerves.
Transforaminal lumbar interbody fusion (TLIF)
A transforaminal lumbar interbody fusion (TLIF), also performed through an incision made on the lower back (posterior spine), utilizes a slightly different angle than a PLIF to remove a damaged or degenerated disc that may be the source of back or leg pain, and replace it with a piece of donor bone or implant made of metal or plastic and filled with natural bone material. Based on your anatomy and the goals of surgery, your surgeon will decide whether a PLIF or TLIF is the best posterior surgery for you.
References:
- Genevay S, Atlas SJ. Lumbar spinal stenosis. Best Pract Res Clin Rheumatol. 2010 Apr;24(2):253-65.
- Mobbs RJ, Phan K, Malham G, Seex K, Rao PJ. Lumbar interbody fusion: techniques, indications and comparison of interbody fusion options including PLIF, TLIF, MI-TLIF, OLIF/ ATP, LLIF and ALIF. J Spine Surg. 2015 Dec;1(1):2-18.
In general, surgical treatment options presented by your surgeon are aimed at relieving pressure on nerve roots in an attempt to address pain.
* The placement of these implants is intended to assist in a healing process called spinal fusion. If successful, spinal fusion will typically take place in the weeks and months following surgery, and can be assessed by your surgeon on imaging studies (e.g. x-rays) taken during follow up visits.
IMPORTANT INFORMATION ABOUT SPINE SURGERY
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The information presented is for educational purposes only. Stryker is not dispensing medical advice. Please speak to your doctor to decide if spinal surgery is right for you. Only your doctor can make the medical judgment regarding which products and treatments are right for your own individual condition.
As with any surgery, spinal surgery carries certain risks. Your surgeon will explain all the possible complications of the surgery, as well as side effects. Each spinal surgery patient will experience a different post-operative activity level, depending on his/her own individual clinical factors. Your doctor will help counsel about how to best maintain your activities in order to recover properly from your surgery. Such activities include not engaging in high-impact activities that could de-stabilize any instrumentation that may have been implanted.
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