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.

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A more in depth look at the individual steps of this procedure as well as tips for preparing for and recovering from an ALIF.

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.*

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A more in depth look at the individual steps of this procedure as well as tips for preparing for and recovering from an LLIF.

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.

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A more in depth look at the individual steps of this procedure as well as tips for preparing for and recovering from a minimally invasive PLIF.

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.

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A more in depth look at the individual steps of this procedure as well as tips for preparing for and recovering from a TLIF.

how to prepare for surgery
recovery
References:
  1. Genevay S, Atlas SJ. Lumbar spinal stenosis. Best Pract Res Clin Rheumatol. 2010 Apr;24(2):253-65.
  2. 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.
Important information

IMPORTANT INFORMATION ABOUT SPINE SURGERY

Some of the images on this website depict Stryker’s or VB Spine's products. Please speak to your doctor if you have questions about these products or anything else on this website.

Spine surgery is intended for use in individuals with the following acute and chronic instabilities or deformities of the spine: degenerative disc disease, spondylolisthesis (slipped vertebra), trauma (fracture or dislocation), spinal stenosis (narrowed space for spinal cord or spinal nerves), curvatures (scoliosis, hyperkyphosis, and/or hyperlordosis), tumor, or pseudarthrosis (failed previous spinal surgery).

Spine surgery is not appropriate for patients with any abnormality present which affects the normal process of bone remodeling (bone rebuilding) including, but not limited to, osteoporosis or osteopenia (reduced bone density), bone absorption, certain types of tumors, certain types of infections, or certain metabolic disorders; insufficient quality or quantity of bone; previous history of infection; certain types of inflammation; open wounds; a patient being overweight or obese; inadequate tissue coverage; pregnancy; a condition of senility, mental illness, or substance abuse; foreign body sensitivity (where material sensitivity is suspected); or other medical or surgical condition(s) which would preclude the potential benefit of spinal implant surgery, including, but not limited to, the presence of tumors, congenital abnormalities (birth defects) or abnormalities in red or white blood cell count.

Like any surgery, spine surgery has serious risks which include, but are not limited to, damage of the spinal cord or spinal nerves; neurological damage (damage to the nervous system); peripheral neuropathies (including pain, numbness, tingling, and/or weakness); neurovascular compromise (including loss of bowel or bladder function, or foot-drop); vascular damage; vascular disorders including thrombosis (non-moving blood clots); visceral damage (damage to organs); genitourinary disorders including kidney malfunction or failure; gastrointestinal disorders (disorders of the digestive system); bronchopulmonary disorders (disorders related to the airways or lungs) including emboli (moving blood clots); soft tissue damage; heterotopic bone formation (abnormal bone growth); bursitis (joint inflammation); heart attack; hemorrhage (blood loss); infection; delayed recovery; pain; paralysis or death.

Implant-related risks, which may lead to a revision of the device(s) include, but are not limited to, damage of the spinal cord, spinal nerves or blood vessels; fracture, fissure or perforation of the spine; wrong vertebrae (spinal bones) fused; bending, disassembly, loosening or fracture of the device(s); delay in or failure to fuse (heal); decrease in bone density; pain; discomfort; abnormal sensations; pressure on skin from components with inadequate tissue coverage, with potential extrusion through the skin; dural (spinal fluid) leak; or loss of proper spinal curvature, correction, height and/or reduction. Spinal implants may not provide the same feeling or performance characteristics experienced with a normal healthy spine. This list may not be comprehensive and/or applicable to every patient. Always speak with your doctor about the risks associated with your specific implant and procedure.

The information presented is for educational purposes only. Speak to your doctor to decide if spine surgery is appropriate for you. Your surgeon will explain all the possible complications of the surgery, as well as side effects. Each spinal surgery patient will experience a different postoperative 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. It is important to closely follow your doctor’s instructions regarding post-surgery activity, treatment and follow-up care. Ask your doctor if spine surgery is right for you.

Stryker Corporation or its divisions or other corporate affiliated entities own, use or have applied for the following trademarks or service marks: AccuStop, Mako, SmartRobotics, Stryker. All other trademarks are trademarks of their respective owners or holders.

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