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.