Lumbar Interbody Fusion: ALIF PLIF TLIF DLIF

Lumbar Interbody Fusion (LIF) surgery is a surgical technique involving the removal of the damaged intervertebral disc, and the insertion of a bone graft into the disc space created between the two adjoining vertebrae. Bone graft promotes healing and facilitate the fusion. Screws and rods are used to stabilize the spine during the healing process.

Lumbar Interbody Fusion (LIF) surgery may be recommended in patients with degenerative disc disease, spondylolisthesis, and disc herniation. The aim of the surgery is to alleviate back or leg pain and stabilize the spine. An interbody fusion can be performed with different approaches which include:

Anterior Lumbar Interbody Fusion (ALIF): In this technique, the spine is approached from the front by making an incision over the abdomen.

Posterior Lumbar Interbody Fusion (PLIF): Your surgeon gains access to the spinal canal, disc, and nerve roots from the back. In this procedure, the lamina is removed and the facet joints are trimmed to gain access to your spine.

Transforaminal Lumbar Interbody Fusion (TLIF): In this technique, the spine is approached from the side. This allows the surgeon to access the front as well as the back of your spine.

Direct Lateral Interbody Fusion (DLIF): In this approach, the spine is also approached from the side. Using minimally invasive technique, the underlying soft tissues and the psoas muscle are gently separated to reach the intervertebral disc. As the spine is approached through the psoas muscle, DLIF is also known as trans-psoas approach.

Anterior lumbar interbody fusion (ALIF), direct lateral lumbar interbody fusion (DLIF), posterior lumbar interbody fusion (PLIF), and transforaminal lumbar interbody fusion (TLIF) may all be performed using minimally invasive technique. All these procedures are performed under general anesthesia with the assistance of X-ray or fluoroscopic guidance.

Before surgery

Before surgery, your doctor will discuss the type of procedure as well as its associated risks and benefits, with you. You will need to obtain a medical clearance for the surgery from your physician. In addition, your doctor may also recommend a few blood tests, X-rays or other imaging tests to evaluate your medical condition.

After surgery

Following the surgery, you will be shifted to the recovery room and the medical staff will closely monitor your vital signs. Minor discomfort, pain at the incision site, muscle spasms in the neck or back, or other related symptoms may be present after the surgery. You may need to wear a lumbar brace to support the spine during the healing process.

Post-operative care

You will need to keep the incision area clean and dry. Do not swim or use hot tubs. Also avoid driving, smoking, and heavy lifting. You can begin physical therapy as directed by your surgeon. You should take the medications as recommended by your surgeon and also schedule a follow-up with him.

Risks

Infection, bleeding, nerve injury, and problems with anesthesia are the potential risks and complications associated with lumbar interbody fusion (LIF) surgery.

If you develop any signs of infection such as pain, redness, swelling, or alteration in the quantity or smell of the drainage, or fever over 101° F you should immediately call your doctor. Also inform your doctor if you develop bowel and bladder dysfunction or numbness over the genital area.