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An Overview of Posterior Lumbar Decompression and Interbody Fusion

Posterior Lumbar Decompression and Interbody Fusion (PLIF) is an invasive surgical technique whereby a bone graft is inserted into the lower section of the spine between two vertebrae to relieve low back pain. Surgeons have performed the procedure since the 1950’s. Research has proven it to be a safe and efficient choice for treating several conditions, such as lumbar degenerative joint disease, lumbar spondylolisthesis, spinal stenosis, scoliosis, facet syndrome, and certain types of lumbar disk problems.

PLIF surgery begins with the surgeon making a three to six inch cut in the middle of the lower back. The muscles there are separated from an area of the vertebrae called the lamina, at several levels on each side. The lamina is removed, and the vertebrae’s bony protrusions, called facets, are trimmed. Next, the nerve roots are transferred to one side, and the matter in the disk space between the vertebrae is cleaned out. The bone graft is then implanted into the disk space. The graft will grow and fill the space, uniting the vertebrae above and below it. The area will solidify and will end the spinal movement causing the pain.

PLIF can be performed in the L3-S1 region. Benefits of this type of surgical approach include:

  • Compression produced by the upper and lower vertebrae cause the bone graft to heal better
  • Risk of nerve compression is slight
  • Increased area of bone contact helps the bone graft share the load at the front part of the spine

The primary risk with PLIF is that a robust integration will not occur. This risk is present for individuals who have the following conditions:

  • History of spine surgery including multi-level fusion
  • Smoking
  • Obesity
  • History of cancer treated with radiation


If you are experiencing unresolved back pain, and have questions about treatment options, please contact us at either our New Braunfels or Seguin offices.

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