Posterior and anterior lumbar interbody fusion

SummaryPosterior Lumbar Interbody Fusion (PLIF) may be indicated for intractable back pain, as it maintains adequate distraction of the intervertebral space thus relieving pressure on the nerve root. Iliac crest autografts, allografts and porous metallic cages are used.Success rates of above 90% have been reported, but complications due to the operative approach have been described. While biomechanically PLIF is superior to simple disc excision in relieving intractable back pain, the procedure is technically difficult in the presence of scar tissue from previous surgery. A proper understanding of operative principles and appropriate patient selection is essential to achieve good results. As an alternative technique, Anterior Lumbar Interbody Fusion (ALIF) has advocates.