Posterior Lumbar


Learn About Posterior Interbody Surgery

Posterior Lumbar Interbody Fusion (PLIF)

In a PLIF surgery, the patient lays face down to access the spine. The surgeon removes disc material to prepare the disc space for the interbody. Two devices (likely straight interbodies in either PEEK or 3D printed titanium alloy) are implanted side-by-side on either side of the spine. Pedicle screws are placed to help stabilize the spine. Traditional open incision or minimally invasive approach may be used.

Transforaminal Lumbar Interbody Fusion (TLIF)

The TLIF surgery resembles the PLIF technique, but it allows the insertion of one implant (likely a curved interbody in either PEEK or 3D printed titanium alloy). It can be performed through traditional open incision or minimally invasive approach. TLIF procedures can be in tandem with minimally invasive screw systems.

Video Overview

Common Causes and Symptoms

Spondylolisthesis or Retrolisthesis

Spondylolisthesis causes the forward motion (or slip) of one vertebral body over the one below it. This can be caused by a traumatic accident or from DDD. Retrolisthesis can also cause DDD, which is a vertebral body slipping backward.

Degenerative Disc Disease (DDD)

DDD can be attributed to age and general wear and tear that shows as herniated discs or osteophytes (bone spurs). These can collapse and press the nerve roots and/or spinal cord. In the lumbar spine, it often occurs due to weight, gravity, or lifting as this area carries 80% of body weight when standing.


Depending on the issue, a posterior lumbar surgery may be an option when non-surgical techniques do not relieve symptoms. The primary goals are to decompress nerves, restore height/lordosis, and stabilize/fuse the spine.

Speak with your doctor if you are experiencing symptoms or for more information.

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Possible Risks

There are possible risks involved with any surgical procedure. Reasonable expectations and compliance with the surgeon’s pre and post-operative instructions are vital. All aspects of any potential surgery should be thoroughly discussed with your healthcare provider.

Risks associated with posterior lumbar procedures include:

  • General adverse effects related to surgical procedures, such as bleeding, infection, blood clots, or allergic reactions
  • Failure of adequate fusion to occur
  • Bowel or bladder issues

It is important to discuss these and all other aspects of any potential surgery with your physician.

Frequently Asked Questions

Below are answers to some frequently asked questions for this procedure. 

What is the difference between anterior and posterior lumbar fusion?

The difference between is how the spine is accessed. An Anterior Lumbar Interbody Fusion (ALIF) approaches the spine from the front (anterior) of the body, while a Posterior Lumbar Interbody Fusion (PLIF) approaches the spine from the back (posterior) of the body. Click here to learn more.

What is a spinal cage?

A spinal cage, also known as an interbody, is used in procedures that remove intervertebral discs from the spine. The cage is placed in the disc space to help fuse the spine for stability and/or to restore curvature of the spine. The shape of the cage differs based on the procedure and location on the spine. Click here to learn more.

What is the difference between PEEK and 3D printed implants?

Poly-ether-ether-ketone (PEEK) implants are comprised of a synthetic material that is “bioinert”, meaning it does not interact when introduced to biological tissue. 3D printed implants are comprised of titanium alloy (Ti-6AL-4V ELI) and are created through additive manufacturing. Click here to learn more about PEEK and 3D printed implants.

What are spine biologics?

Spine biologics provide mechanisms for bone growth. They help in the healing and fusion process during spine surgeries and may include scaffold, signaling, or cell elements for bone formation. Click here to learn more about the types of spine biologics. 


Important Note: This information is intended as an educational resource to provide an overview of the procedure. The information should, in no way, be used as a substitute for informed discussions between the patient and physician regarding possible and eventual course of treatment. Medical treatment is individually specific to each patient’s symptoms. The information contained herein may not apply to you, your condition, treatment, or expected outcome. Surgical techniques and practices vary. Complications may occur. It is important to talk with your physician about all indications, contraindications, warnings, precautions, clinical results, and other important medical considerations as pertain to this procedure. For further information on product contraindications, warnings, precautions, and possible adverse effects, click here.

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