Interbody Fusion

What is it?

This is a form of spinal fusion that removes the entire disc and places a cage-like block in to the residual space.  Screws are also used in the back of the spine to gain as much stability as possible.  The technique is particularly useful at relieving nerve compression related to narrowing in the spine at the point where they exit (foraminae).

PLIF stand for posterior lumbar interbody fusion whilst TLIF is transforaminal lumbar interbody fusion.  The difference lies in the access to the spine in order to place the cage.

What happens on the day?

The operation is performed under general anaesthetic and we therefore ask patients to refrain from eating or drinking anything for 6 hours prior to the injection.  Water however is allowed up to 2 hours before admission.  

Upon admission, the patient will be seen by the ward nurse, the anaesthetist and Mr. Lau himself.  Informed consent will be obtained and a mark placed on the back to confirm the correct site of the operation. The patient will be given a general anaesthetic and carefully positioned on their front for the operation which will be guided by a specialised X-ray machine.

After adequate and safe exposure of the spine, screws are inserted in the tunnel of bone that connects the back and front of the spine (pedicle) and these are later connected with rods. A window is made to access the disc and with the nerves protected, the disc is removed and a cage placed.  Bone-like material (bone graft) is then added to encourage bone growth and fusion.

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Follow up

Patients can mobilise as pain allows immediately after their surgery.  If there is a drain, then it is usually removed at 24 hours.  Patients will typically stay for 1-2 days.  The first follow up is arranged for 6 weeks post operation with physiotherapy input in the intervening period.  Further follow up at 3 and 6 months with x-rays are also required.

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