I just came back from the orthopedic surgeon’s office. My head is spinning from all that I heard. I’m going to have a spinal fusion at L34. There are quite a few choices as to how it’s done. My surgery will be a PLIF. Please tell me again what this means.

There are two basic ways to do a spinal fusion: the anterior or posterior approach. Anterior means the surgeon goes through the patient’s abdomen to reach the spine. Posterior refers to entry from behind the spine. Most often the posterior approach is really posterolateral (PL). PL indicates the entry is at an angle from the back and side. This method avoids pulling the nerve root out of the way.

PLIF stands for posterior lumbar interbody fusion (PLIF). The disc is removed and replaced with a titanium cage. PLIF helps reduce back pain but can result in nerve pain from damage when the nerve is retracted. PLIF does restore the natural disc height which takes pressure off the nerve roots as they leave the spinal canal.

Surgeons often choose PLIF because there is less blood loss and a shorter operative time. And without a bone graft for the fusion there are no donor site problems.