Anyone who has suffered from back pain knows how difficult it is to live with it. Sometimes this back pain can radiate down the legs and cause tingling. As a solution to this severe pain, which is not helped by taking medication and undergoing physiotherapy, your doctor may suggest surgery. One such surgery is called PLIF. Don't be scared when you hear this name. So today we will talk about what this PLIF surgery is, how it is done, and whether you should be afraid of it.
What is PLIF surgery?
Simply put, PLIF is a type of spinal fusion surgery. Our spine is made up of bones called vertebrae that are stacked on top of each other. Between these two bones, there is a cushioned area that acts like a shock absorber in a car. We call this the intervertebral disc.
Over time, due to an accident or other medical condition, this disc can become damaged. Then it can bulge out and start pressing on the nearby spinal nerve. That's when unbearable back pain and pain that travels down your legs begin.
In PLIF surgery, surgeons remove the damaged disc and insert a special device called a `spacer` into the space. This `spacer` can be made of metal, plastic, or bone. It is the exact same height as the removed disc. The space is then filled with a bone graft. This is like putting mortar between the bricks when building a brick wall. Over time, the two vertebrae above and below fuse together, forming a single, strong bone.
Why is this PLIF surgery performed?
Doctors usually consider this surgery when other treatments, such as painkillers and physiotherapy, have failed. The table below lists some of the main cases in which PLIF surgery is used.
| Condition | A simple explanation |
|---|---|
| Degenerative Disk Disease | As we age, the discs between the vertebrae wear out and become weaker. |
| Spondylolisthesis | One vertebra sliding forward over another. |
| Back deformities such as scoliosis | Pain caused by lateral curvature of the spine. |
| Recurring Herniated Discs | Nerve compression from repeated disc protrusion. |
| Spinal Stenosis | Nerve compression due to narrowing of the spinal cord passage. |
What happens before the surgery?
Before surgery, you will be examined carefully to see if this surgery is suitable for you.
Discussion with the doctor
Your doctor will ask you about your medical history, previous surgeries, and medications you are taking (including vitamins and herbal remedies). They will also do things like blood tests to check your general health.
This is very important: If you are a smoker, you will be advised to stop smoking completely . You will be told not to use anything that contains nicotine, such as cigarettes, bidis, nicotine patches, chewing gum, or vapes. Research has shown that nicotine can cause new bone grafts to fail to form properly, delay wound healing, and increase the risk of infection.
Preparing for surgery
The doctor will explain to you what you need to do before the surgery.
| Time | Things to do |
|---|---|
| About a week before surgery |
|
| On the day of surgery |
How is the surgery performed?
The surgery is performed under general anesthesia, meaning you won't feel anything. The surgery usually takes about 2-3 hours.
1. The surgeon will make an incision in your lower back .
2. Carefully stretch the back muscles to the sides, reaching the spine.
3. The damaged disc is removed by removing a portion of the vertebrae called the `lamina`, carefully moving the membrane (dura) surrounding the spinal cord aside.
4. A bone graft is prepared to fill the empty space.
5. A `spacer` (sometimes called a `cage`) is filled with the `bone graft`.
6. Then, insert this `spacer` into the gap and secure it with screws to prevent it from moving.
7. Finally, the muscles are put back in place and the incision is sewn closed.
What happens after the surgery?
After the surgery, you will be taken to a recovery area. There, your heart rate and breathing will be monitored. You will be given pain medication. You will then be transferred to a regular ward. You will need to stay in the hospital for a day or two to check for complications such as infection.
Recovery time and precautions
You'll feel great relief when your back pain is gone. But don't rush back to your old activities. You need to give your body time to heal. It can take months or even a year for the bone graft to fully form and the two vertebrae to fuse together.
| Time | Things not to do (AVOID) |
|---|---|
| First 2-4 weeks |
|
| Between 4-6 weeks |
If you have these symptoms, see a doctor immediately.
If you experience any of these symptoms when you get home after surgery, call your doctor immediately.
- If you have a fever higher than 39.4 degrees Celsius (103 Fahrenheit).
- If you feel cold and shivering.
- If the surgical site is red, swollen, or painful to touch.
- If there is more severe pain than expected.
It's normal to feel a little scared and nervous when thinking about PLIF surgery. But remember, this is a very effective treatment for severe back and leg pain. Don't hesitate to ask your doctor any questions or concerns you may have. He or she will explain everything to you.
Take-Home Message
- PLIF is a successful surgery for severe back and leg pain that has not been relieved by other treatments.
- For the surgery to be successful, it is imperative to completely stop smoking and all nicotine-containing products.
- It is important to be patient, as it can take several months or even a year to fully recover.
- Follow your doctor's instructions carefully regarding bending, lifting, and driving for the first few months after surgery.
- Talk openly with your healthcare team. Don't be afraid to ask them your doubts and questions.
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