Posterior Lumbar Fixation Surgeries, Indications and Approaches (Posterolateral Fixation, PLIF and TLIF)

Abstract

The first posterior lumbar fusion was introduced by Cloward in 1953 for degenerative disc disease and spondylolisthesis. Since then, pedicle screw instrumentation has enabled a rigid construct to promote stability and fusion for numerous spinal pathologies including: trauma, tumours, deformity and degenerative diseases. (Kanter & Mummaneni, 2008)

Lumbar arthrodesis is a commonly performed surgical procedure for the treatment of spondylosis, trauma, infection, neoplasm, and spinal instability. (Brantigan et al., 2004)

A posterolateral fusion with autologous bone graft has traditionally resulted in acceptable clinical results; however, reported fusion rates have been inconsistent. (Matsumoto et al., 1992)

With the addition of internal fixation using posterolateral transpedicular screw instrumentation, fusion rates have improved significantly especially in cases of instability. (Brantigan et al., 2004)

Performing an interbody arthrodesis may further improve the clinical results by eliminating the disc as a potential pain generator, improving fusion rates, and restoring intervertebral height and lumbar lordosis. (DiPaola & Molinari, 2008)

Posterior lumbar interbody fusion (PLIF) and transforaminal lumbar interbody fusion (TLIF) create