Spinal Fusion Surgeries: What’s The Difference Between ALIF & PLIF?

Which Surgery Is Best For You?

Spinal surgery is often the last resort for patients suffering from chronic back pain. Surgery seeks to relieve pain and restore functionality. In some cases, the surgeon will suggest a spinal fusion. More importantly, the surgeon will decide on one of two procedures, ALIF or PLIF. Both have key differences that determine recovery and success rate.

Why spinal fusion surgery?

If a patient requires spinal surgery, there is usually a problem with the discs in the spine. The spine consists of several bones called vertebrae, separated by fibrous discs. Degenerative disc disease can cause the disc to press on nerves. Other conditions like spondylolisthesis cause the affected vertebrae to shift forward. Over time, both issues can affect the quality of life.

Starting at the front with ALIF

ALIF means anterior lumbar interbody fusion. The objective is to fuse the two affected vertebrae into one stable structure. This happens over time, but the surgery removes the damaged disc and sets the bones for fusion. The anterior part of the surgery comes from the fact that the doctor will enter from the abdomen. ALIF is often completed via conventional surgery. However, there are minimally invasive options available.

A complex surgery

The surgeon performs ALIF by first placing the patient under general anesthesia. An incision is then made near the belly button. The surgeon retracts or moves the abdomen and intestines out of the way. Another surgeon may be present to move major blood vessels to access the spine. From there, the damaged disc is removed and fitted with a spacer to restore the natural height. Next, the surgeon fills the space with a bone graft. Metal screws and rods hold the two bones in place. After some time in the hospital, the patient will start the recovery process at home, which can take up to 3 months.

Pain relief with PLIF

PLIF or posterior lumbar interbody fusion seeks to achieve the same objective as ALIF. The patient has a damaged or degenerated disc. And the best option is to fuse the surrounding bones. PLIF should stop unnecessary movement and relieve pain. Instead of approaching the surgery from the front, PLIF happens from the back. The damaged disc is removed, and steps are taken to fuse the vertebrae.

What happens during PLIF?

Like ALIF, the surgeon places the patient under general anesthesia. However, this time the patient will be facedown. Small incisions are made at the location of the issue. The surgeon retracts the surrounding back and spinal muscles. From here, the surgeon removes part of the vertebrae called the laminae to expose the nerve roots. Surgeons may also trim the facet joints. After moving the nerve roots to expose the disc, the surgeon removes the damaged disc. Similar to ALIF, a spacer, bone graft, and rods are used to complete the procedure.

Key differences between ALIF and PLIF

The area affected will best determine which approach to use. The disc damage can be at the front, making ALIF a smarter choice. PLIF can happen if the damage is more comfortable to access from the back. With ALIF, the doctor has a broader view of the spine and more surface area to work with. This makes ALIF the better option if more than one fusion is needed. PLIF may have fewer incisions, but the risks increase with direct access to the spine. Both surgeries boast high success and satisfaction rates. And for both, recovery can take about 3 months, with up to 18 months for a full fusion.

Trust your medical team

Spinal fusion, either ALIF or PLIF, has both pros and cons. Both surgeries have the same outcome, which is to stabilize the spine. The most significant difference is the route the surgeon takes, based on the location of the condition. In either case, trust that the medical team will choose the best procedure based on patient needs. For more information about spine surgery, speak with a healthcare provider.