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J Am Acad Orthop Surg, Vol 16, No 3, March 2008, 130-139.
© 2008 the American Academy of Orthopaedic Surgeons
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Posterior Lumbar Interbody Fusion

Christian P. DiPaola, MD and Robert W. Molinari, MD

Dr. DiPaola is Chief Resident, Department of Orthopaedic Surgery, University of Rochester, Rochester, NY. Dr. Molinari is Associate Professor, Department of Orthopaedic Surgery, University of Rochester.

None of the following authors or a member of their immediate families has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article: Dr. DiPaola and Dr. Molinari.

Reprint requests: Dr. DiPaola, Department of Orthopaedic Surgery, University of Rochester, 601 Elmwood Avenue, Rochester, NY 14642.

Posterior lumbar interbody fusion (PLIF) and transforaminal lumbar interbody fusion (TLIF) create intervertebral fusion by means of a posterior approach. Both techniques are useful in managing degenerative disk disease, severe instability, spondylolisthesis, deformity, and pseudarthrosis. Successful results have been reported with allograft, various cages (for interbody support), autograft, and recombinant human bone morphogenetic protein-2. Interbody fusion techniques may facilitate reduction and enhance fusion. The rationale for PLIF and TLIF is biomechanically sound. However, clinical outcomes of different anterior and posterior spinal fusion techniques tend to be similar. PLIF has a high complication rate (dural tear, 5.4% to 10%; neurologic injury, 9% to 16%). These findings, coupled with the versatility of TLIF throughout the entire lumbar spine, may make TLIF the ideal choice for an all-posterior interbody fusion.






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Copyright © 2008 by the American Academy of Orthopaedic Surgeons.