✦ Bilateral Fusion Surgery

Posterior Lumbar Interbody Fusion (PLIF)

Q: When is PLIF preferred over TLIF?

PLIF is preferred when severe bilateral central canal stenosis requires comprehensive bilateral decompression that unilateral TLIF cannot reach.

Q: Are two cages always used in PLIF?

Yes — PLIF traditionally uses two cages placed side-by-side, providing bilateral support and excellent biomechanical stability across the disc.

Q: Is recovery longer than TLIF?

Recovery is broadly similar between PLIF and TLIF — most patients walk within days; full recovery takes 3–6 months as biological fusion matures.

Q: Does PLIF restore natural curvature?

Yes — PLIF restores disc height and helps recreate lumbar lordosis through cage placement and proper compression across the construct.

A bilateral midline approach allows comprehensive decompression and bilateral cage insertion into the disc space — providing wide access for severe central stenosis with disc disease.

3–4 Hours PROCEDURE

5–7 Days HOSPITAL STAY

>90% SUCCESS RATE

3–6 Months FULL RECOVERY

What is Posterior Lumbar Interbody Fusion (PLIF)?

Posterior Lumbar Interbody Fusion (PLIF) is a comprehensive lumbar fusion technique performed through a midline posterior approach providing bilateral exposure of the affected level. After bilateral laminectomy and nerve decompression, both sides of the disc space are entered, disc material is removed, and two interbody cages filled with bone graft are inserted bilaterally. Bilateral pedicle screws and rods complete the construct. The wide bilateral exposure makes PLIF ideal for severe central canal stenosis with concurrent disc disease, where comprehensive bilateral decompression is essential. Dr. Hithesh performs PLIF in Hyderabad for patients requiring complete bilateral access to the spinal canal and disc space.

Indicated for severe central canal stenosis with disc disease, spondylolisthesis with bilateral nerve compression, recurrent disc herniation needing comprehensive decompression, or revision lumbar fusion surgery requiring full bilateral access.

How the Procedure Works

Anaesthesia & Positioning

General anaesthesia is delivered; the patient is positioned prone on a Wilson frame, allowing safe surgical access to the lumbar spine.

Bilateral Decompression

A midline incision exposes both sides; bilateral laminectomy decompresses the central canal and both nerve roots simultaneously and effectively.

Bilateral Discectomy

The disc space is entered from both sides; disc material is comprehensively removed, preparing both sides of the disc space for cages.

Bilateral Cage Insertion

Two interbody cages filled with bone graft are inserted side-by-side into the prepared disc space, beginning the biological fusion process.

Pedicle Screw Fixation & Closure

Bilateral pedicle screws and rods stabilise the segment; soft tissue layers are closed; structured progressive recovery follows postoperatively over months.

Outcomes

3–4 HoursDURATION

5–7 DaysHOSPITAL STAY

>90%SUCCESS RATE

3–6 MonthsFULL RECOVERY

Who Needs This Treatment?

→Comprehensive bilateral exposure for severe central canal stenosis effectively
→Bilateral cage placement provides excellent biomechanical support and stability
→Restores natural disc height and lumbar lordotic spinal curvature reliably
→Provides reliable lasting relief from back pain and radicular leg pain
→Modern interbody cages deliver durable consistent biological fusion outcomes successfully
→Outstanding long-term outcomes for severe complex lumbar pathology cases

PLIF earns its place when stenosis is severe and bilateral. The wide exposure feels old-school, but for the right pathology — where you genuinely need to see and decompress both sides — nothing else gives that completeness.

— — Dr. Bathini Hithesh, Consultant Orthopaedic Surgeon, Trauma & Joint Replacement Specialist, Lux Hospitals, Hyderabad

Common Questions

Frequently Asked Questions

When is PLIF preferred over TLIF?+

Are two cages always used in PLIF?+

Is recovery longer than TLIF?+

Does PLIF restore natural curvature?+

Not sure which treatment is right for you?

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