PLF is a surgical method where two or more lumbar spine bones are joined using a bone graft. Unlike interbody fusion, the bone graft in PLF is placed alongside the spine bones. Metal screws and rods are often used to provide instant stability and enhance the fusion success rate. Conditions that may warrant PLF include spinal fractures, spondylolisthesis, tumors, infections, and scoliosis, among others.

PLF Surgery: A Step-by-step Overview

• Preparation: Under general anesthesia, the patient is positioned lying on the stomach. Sterile precautions are maintained.
• Incision: A 4-8 cm incision is made in the lower back area over the target spinal levels.
• Visualization: Muscles are gently divided, and retractors are placed for the surgeon to see the vertebral arches. An X-ray confirms the right spinal level.
• Procedure: The surgeon places bone graft alongside the vertebrae, using pedicle screws or hooks connected by titanium rods for stability.
• Optional Steps: If needed, a laminectomy or foraminotomy may be performed to alleviate nerve compression. This involves removing bone spurs or overgrown bone.
• Closing Up: The wound is cleansed and sutured. A sterile bandage is applied.

Surgery duration: 2-5 hours, based on spinal levels involved.

Post-Operative Recommendations

• Hospital Stay: Typically, 2-5 days.
• Mobility: Learn correct techniques for moving with the assistance of physical therapists.
• Activity Restrictions: Refrain from bending, lifting more than 5 pounds, or twisting for the initial 2-4 weeks. Gradually resume activities over the next months.
• Bracing: Most patients won’t need a back brace. Some, especially those with complex conditions, might receive a custom brace.
• Wound Care: Keep the surgical site clean and dry, changing the bandage every 1-2 days.
• Showering: Shower with care to avoid direct water contact on the incision. No baths until the wound fully heals (about 2 weeks).
• Driving: Resume after 7-14 days, avoiding narcotics. Initially, take short drives with company.
• Work and Sports: Return to light work as early as 2-3 weeks. Heavy tasks and sports should be resumed cautiously, based on fusion levels and doctor’s advice.

Follow-Up and Recovery

• Doctor Visits: First visit around 12-14 days post-surgery for incision inspection. Regular 4-6 week check-ups follow, often accompanied by X-rays. Physical therapy usually commences 8-12 weeks post-surgery.
• Surgical Outcomes: Research indicates 85-96% of PLF patients experience positive results. Many report a significant reduction in back pain and resume daily activities.

For a deeper understanding or to schedule a personalized consultation, connect with Dr. BSV Raju’s dedicated team. We’re here to assist you every step of the way.