Overview and Indications
Posterior Lumbar Fusion (PLF) is the general term used to describe the technique of surgically mending two lumbar spine bones together along the sides of the bone. Bone graft is placed along side the spine bones, and ultimately fuses together. PLF may be performed in conjunction with or without a posterior decompression and/or instrumentation. Typically, metal screws and rods are placed so as to impart immediate stability while the bone mends and to increase the fusion rate.

Why is it done?
A posterolateral fusion may be recommended as a surgical treatment option for patients with a condition causing spinal instability, such as degenerative disc disease, spondylolisthesis or spinal stenosis, that has not responded to conservative treatment measures. The symptoms of spinal instability may include pain, numbness and/or muscle weakness.

How is it done?
The operation is performed with the patient positioned on his or her stomach.

Spinal Access and Bone Removal
First the surgeon will make a small incision in the skin of  lower back. Depending on the instrumentation to be used, the incision could be as small as approximately 3 centimeters. In a traditional posterolateral fusion, a 3- to 6-inch incision is typically required.

The muscles surrounding the spine will then be dilated to allow access to the section of spine to be stabilized. After the spine is accessed, the lamina is removed to allow visualization of the nerve roots. The facet joints, which are directly over the nerve roots, may be trimmed to give the nerve roots more room.

A bone graft is then laid between the transverse processes in the back of the spine. Screws and rods are implanted to stabilize the spine while the treated area heals and fusion occurs. Finallly surgeon will then close the incision, which typically leaves behind only a small scar or scars.

After Surgery:
This minimally invasive procedure typically allows many patients to be discharged the day after surgery; however, some patients may require a longer hospital stay. 

A positive attitude, reasonable expectations and compliance with your doctor`s post-surgery instructions all may contribute to a satisfactory outcome. Many patients are able to return to their regular activities within several weeks.

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