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Development of the PLIF and TLIF Techniques

Publication |
2010

Abstract

PLIF (posterior lumbar interbody fusion) and TLIF (transforaminal lumbar interbody fusion) are surgical techniques employed in cases of degenerative lumbar spinal disorders. They involve a surgical approach to the area of the lumbar intervertebral disc, its resection, and subsequent application of biocompatible material that will achieve fusion of two or more vertebrae.

Briggs and Milligan published the PLIF method in 1944, involving application of cancellous bone grafts into the intervertebral space. Others, but mainly Cloward, further improved this technique.

Bagby and Kuslich introduced a cylindrical stainless steel cage in the 1980?s, while Brantigan used a rectangular cage made of a polyether-etherketone polymer (PEEK), reinforced with carbon fiber. Implants of variable shape and materials characterize spinal fusion technique improvements in the 1990?s.

Current trends work towards the development of a stand-alone cage without the need for posterior stabilization. Though the PLIF and TLIF techniques have been extensively used and verified, lumbar fusion may become unstable or even fail when biomechanical laws are neglected.