The PLIF procedure is a minimally disruptive approach to traditional back surgery. During a PLIF (Posterior Lumbar Interbody Fusion) procedure, the damaged disc is removed from between two vertebrae in the lower back (the lumbar region). The vertebrae are then fused together to reduce motion. The goals of the procedure are to restore stability in the spine, eliminate pain, and treat common spinal pathologies.

Traditionally, a PLIF is performed by making a midline incision in the patient’s back. The attached muscles are then pulled back and laterally (to the side) to allow sufficient exposure for the surgeon to place pedicle screws for fixation. This often results in postoperative approach-related muscle pain and denervation (loss of nerve supply).

The distinct difference between a traditional “open” PLIF and a MIS (minimally invasive surgery) PLIF, is the medialized surgical approach. By using a medialized (closer to the spinous process) screw entry point, the MIS PLIF procedure is designed to eliminate the need to retract muscle laterally past the facet joint to the transverse process, therefore requiring a smaller incision than an “open” PLIF. By minimizing the amount of muscle disruption, this procedure is intended to reduce postoperative approach-related muscle pain and enable a faster recovery for the patient.

Advantages of Minimally Invasive PLIF

In general, the MIS PLIF procedure results in a shorter recovery and a faster return to normal activities compared to a traditional “open” PLIF procedure. Benefits include:

  • Reduced blood loss compared to a traditional PLIF procedure – the MIS PLIF procedure requires a smaller incision and causes less muscle disruption than a traditional PLIF.
  • Minimal scarring and postoperative pain – the MIS PLIF procedure avoids excessive lateral dissection/retraction that can cause trauma to and denervation of back muscles.
  • Reduced hospital stay – most MIS PLIF patients are discharged from the hospital 1-2 days after surgery.
  • Faster return to normal activity – because this procedure is less disruptive than conventional posterior surgery, most patients are able to stand up and walk the evening after surgery.

Potential Risks

All surgical procedures present risks and complications, and it is important to discuss them with your surgeon prior to surgery. Listening to your surgeon’s guidance, both before and after surgery, will help to encourage the best possible outcome from your procedure.

Operative and postoperative complications known to occur may include: early or late infection which may result in the need for additional surgeries; damage to the spinal cord or peripheral nerves, pulmonary emboli; loss of sensory and/or motor function; permanent pain and/or deformity. Rarely, some complications may be fatal.



Scott B. Phillips, MD is a neurological spine surgeon based in San Antonio who specializes in minimally invasive spine surgery, artificial disc replacement, carpal tunnel surgery, spinal cord stimulator implants and other brain disorders, including brain tumor and chiari decompression. Patients travel from Bexar County, San Marcos and South Texas, including Corpus Christi, Kingsville, McAllen and Brownsville for treatment of back pain, neck pain, brain tumor, carpal tunnel and epilepsy-related neurological problems. Dr. Scott Phillips provides a second opinion for back surgery and neck surgery, and emphasizes non-surgical treatment options in advance of spine surgery. Where surgery is necessary because of a herniated disc or spinal instability, Dr. Phillips uses minimally invasive spine surgery techniques and advanced technology like the artificial disc to help patients relieve pain symptoms and get back to activity. This spine neurosurgeon expertise enables many patients to have outpatient spine surgery and be home the same day. This educational web site at AlamoBrainandSpine.com has home remedies for back pain, neck pain and herniated disc. This site also has our philosophy of care about controversial treatments like laser spine surgery.