Posterior lumbar interbody fusion with specialized instruments.

Posterior lumbar interbody fusion (PLIF) has been performed in 100 individuals by use of specialized surgical instruments and allogeneic preserved bone grafts from 1979 to March 1982, after the advantages of performing PLIF in 342 individuals from 1965 to 1978 were noted. No deaths occurred, nor any infections or thrombophlebitis postoperation. Eleven (11%) reoperations were required: six for proven pseudarthrosis, three for gradual bone graft extrusion (of six extrusions total), one for bone graft fracture (with manifestations of nerve root compression), and one for hematoma. Operative results were excellent in 35%, good in 39%, fair in 17%, and poor in 9%. Specialized surgical instruments used for the operation included mortising chisels with cannulated reamers, right-angled curettes, and depth-limited impactors. PLIF is technically demanding; however, it establishes a mortise-graft interbody fusion to stabilize and restore the spinal architecture.