Instrumented Fusion Surgery / Posterior Lumbar Interbody Fusion (PLIF) and / Transforaminal Lumbar Interbody Fusion (TLIF) and Anterior Lumbar Interbody Fusion (ALIF)

Spinal fusion and instrumentation are both operations used to stabilise the spine. In fusion, two or more vertebrae are joined with the help of bone grafts, spinal instrumentation is often used. This stabilises the spine using implants such as rods, plates, screws and cages.

Conditions treated

Lumbar fusion surgery is used to treat slipped or damaged discs, spinal tumours and other spinal injuries.


The fusion procedure is performed under general anaesthesia. An incision in the patient’s back (or through their stomach with an ALIF) allows the surgeon to remove part of or the whole damaged disc between two adjacent vertebrae. The vertebrae are then fused using implants and sometimes bone grafts. External implant materials such as rods, screws, plates and wires may be fixed to the treated vertebrae to deliver extra support and stability.

The TLIF and PLIF use a posterior approach (from the back), whereas the ALIF utilises an anterior approach. A vascular surgeon may be needed as part of the surgical team during an ALIF, depending on the levels operated.

There are benefits and risks with each type of surgery, which Dr Tollesson will discuss these and recommend the most appropriate surgery based on your health, age, radiology and medical history.


Recovery differs between patients and surgeries. As a general guide recovery may include the following:

  • Five to seven days in hospital
  • No heavy lifting for the first few weeks or so (and graduated lifting restrictions thereafter)
  • Some time off work in order to recover
  • You may need to return to work on restricted duties for a period of time
  • You may not be able to drive for 4 to 6 weeks
  • No swimming for 4 to 6 weeks
  • Physiotherapy
  • Pain medication
  • Rehabilitation depending on the surgery
  • A back brace is sometimes required
  • You may need to meet with an Occupational Therapist


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