NuVasive®, Inc.



This webpage is designed to inform you about the Maximum Access Surgery Posterior Lumbar Interbody Fusion (MAS PLIF) surgical procedure. It is not meant to replace any personal conversations that you might wish to have with your physician or other member of your healthcare team.

Not all the information here will apply to your individual treatment or its outcome. The information is intended to answer some of your questions and serve as a stimulus for you to ask appropriate questions about the procedure.

Posterior Lumbar Interbody Fusion (PLIF) is a surgical technique that attempts to eliminate instability in the back and pain in the lower back and lower extremities. A Maximum Access Surgery Posterior Lumbar Interbody Fusion (MAS PLIF) achieves this by using a less disruptive approach to decompress nerve roots and fuse one or more vertebrae together to reduce their motion.

The distinct difference between a traditional “open” PLIF and a MAS PLIF is the medialized surgical approach. The MAS PLIF procedure is designed to eliminate the need to retract muscle laterally, 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.


Many symptoms can be treated without surgery with methods that involve medication, rest, heat, and physical therapy. It is important that you speak to your physician about the best options for you.

If your symptoms do not improve with other methods, your physician may suggest spinal surgery. Surgery is reserved for those who do not gain relief from non-operative forms of treatment, patients whose symptoms are increasing or worsening, and/or patients that present with a spinal condition which indicates the need for surgery.

Your physician might determine a MAS PLIF procedure is a good option for you if you require an intervertebral fusion at any lumbar level between L1 and S1, and you would benefit from a less disruptive approach.

Conversely, your physician may determine that a MAS PLIF procedure is not a good option for you. It is important to discuss all treatment options with your physician.

Are there risks involved?

Keep in mind that all surgery presents risks and complications that are important to discuss with your physician prior to your surgery. Listening to your physician’s guidance both before and after surgery will help to ensure the best possible outcomes from your procedure.

Some of the most common complications following MAS PLIF surgery include: problems with anesthesia, infection, nerve damage, problems with the graft or hardware, and ongoing pain. This is not intended to be a complete list of the possible complications.

Your physician will review your condition and explain all of your treatment options, including non-operative treatments, such as medications and physical therapy. Once you have been admitted to the hospital, you will be taken to a pre-op room and prepared for surgery. This may include instruction about the surgery, cleansing of your surgical site, as well as instruction about the postoperative period.

Your surgeon will make a small incision in the center of your back, near the affected area of your spine, and place the MAS PLIF access system. The size of the incision can vary based on the number of vertebral levels and/or complexity of your case.

A retractor is utilized to hold the skin incision open and to provide safe access and visibility to the disc space and affected areas. Your surgeon will then place screws into the vertebrae that will be utilized at the end of the procedure to provide fixation. Next, your surgeon will remove any bony anatomy that is causing back/leg pain (stenosis) in order to relieve the compression of the nerve roots.

Your surgeon will then remove the disc and prepare the disc space for fusion. Appropriate implants, chosen by your surgeon, will be placed into the empty disc space to restore the proper disc height and assist in spinal load, alignment, and fusion.

In order to stabilize the spine, once bone and the disc have been removed the screws will be connected with a rod. This stabilization will encourage bone to grow and fuse the vertebrae into the postoperative position.

Patients usually require a stay of 1-2 days in the hospital. Your physician will discuss with you what is right for your particular case. The day after your surgery, your physician may instruct you to use a brace for a period of time to assist with the spinal fusion process. Supervised by trained medical professionals, your physician may ask you to carefully sit, stand, or walk within 24 hours of the surgery. Once you are discharged from the hospital it is important to limit your activities for a period of time (determined by your healthcare provider) to give your body a chance to heal. Your physician will discuss with you any pain medications to take home, as well as a prescribed program of activities. Your physician will provide instructions on wound care, exercises, and limitations to postoperative activity.

Depending on your surgical incision, you may have showering restrictions. Ask your physician for appropriate instructions.

Your physician will discuss the incisions that will be made during your MAS PLIF surgery. Small scars of approximately one and a half inches are common.

For a period of time after your surgery, you may be cautioned about activities such as driving. Your physician will tell you when you may drive again.

The implants used in the MAS PLIF procedure may activate a metal detector. Because of increased airport security measures, please call your local airport authority before traveling to get information that might help you pass through security more quickly and easily. Ask your physician to provide a patient identification card.

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