Lumbar spinal fusion is surgery to join, or fuse, two or more vertebrae in the low back.
Spinal fusion is major surgery, usually lasting several hours. There are different methods of spinal fusion.
Bone is taken from the pelvic bone or from a bone bank. The bone is used to make a bridge between vertebrae that are next to each other. This bone graft helps new bone grow.
Metal implants are usually used to hold the vertebrae together until new bone grows between them.
What To Expect After Surgery
You will need to be watched in the hospital for a few days after surgery.
Bed rest is not usually needed while you recover at home.
Your doctor may recommend that you wear a back brace while you recover.
Rehabilitation can take a long time. It includes walking, riding a stationary bike, swimming, and similar activities.
Why It Is Done
Spinal fusion may be done by itself or along with surgery to remove bone and tissue that are narrowing the spinal canal and squeezing the spinal cord and/or the spinal nerves.
It may be done as a follow-up after surgery that was done to treat problems such as spinal stenosis, herniated discs camera.gif, injuries, infection, and tumors.
Spinal fusion was first used to treat fractures or other problems. It is now also used to treat age-related spinal problems and spinal stenosis.
Types of Spinal Fusion
There are several types of spinal fusion surgery options. The most commonly employed surgical techniques include:
- Posterolateral gutter fusion – the procedure is done through the back
- Posterior lumbar interbody fusion (PLIF) – the procedure is done from the back and includes removing the disc between two vertebrae and inserting bone into the space created between the two vertebral bodies
- Anterior lumbar interbody fusion (ALIF) – the procedure is done from the front and includes removing the disc between two vertebrae and inserting bone into the space created between the two vertebral bodies
- Anterior/posterior spinal fusion – the procedure is done from the front and the back
- Transforaminal lumbar interbody fusion (TLIF) – Similar to the PLIF, this procedure is also done from the back of the spine
- Extreme Lateral Interbody Fusion (XLIF) – an interbody fusion in which the approach is from the side
- It is important to note that with any type of spine fusion, there is a risk of clinical failure (meaning that the patient’s pain does not go away) despite achieving a successful fusion.
How Well It Works
Spinal fusion is often needed to keep the spine stable after injury, infection, or a tumor.
But there is not a lot of research about how well it works for other spinal problems.
In general, studies do not show a clear difference between spinal fusion and intense rehabilitation for treating chronic low back pain from degenerative changes in the spine.
As you decide about having spinal fusion, talk with your doctor about the benefits and risks. The surgery costs a lot and has serious risks.
Although this type of surgery is common, there is no guarantee it will work to relieve your pain.
The risks of this surgery depend on your age and overall health, what you’re having the surgery for, and the type of procedure you have.
- Pain at the bone graft site.
- Failure of the fusion, breakage of metal implants, or both.
- Blood clots that may also lead to pulmonary embolism.
- Nerve injury.
- Graft rejection.
What To Think About
Because there are so many things to consider when spinal fusion is recommended, seek a second opinion before making a decision.
Obtaining a successful result from a spine fusion requires a number of factors, including an accurate preoperative diagnosis, a technologically adept surgeon, and a patient with a reasonably healthy lifestyle (non smoker, non obese) who is motivated to pursue rehabilitation and restoration of his or her function.