Lumbar Fusion is a surgical procedure in which a degenerative or injured spinal disc is removed and replaced with a spacer and bone products to weld the adjacent bones together and stop motion at the affected segment.
Lumbar Fusions can be performed from a posterior approach, anterior approach, or a combined anterior-posterior approach. Lumbar fusion surgery is recommended as an option for very specific conditions affecting the lumbar spine.
Lumbar Disc Deterioration
Lumbar spinal discs can break down for a number of reasons, including:
- Injury from an accident or sport
- Natural breakdown over time
- Genetic Predisposition
When a disc deteriorates it can result in pain or decreased functionality. Worn out discs can be treated non-surgically with physical therapy, pain medication, and injections. If these treatments fail, a lumbar fusion may be the best avenue for relieving pain and getting your body back to peak physical condition.
Who Can Benefit From A Lumbar Fusion?
One of the most common procedures in spinal surgery is a lumbar fusion operation. Patients who are candidates for fusion surgery usually have some combination of back pain, leg pain, leg weakness, or even changes in gait and difficulty walking. This option is recommended for patients who are not candidates for lumbar decompression or lumbar total disc replacement. Lumbar fusion is indicated for many conditions, including:
Posterior Spinal Fusion Procedure
The lumbar spine is exposed through a posterior (back) incision and the target disc is marked using imaging. Screws are placed into the vertebral bodies, which are being fused together. Decompression of compressed nerves is performed if necessary. Using specialized tools the degenerated or injured disc is removed completely. Trial spacers are placed to achieve the exact right fit for the actual spacer. The spacer is then filled with bone products and is inserted using specialized delivery devices to achieve the perfect fit. Rods are then placed to connect the screws together and additional bone graft is placed alongside the spine. Final x-rays are taken to confirm proper placement. The incision is closed with absorbable stitches and the patient is brought to the recovery area. Lumbar fusion generally takes one to two hours hour per level performed. After completing the surgery patient will usually spend one to three nights in the hospital.
Anterior Spinal Fusion Procedure
The lumbar spine is exposed through an anterior (front) incision with the assistance of a vascular surgeon and the target disc is marked using imaging. Using specialized tools the degenerated or injured disc is removed completely. Trial spacers are placed to achieve the exact right fit for the actual spacer. The spacer is then filled with bone products and is inserted using specialized delivery devices to achieve the perfect fit. An additional plate with screws, or screws through the device are placed in the bones, which are being fused. Final x-rays are taken to confirm proper placement. The incision is closed with absorbable stitches and the patient is brought to the recovery area. Anterior lumbar fusion generally takes one hour per level performed. After completing the surgery patient will usually spend one night in the hospital.
Anterior & Posterior Lumbar Fusion Combined Procedure
In some instances a combined approach will be required. Usually the anterior fusion is done initially, followed by posterior fusion. Hospital stay is typically longer for the combined approach.
Patient’s who undergo lumbar fusion surgery can often return to light activities within a few weeks, but this can vary depending on the individual patient, number of levels treated, and other factors.
Recovery will include rest, physical therapy, and a variable course of pain management medication.
TLIF is generally used to treat back or leg pain caused by degenerative disc disease. The surgeon will stabilize the spine by fusing vertebrae together with bone graft material.
Unlike traditional back surgery, XLIF® is performed through the patient's side. By entering this way, major muscles of the back are avoided. This minimally-invasive procedure is generally used to treat leg or back pain caused by degenerative disc disease. It can be performed on an outpatient basis.
Minnesota Spine Fusion Surgeons
If you are experiencing neck and arm pain, an anterior cervical fusion may be the best option for you. Contact us at Midwest Spine & Brain Institute to discuss your options. 1.800.3353.7720.