Spinal Fusion (Lumbar)

Lumbar spinal fusion surgery joins two or more vertebral bones to create a solid bone mass and stabilize the spine. The procedure helps stop painful movement in the lumbar vertebral segment.

What You Need To Know About Lumbar Spinal Fusions

What is a Lumbar Spinal Fusion?

Lumbar spinal fusion surgery aims to stop unwanted and painful motion in the lumbar vertebral segment. Conditions like arthritis or injuries may cause compromised vertebrae. By fusing two or more problematic vertebrae into a single solid bone, the patient gains greater stability in the spine, which helps prevent stretched nerves in surrounding back ligaments.

Surgery helps stop unwanted motion to reduce pain and prevent bone spur formation. A physician may also remove intervertebral discs to relieve nerve pressure, avoid nerve injuries, and reduce chronic pain.

Types of Lumbar Spinal Fusion

There are several different subtypes of lumbar spinal fusion, including:

  • Posterior lumbar interbody fusion (PLIF): During this procedure, a physician removes the disc between two inflamed back vertebrae and inserts a bone into the space to create two new vertebral bodies.
  • Anterior lumbar interbody fusion (ALIF): As opposed to a PLIF, a physician removes discs between two problematic vertebrae from the front rather than the back. The surgeon still inserts bone in the space between the two vertebral bodies to stabilize the spine and reduce pain.
  • Transforaminal lumbar interbody fusion (TLIF): A surgeon performs a TLIF very similarly to a PLIF but operates through the spine's posterior part.

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Why is a Spinal Fusion Procedure Performed?

There are many reasons why a surgeon may recommend spinal fusion. Injured or degenerated vertebrae may form from deformities in the spine, herniated disks, scoliosis, or sports injuries.

A spinal fusion may also help people suffering from an unstable spine due to conditions such as lumbar degenerative disc disease, lumbar spondylolisthesis, spinal stenosis, fractured vertebra, or tumors.

Spinal fusion helps correct spinal deformities due to conditions such as scoliosis to reduce pain and stabilize the spine. Arthritis and similar joint conditions may cause spinal weakness or instability, and spinal fusion aids spinal stability. A surgeon will also be able to remove herniated disks that may cause chronic pain and nerve issues.

How to Prepare for a Spinal Fusion

Since spinal fusion is an intensive surgical procedure, patients should follow this quick checklist to prepare for surgery properly:
  • At home: Before your planned surgical date, patients should situate their home for an easy recovery. Have easy-to-prepare meals ready in the fridge and place cooking utensils and equipment on countertops to avoid bending over. Place shoes, clothes, and essentials at level heights and remove potential tripping hazards. Try to have everything you need for recovery on one level of your home.
  • Transportation: Arrange a ride home after surgery and recline in the front seat or lie down in the back seat.
  • Medication: Stop taking nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen and Indocin, 14 days before surgery. Talk to your doctor about alternative medications to take in the interim. Also, disclose all medication you regularly take to your physician before the day of surgery.
  • Stop smoking: Smoking impedes bone graft recovery, so physicians advise patients to stop smoking two weeks before surgery and six weeks after surgery.
  • Medical Consultation: Visit a medical physician before surgery to document your current medical condition. Your surgeon will need to review your medical history and blood and urine test. Additionally, a physician may want you to have an electrocardiogram, chest x-rays, and an anesthesia interview to proceed safely with surgery.
  • What to Bring on the Day of Your Surgery: Bring your own toiletries to the hospital along with comfortable clothing to move around, including pajamas, nightgowns, robes, walking loafers, and cotton t-shirts.

Your Resurgens physician will be able to give you a more thorough run-down of steps to prepare for surgery.

What Happens During a Spinal Fusion Procedure?

A surgeon will position you for surgery and administer anesthesia to begin the procedure. The surgeon will make an incision in your skin and gently move tissues aside to create a path to your spine.

Your surgeon may remove part or all of the lamina from one or more vertebrae. Removing this bone creates more space for the spinal nerves. If bony growths are pressing against your nerves, your surgeon removes these as well. The surgeon may also modify the position of your spine to relieve pressure on the surrounding spinal nerves.

To create the fusion, your surgeon uses a bone graft, which is usually taken from the patient's hip. It can also come from a donor. The surgeon removes some bone from the surface of your vertebrae to create a bed where this graft can grow.

The surgeon stabilizes your spine by implanting hardware to lock the vertebrae together. Many devices are available. Your surgeon may use screws and rods, plates, or other devices. Finally, the physician places a graft against your vertebrae.

Are There Risks Associated with Spinal Fusion Surgery?

Every surgical procedure has a certain amount of inherent risk. Some common risks associated with any surgical procedure include:

  • Infection: A surgeon will use antibiotics before, during, and after the procedure to avoid infection. Excessive Bleeding: As with all surgeries, a certain amount of bleeding is expected.
  • Blood Clots: A rare complication is the formation of blood clots in the legs. A surgeon will monitor any potential blood clots and provide a solution as early as possible.
  • Nerve Damage: A surgeon may injure nerves or blood vessels during surgery. However, nerve damage only occurs in rare circumstances.
  • Persisting Symptoms: If you are having chronic pain or recurring symptoms following surgery, schedule an appointment with your physician.
  • Pain at Graft Site: Some patients continue to deal with persistent pain at the bone graft site.
  • Pseudarthrosis: Some diabetic patients, older patients, or patients that smoke have an increased risk of developing pseudarthrosis. The condition occurs due to improper bone formation, and a physician may recommend a second surgery.

Post Spinal Fusion & Recovery

When the spinal fusion procedure is complete, the incision is closed. A physician may place you in a brace to support your spine. Several weeks after the surgery, new bone grows and attaches securely to the spine to create a permanent fusion.

A patient will stay at the hospital for two to three days following surgery. It may take several months for the spine to heal entirely and the fusion to stabilize. Chat with your doctor about appropriate pain medications to take during recovery. Patients should regularly attend physical therapy sessions six weeks to three months after surgery to improve movement and strengthen the spine. Patients should keep physical activity to a minimum and only go on walks or other light exercises.

Learn more about the Spine Center at Resurgens Orthopaedics.

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