Lumbar fusion, or spinal fusion, describes a procedure to fuse together damaged vertebrae (bones of the spine) to create a single, solid bone. It may relieve pain from a number of back disorders, including:
Spinal fusion eliminates movement between afflicted vertebrae, with the intention being that lack of movement between painful discs should eliminate pain. Lumbar fusion may also prevent the stretching of nerves, ligaments, and muscles in the affected regions. While there may be some loss of motion after spinal fusion surgery, most surgeries affect only a small area, so loss of range of motion is limited as much as possible.
This surgery may be performed through one of three approaches:
The anterior approach requires an incision in the lower abdomen, while the posterior approach has the patient on their stomach, with the surgeon operating directly on their back. The lateral approach has the surgeon making incisions in the patient’s side.
Lumbar fusions may also be performed through a minimally invasive technique. Which approach is used depends on the condition of the patient, and the nature and location of their disease.
Whatever the approach, lumbar fusion surgery requires the use of bone grafts. This promotes bone fusion and stimulates bone healing. The three types of bone grafts include:
Autograft is the “gold standard” for rapid healing and spinal fusion, but the harvesting of bone cells can be painful. Spinal fusion may produce some loss of motion, particularly in a multi-level discectomy. Artificial discs have been developed which may preserve the range of motion in the neck.
Artificial Bone Graft Materials
There are several artificial bone graft materials that have been developed, including:
Once the lumbar fusion is performed, your surgeon may recommend the wearing of a back brace to limit motion and give the fused vertebrae time to heal. Another technique used includes use of plates, screws and rods (hardware) to increase the rate of bone healing by holding the bones still and allowing bone growth to envelop them, creating a stronger fusion. Often the internal fixation of this hardware allows patients to move earlier after surgery.
Lumbar fusion takes time, requiring months for the bone cells to heal and properly fuse, although pain relief tends to occur far sooner. Proper alignment will be necessary to facilitate healing, and your doctor and physical therapist will assist in this. As healing continues, activity levels can increase.
Are There Complications?
Any surgical procedure may have complications. In the face of lumbar fusion, there are several particular complications that may result, requiring attention, including:
Complications from blood clots are most likely to happen the first few weeks after surgery, and may include symptoms such as:
If a blood clot breaks loose and travels through the bloodstream, it may settle in your lungs. You may feel sudden chest pain and shortness of breath or cough. If you feel this, you should contact your doctor immediately, or be taken immediately to the hospital emergency room or call 911.
Signs of infection may be shaking, chills, fever of over 100° F, drainage from the wound. If you experience these symptoms, you should contact your doctor immediately or go to the nearest available emergency room.