Understanding Lumbar Fusion Surgery
Stabilizing the spine to help relieve low back and leg pain
The goal of lumbar (low back) fusion surgery is to relieve pain, numbness, tingling sensations, weakness, restore nerve function, and stop or prevent abnormal motion in the spine. This is done by fusing (joining) the vertebrae together. Often fusion surgery includes other procedures, such as decompression or foraminotomy—both procedures take pressure off a spinal nerve.
- Low back fusion may be performed from the front (anterior) or back (posterior) of the spine. Sometimes it is necessary to remove an intervertebral disc—a procedure called a discectomy. To fill the empty disc space, an interbody device with bone graft is implanted between the vertebral bodies.
- Besides interbody devices (eg, cages), a lumbar fusion procedure may include implanting a plate, rods, and screws.
- Bone graft stimulates new bone to grow in and around the interbody device eventually healing the two vertebral bodies together. This process is called fusion.
- Two types of bone graft are autograft (bone taken from your own body) and allograft (donor bone).
When may low back fusion surgery be necessary?
Most often the first course of treatment is nonsurgical, and may include medications, physical therapy, and/or spinal injections. Spine surgery may be recommended if nonoperative treatment is not effective, symptoms worsen, and/or neurologic problems develop. The term neurologic means nerve-related symptoms, which can include worsening pain, sciatica, numbness, tingling sensations, and leg weakness.
What types of spine problems are treated with lumbar spinal fusion?
- Spondylolisthesis occurs when one vertebra slips forward over the one beneath it. A fusion procedure may be recommended to correct the slip and stabilize the spine, as motion can irritate spinal nerve roots and cause back and leg pain.
- Degenerative Disc Disease develops over time and causes one or more intervertebral discs to shrink, which changes the structure and strength of the disc. Structurally, as disc height it reduced, spinal nerves can become compressed causing sciatic-like symptoms.
What are the potential complications of lumbar spine fusion surgery?
Like any medical procedure, there are risks associated with spine fusion surgery. Your surgeon will take precautions to reduce your risk for a complication.
Certain patients are at high risk for pseudoarthrosis—the term for a fusion that does not heal; also referred to as a nonunion. In general, patients who smoke, use alcohol excessively, have diabetes, osteoporosis, are obese, or use certain medications (eg, steroids) are at risk for a failed low back fusion. Your surgeon will discuss your potential risk factors with you, and may prescribe a bone growth stimulator to be used after surgery to help your spine fuse/heal.