Our Summary

This study looked at how different surgical methods for a specific type of back surgery (single-level lumbar fusion) have been used over the past decade. The researchers looked at data from over 53,000 patients who had this surgery between 2010 and 2019.

They found that the use of a surgical method that only involves the back side of the spine (posterior-only interbody approach) has been declining. On the other hand, surgeries that involve the front side of the spine (anterior-only approach), or both the front and back sides of the spine (anterior with posterior instrumentation approach), have been used more often.

The researchers suggest that this information could be useful for trainees and spine surgeons as new techniques and technologies become available.

FAQs

  1. What was the primary focus of this study on single-level lumbar fusion?
  2. What trends in surgical methods for lumbar fusion were observed between 2010 and 2019?
  3. How could this research potentially benefit trainees and spine surgeons?

Doctor’s Tip

One helpful tip a doctor might tell a patient about lumbar fusion is to discuss with their surgeon the different surgical approaches available and which one might be most appropriate for their specific case. It’s important to understand the risks and benefits of each approach and to make an informed decision together with your healthcare provider. Additionally, it’s important to follow your surgeon’s post-operative instructions carefully to ensure a successful recovery.

Suitable For

Patients who are typically recommended for lumbar fusion surgery are those who have:

  1. Severe back pain that does not improve with conservative treatments such as physical therapy, medications, and injections
  2. Nerve compression leading to symptoms such as leg pain, weakness, and numbness
  3. Spinal instability or deformity
  4. Degenerative disc disease
  5. Spondylolisthesis (slipping of one vertebra over another)
  6. Failed previous back surgery

The choice of surgical method for lumbar fusion depends on the specific condition of the patient and their individual needs. The anterior-only approach may be recommended for patients with disc degeneration or spondylolisthesis, while the posterior-only approach may be more suitable for patients with spinal stenosis or degenerative disc disease. The anterior with posterior instrumentation approach may be used for patients with more complex spinal conditions requiring stabilization from both the front and back sides of the spine.

Timeline

Before lumbar fusion:

  1. Patient experiences chronic back pain that does not improve with conservative treatments such as physical therapy or medication.
  2. Patient undergoes imaging tests such as X-rays, MRI, or CT scans to determine the cause of their back pain.
  3. Patient consults with a spine surgeon to discuss the possibility of lumbar fusion surgery.
  4. Patient undergoes pre-operative testing and medical clearance to ensure they are a suitable candidate for surgery.

After lumbar fusion:

  1. Patient undergoes lumbar fusion surgery, which involves the fusion of two or more vertebrae in the lower back to stabilize the spine and relieve pain.
  2. Patient stays in the hospital for a few days for post-operative care and monitoring.
  3. Patient undergoes physical therapy and rehabilitation to regain strength and mobility in the back.
  4. Patient may experience temporary discomfort and limitations in activities as they recover from surgery.
  5. Over time, patient gradually experiences pain relief and improved function in the back as the fusion heals and stabilizes the spine.

What to Ask Your Doctor

Some questions a patient should ask their doctor about lumbar fusion based on this information include:

  1. What surgical method do you recommend for my single-level lumbar fusion surgery?
  2. Can you explain the differences between the posterior-only, anterior-only, and anterior with posterior instrumentation approaches?
  3. Why have certain surgical methods for lumbar fusion been used more frequently in recent years?
  4. What are the potential benefits and risks of each surgical approach?
  5. How will the choice of surgical method impact my recovery and long-term outcomes?
  6. Are there any new techniques or technologies that could be beneficial for my surgery?
  7. How experienced are you with the surgical method you are recommending?
  8. Are there any alternative treatment options to lumbar fusion that I should consider?
  9. What can I do to prepare for surgery and optimize my recovery?
  10. Can you provide me with any resources or additional information to help me understand my treatment options better?

Reference

Authors: Wilder JH, Ross BJ, McCluskey LC, Cyriac M, Patel AH, Sherman WF. Journal: Clin Spine Surg. 2023 Aug 1;36(7):E324-E328. doi: 10.1097/BSD.0000000000001373. Epub 2022 Aug 11. PMID: 35969681