Our Summary

This research paper is about Lumbar interbody fusion (LIF), a type of spine surgery. In recent years, there have been many new ways to perform this surgery, which has led to a lot of new names for it. This study looked at 1455 articles about LIF and recorded 605 terms used to describe the surgery.

The researchers found that the most common place to do the surgery was through the side of the back (43%), followed by the back of the spine (25%), the side of the body (19.7%), and the front of the body (10.9%). There were 72 different ways to describe the surgery.

Some terms like “MI”, “MIS”, and “MISS” refer to surgeries that are less invasive, meaning they don’t require a large incision or cut. Other terms like “O”, “CO”, and “TO” refer to surgeries that are more open and require a larger cut. Lastly, “Endo”, “Endoscopic-assisted”, and “PE” refer to surgeries that use a small camera to help guide the surgeon.

The researchers found that the current names for LIF are often confusing, repetitive, or unclear. So, they suggest using a new 4-part naming system that makes it easier to understand what the surgery involves. This includes information about how the patient is positioned during the surgery, where the surgeon makes the cut, and the direction of the surgical pathway.

FAQs

  1. What is Lumbar interbody fusion (LIF) and why are there so many terms for it?
  2. What are the most common places for performing LIF surgery and what terms are used to describe them?
  3. What is the proposed 4-part naming system for LIF, and why do researchers suggest using it?

Doctor’s Tip

A doctor might tell a patient undergoing lumbar fusion surgery to make sure to follow their post-operative instructions carefully, including proper wound care, physical therapy exercises, and avoiding heavy lifting or strenuous activities until cleared by their doctor. It is also important to attend all follow-up appointments and communicate any concerns or changes in symptoms to their healthcare provider.

Suitable For

In terms of patients who are typically recommended for lumbar fusion, it is generally advised for those who have not responded to conservative treatments such as physical therapy, medications, or injections for conditions such as degenerative disc disease, spondylolisthesis, spinal stenosis, or spinal fractures. Patients who experience chronic back pain, leg pain, weakness, or numbness due to these conditions may benefit from lumbar fusion surgery.

Additionally, patients who have spinal instability, such as excessive movement between vertebrae, may also be candidates for lumbar fusion. Spinal instability can result from conditions such as severe arthritis, trauma, or previous spine surgeries. Lumbar fusion can help stabilize the spine and reduce symptoms associated with instability.

It is important for patients considering lumbar fusion to undergo a comprehensive evaluation by a spine specialist to determine if they are good candidates for the surgery. The decision to proceed with lumbar fusion should be based on the severity of symptoms, the underlying condition causing the symptoms, and the patient’s overall health and lifestyle goals.

Timeline

Before lumbar fusion:

  1. Patient experiences chronic back pain and/or leg pain that does not improve with conservative treatments such as physical therapy or medications.
  2. Patient undergoes diagnostic tests such as X-rays, MRI, or CT scans to determine the cause of their symptoms.
  3. Patient consults with a spine surgeon to discuss surgical options, including lumbar fusion.
  4. Patient undergoes pre-operative evaluations and prepares for surgery, which may include stopping certain medications or adjusting diet and exercise routines.

After lumbar fusion:

  1. Patient undergoes the surgical procedure, which may involve removing damaged disc material, inserting bone grafts or implants, and stabilizing the spine with hardware such as screws and rods.
  2. Patient stays in the hospital for a few days to recover and receive pain management.
  3. Patient begins physical therapy and rehabilitation to regain strength and mobility in the spine.
  4. Patient follows up with their surgeon for post-operative appointments and monitoring of their progress.
  5. Over time, patient experiences improvement in symptoms and function, with the goal of returning to normal activities and reducing pain.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with lumbar fusion surgery?

  2. How long is the recovery process and what can I expect in terms of pain management and rehabilitation?

  3. What type of anesthesia will be used during the surgery and what are the potential side effects?

  4. Will I need to stay in the hospital after the surgery, and if so, for how long?

  5. What is the success rate of lumbar fusion surgery for my specific condition?

  6. Are there any alternative treatment options that I should consider before proceeding with surgery?

  7. How many lumbar fusion surgeries have you performed and what is your success rate?

  8. What is the expected outcome in terms of pain relief and improvement in mobility after the surgery?

  9. Will I need to follow any specific post-operative care instructions or restrictions?

  10. How long do the results of lumbar fusion surgery typically last, and are there any potential long-term effects to be aware of?

Reference

Authors: Turlip R, Ahmad HS, Ghenbot YG, Wathen C, Chauhan D, McCloskey K, Yoon JW. Journal: World Neurosurg. 2023 Jul;175:e134-e140. doi: 10.1016/j.wneu.2023.03.040. Epub 2023 Mar 14. PMID: 36921714