Our Summary

This research paper discusses a type of spine surgery called lumbar spinal fusion. This surgery is meant to create a lasting union between vertebrae in the lower back (lumbar region) to help maintain the spine’s stability. There are several ways to perform this surgery, including from the back (posterior), from the side (lateral), or from the front (anterior) of the body. The paper reviews these different methods, when they should be used, potential complications, and their results.

FAQs

  1. What is lumbar spinal fusion surgery and why is it performed?
  2. What are the different methods of performing lumbar spinal fusion surgery?
  3. What potential complications can arise from lumbar spinal fusion surgery?

Doctor’s Tip

One helpful tip a doctor might tell a patient about lumbar fusion is to follow post-operative instructions carefully to ensure proper healing and recovery. This may include avoiding heavy lifting, bending at the waist, or twisting the spine for a certain period of time. Physical therapy and rehabilitation exercises may also be recommended to help strengthen the surrounding muscles and improve mobility. It is important for patients to communicate openly with their healthcare team about any concerns or symptoms they may experience during the recovery process.

Suitable For

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

  • Severe lower back pain that has not improved with conservative treatments such as physical therapy, medication, and injections
  • Spinal instability due to conditions such as spondylolisthesis, degenerative disc disease, or spinal stenosis
  • Spinal deformities such as scoliosis or kyphosis
  • Failed previous spinal surgery
  • Fractures or tumors in the spine

It is important for patients to undergo a thorough evaluation by a spine specialist to determine if lumbar fusion surgery is the best treatment option for their condition. The decision to undergo surgery should be based on the severity of symptoms, the patient’s overall health, and the potential risks and benefits of the procedure.

Timeline

Before Lumbar Fusion:

  1. Patient consults with a healthcare provider and undergoes a thorough physical examination and imaging tests to determine the need for lumbar fusion surgery.
  2. Patient discusses the risks and benefits of the surgery with their healthcare provider and decides to proceed with the procedure.
  3. Patient may undergo pre-operative testing and preparations, such as blood tests and medication adjustments.
  4. Patient is instructed on how to prepare for surgery, including fasting before the procedure.

During Lumbar Fusion:

  1. Patient is placed under general anesthesia for the surgery.
  2. Surgeon makes an incision in the back, side, or front of the body to access the spine.
  3. Degenerated or damaged discs and/or vertebrae are removed and replaced with bone graft or implants to promote fusion.
  4. Surgeon may use metal plates, screws, or rods to stabilize the spine during the healing process.
  5. Incision is closed, and patient is moved to a recovery area to wake up from anesthesia.

After Lumbar Fusion:

  1. Patient may experience pain, discomfort, and limited mobility immediately following surgery.
  2. Patient is monitored in the hospital for a few days to ensure proper healing and manage pain.
  3. Patient may be prescribed pain medications, physical therapy, and instructions for at-home care.
  4. Patient follows up with their healthcare provider for post-operative appointments and imaging tests to monitor fusion progress.
  5. Patient gradually resumes normal activities and may experience improved spine stability and reduced pain over time.

What to Ask Your Doctor

  1. What are the different types of lumbar spinal fusion surgery and which one do you recommend for me?

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

  3. What is the success rate of lumbar fusion surgery in terms of pain relief and improved function?

  4. How long is the recovery process after lumbar fusion surgery and what can I expect during this time?

  5. Will I need physical therapy or rehabilitation after the surgery, and if so, for how long?

  6. Are there any alternative treatments or therapies that I should consider before deciding on lumbar fusion surgery?

  7. How long will I need to take off work or limit my activities after lumbar fusion surgery?

  8. What is the likelihood of needing additional surgeries or treatments in the future after lumbar fusion surgery?

  9. Are there any lifestyle changes or precautions I should take after lumbar fusion surgery to prevent complications or worsen my condition?

  10. How long do the results of lumbar fusion surgery typically last, and what can I do to prolong the benefits of the surgery?

Reference

Authors: Schnake KJ, Rappert D, Storzer B, Schreyer S, Hilber F, Mehren C. Journal: Orthopade. 2019 Jan;48(1):50-58. doi: 10.1007/s00132-018-03670-w. PMID: 30552449