Our Summary

This research paper is about two types of surgeries for degenerative disorders of the lumbar (lower back) region: lumbar fusion and motion-preserving procedures (MPP). Lumbar fusion is a common treatment that improves patient outcomes, but it can also lead to problems in the nearby areas of the spine due to reduced mobility. As a result, MPP have been developed to try to avoid these issues.

The researchers conducted a systematic review and meta-analysis of 19 studies involving 1,751 patients to compare the rates of spine degeneration, symptomatic disease, and reoperation in the areas adjacent to the surgical site for both types of procedures.

The results showed no significant difference in the rates of these complications between the two types of surgery. However, a more detailed analysis revealed that patients who underwent MPP were significantly less likely to experience spine degeneration and require reoperation compared to those who had lumbar fusion.

The researchers concluded that while MPP have shown potential benefits in lab models, more high-quality studies are needed to fully understand their long-term effects on patients, postoperative complications, and related costs.

FAQs

  1. What are the two types of surgeries discussed in this research for treating degenerative disorders of the lumbar region?
  2. What were the key findings of the systematic review and meta-analysis comparing lumbar fusion and motion-preserving procedures (MPP)?
  3. What did the researchers conclude about the potential benefits and long-term effects of MPP?

Doctor’s Tip

One helpful tip a doctor might tell a patient about lumbar fusion is to carefully follow the prescribed post-operative care instructions, including physical therapy and activity restrictions. This can help optimize healing, reduce the risk of complications, and promote a successful outcome. It’s also important to communicate with your healthcare team about any concerns or changes in symptoms during the recovery process.

Suitable For

Typically, patients who are recommended lumbar fusion are those with severe lower back pain, instability in the spine, spinal stenosis, spondylolisthesis, or degenerative disc disease that has not responded to conservative treatments such as physical therapy, medication, or injections. Patients with conditions such as herniated discs, spinal fractures, or tumors in the lumbar region may also be candidates for lumbar fusion surgery.

It is important for patients to discuss their symptoms, medical history, and treatment options with their healthcare provider to determine the most appropriate course of action for their specific condition. In some cases, a combination of lumbar fusion and motion-preserving procedures may be recommended to achieve the best possible outcome for the patient.

Timeline

  • Before lumbar fusion:
  1. Patient experiences chronic lower back pain, leg pain, and/or numbness due to degenerative disorders in the lumbar region.
  2. Patient undergoes diagnostic tests such as X-rays, MRIs, and CT scans to confirm the diagnosis and determine the extent of the damage.
  3. Patient and surgeon discuss treatment options, risks, and benefits of lumbar fusion surgery.
  4. Patient undergoes preoperative evaluations and preparations for surgery, including physical therapy and medication management.
  • After lumbar fusion:
  1. Patient undergoes the surgical procedure to fuse the affected vertebrae together, stabilizing the spine and reducing pain.
  2. Patient stays in the hospital for a few days for postoperative care, pain management, and physical therapy.
  3. Patient may experience temporary pain and discomfort at the surgical site, as well as limitations in mobility and activities.
  4. Patient follows a rehabilitation plan to gradually increase strength and flexibility, and to learn proper body mechanics to prevent future injuries.
  5. Patient attends follow-up appointments with the surgeon to monitor healing progress and address any complications or concerns.

What to Ask Your Doctor

Some questions a patient should ask their doctor about lumbar fusion include:

  1. What are the potential risks and complications associated with lumbar fusion surgery?
  2. How long is the recovery process after lumbar fusion surgery?
  3. What are the expected outcomes and success rates of lumbar fusion surgery?
  4. Are there alternative treatments or procedures to lumbar fusion that I should consider?
  5. How will lumbar fusion surgery affect my mobility and quality of life in the long term?
  6. What is the likelihood of needing additional surgery or treatment in the future after lumbar fusion?
  7. How experienced are you in performing lumbar fusion surgery, and what is your success rate with this procedure?
  8. Are there any specific lifestyle changes or precautions I should take before or after lumbar fusion surgery?
  9. Will I need physical therapy or rehabilitation after lumbar fusion surgery, and if so, for how long?
  10. What can I expect in terms of follow-up care and monitoring after lumbar fusion surgery?

Reference

Authors: Donnally CJ 3rd, Patel PD, Canseco JA, Divi SN, Goz V, Sherman MB, Shenoy K, Markowitz M, Rihn JA, Vaccaro AR. Journal: Spine J. 2020 Oct;20(10):1554-1565. doi: 10.1016/j.spinee.2020.05.100. Epub 2020 May 20. PMID: 32445805