Our Summary

This research paper is about a less invasive surgical procedure known as lateral lumbar interbody fusion, which is used to treat common spine issues like instability, narrowing of the spinal canal, curvature of the spine, and disease of the spinal discs. This technique uses a side approach to the spine and has shown promising results in terms of graft placement, graft volumes, and early stability after surgery, which are comparable to an older method known as anterior lumbar interbody fusion that uses a frontal approach. However, it’s not without its risks. Patients can experience temporary groin pain or numbness, and in rare cases, long-lasting and debilitating muscle weakness in the thigh. Other infrequent but serious complications include damage to blood vessels and internal organs. Nevertheless, as our understanding of the technique and the nervous system of the lower back improves, this surgery is expected to continue to be a safer and more successful option compared to traditional methods.

FAQs

  1. What is lateral lumbar interbody fusion and how does it compare to anterior lumbar interbody fusion?
  2. What are some of the potential complications or side effects of lateral lumbar interbody fusion?
  3. What conditions can be treated using lateral lumbar interbody fusion?

Doctor’s Tip

A helpful tip a doctor might tell a patient about spinal fusion is to follow the post-operative care instructions carefully, including proper lifting techniques, physical therapy exercises, and avoiding activities that could put strain on the spine. It is also important to attend all follow-up appointments to ensure proper healing and address any concerns or complications that may arise.

Suitable For

Patients who are typically recommended for spinal fusion surgery include those with:

  1. Degenerative disc disease: Spinal fusion may be recommended for patients with degenerative disc disease that causes chronic back pain and/or nerve compression.

  2. Spinal instability: Patients with spinal instability, such as spondylolisthesis or spinal fractures, may benefit from spinal fusion surgery to stabilize the spine.

  3. Scoliosis: Spinal fusion may be recommended for patients with severe scoliosis that is causing pain or affecting the function of the spine.

  4. Spinal stenosis: Patients with spinal stenosis, a narrowing of the spinal canal that can cause nerve compression and pain, may benefit from spinal fusion surgery to relieve pressure on the nerves.

  5. Failed back surgery syndrome: Patients who have not experienced relief from previous back surgeries may be recommended for spinal fusion surgery to address ongoing pain and instability.

  6. Other spinal conditions: Spinal fusion may also be recommended for patients with other spinal conditions, such as spinal tumors or infections, that require stabilization of the spine.

Timeline

Before spinal fusion:

  • Patient will typically undergo a series of conservative treatments such as physical therapy, medications, injections, and/or spinal bracing to manage their back pain and symptoms.
  • If these treatments are unsuccessful in alleviating the pain and symptoms, the patient may be recommended for spinal fusion surgery.
  • Before surgery, the patient will undergo a thorough evaluation by their medical team to assess their overall health and suitability for surgery.
  • The patient will receive pre-operative instructions and may need to undergo pre-operative testing such as blood work, imaging studies, and possibly a pre-surgical clearance from other specialists.

After spinal fusion:

  • The patient will be monitored closely in the immediate post-operative period in the hospital to ensure proper healing and manage pain.
  • Physical therapy and rehabilitation will be initiated to help the patient regain strength and mobility in the spine.
  • The patient will be given instructions on how to care for their surgical incision and any restrictions on physical activity.
  • Follow-up appointments will be scheduled with the surgeon to monitor the healing process and address any concerns or complications.
  • Over time, the patient will gradually return to normal activities and may experience improved function and reduced pain in the spine.

What to Ask Your Doctor

  1. What specific conditions or symptoms indicate that spinal fusion may be necessary for me?
  2. What are the potential risks and complications associated with spinal fusion surgery?
  3. How long is the recovery period after spinal fusion surgery and what can I expect during the recovery process?
  4. Are there alternative treatment options to spinal fusion that I should consider?
  5. What type of spinal fusion technique will be used in my case and why?
  6. How experienced are you in performing spinal fusion surgeries and what is your success rate?
  7. Will I need physical therapy or additional treatments after the surgery?
  8. How long can I expect the effects of spinal fusion surgery to last?
  9. Are there any lifestyle changes or restrictions I should be aware of after the surgery?
  10. What should I do if I experience any complications or concerns after the surgery?

Reference

Authors: Kwon B, Kim DH. Journal: J Am Acad Orthop Surg. 2016 Feb;24(2):96-105. doi: 10.5435/JAAOS-D-14-00208. PMID: 26803545