Lumbar spinal fusion surgery involves fusing spine bones, or vertebrae, together in the area of the spine between the ribs and hipbone, according to the MayoClinic.com. Fusing is a term used to describe two vertebrae bones being permanently placed together. Lumbar spinal fusion surgery stops movement between the two bones, so the person no longer experiences back problems.
Candidates
Spinal fusion surgery permanently connects two or more vertebrae in the spine to improve stability, correct a deformity, or reduce pain, according to the MayoClinic.com. Spinal fusion surgery, therefore, may be recommended to treat spine problems including spinal stenosis, fractured vertebrae, spinal infections or tumors, spinal weakness or instability, spinal deformities, spondylolisthesis, herniated disc, or chronic low back pain.
Risks
Risks for any surgery in general include blood clots in legs that may travel to the lungs, breathing problems, pneumonia, blood loss, and heart attack or stroke during surgery. Spinal surgery also includes its own risk, such as infection in the wound or vertebral bones, and damage to a spinal nerve, which can cause weakness, pain, loss of sensation and problems with bowel or bladder movements, according to MedlinePlus.
Post-surgery, the fusion of vertebrae changes how the spine works by shifting stress from the fused vertebrae to adjacent areas of the spine. MedlinePlus states this added stress may, therefore, cause wear-and-tear in the vertebral joints on either side of the fusion, causing further damage and possible chronic pain years after surgery.
Surgery Prep and Procedure
In order to prepare for surgery, hair that is covering the surgical site is trimmed and then cleaned with a special soap or antiseptic, according to the MayoClinic.com. Lumbar spinal fusion surgery is performed under general anesthesia. During the procedure, a surgical team monitors the patient's heart rate, blood pressure and blood oxygen.
Surgical Techniques
Surgeons have developed a variety of techniques for performing lumbar spinal fusion surgery, according to MayoClinic.com. The technique a surgeon uses typically depends on the reason for lumbar spinal fusion surgery. The incision can occur in one of two places, either the abdomen or the posterior surface of the spine. After the incision is made, the surgeon moves the muscles and blood vessels away to gain the greatest access they can to the spine.
Anterior Lumbar Spinal Fusion
Anterior lumbar spinal fusion surgery involves retracting the abdominal muscles, removing the disk and placing a bone graft between the vertebrae. Bone used for the grafts comes from either the patient's hip or pelvis. Wires, rods, screws, cages and mental plates may also be used, according to the MayoClinic.com. The vertebrae then permanently fuse together over time, discontinuing movement between them, and eliminating nerve irritation and painful motion.
Posterior Lumbar Spinal Fusion
Posterior lumbar spinal fusion surgery involves removing the lamina, a thin layer of bone covering the vertebrae to provide access to the disk space. Nerves are pushed aside and the disc is then removed. Bone grafts are placed into the empty space where the disc used to reside. Over time, the vertebrae fuse together and no longer move, eliminating nerve irritation and painful motion.
