A lumbar spinal fusion is a surgery performed to relieve back pain. During the operation, the surgeon removes the lumbar disc and replaces it with a bone graft. The vertebral bones on each side of the graft fuse, forming one solid area of bone. Rods and screws can be used to secure the vertebrae. Although the procedure is more successful than it was in years past, there are still complications associated with the operation.
Urinary Complications
Urinary tract infections and episodes of the bladder not emptying completely can occur after a lumbar fusion. An indwelling urinary catheter placed in the patient during surgery and for the immediate postoperative period normally causes these complications. Antibiotics treat the infection.
Wound Infection
After the operation, a wound infection in the back is possible. Signs of an infection include fever, redness at the incision site, drainage coming from the incision and increased pain. Antibiotics, administered before the surgery, help prevent this complication.
Thrombophlebitis
Phlebitis is an inflammation of the blood vessels. This can occur in the legs during surgery, causing pain and possible causing blood clots to form. The blood clots might break free from the vessels in the legs and migrate to the lungs, heart or brain. A blood clot in these regions may cause permanent injury or death. The surgeon orders compression pumps for the legs that increase the circulation in the legs during surgery and immediately following the operation. The pumps decrease the chance of the thrombophlebitis. Walking as soon as possible after surgery also decreases the risk.
Pnuemonia
Following a surgery and general anesthesia, the bottom lobes of the lungs might not expand as much as normal. Pain and decreased mobilization also increase the likelihood of the lower sections of exercising the lungs properly. This allows fluid to collect in the lungs, causing pneumonia. Walking, deep breathing and coughing help open the lower sections of the lungs preventing pneumonia from occurring.
Pain
Pain is an expected complication of surgery, but the pain might linger longer than expected. The pain might be from hardware malfunction or migration at the surgical site. Other times it might mean that the surgery did not eliminate the preoperative pain.
Nerve Damage
Because the spinal fusion involves manipulating the spinal cord and the surrounding nerves, the lower body and lower extremities may no longer have the same sensation as before surgery. This can cause numbness and tingling to the legs. Damage to the nerves that run to the pelvis may cause sexual dysfunction.
Pseudoarthrosis
Pseudoarthrosis is a condition where the bone graft does not heal properly. The hardware placed in the back might also fail to work properly, causing the condition. The ultimate goal of the surgery is to fuse the vertebrae together. If pseudoarthrosis occurs, the fusion is not complete and the vertebrae can still move independent of each other. This also causes continued pain for the individual. Additional surgeries might be necessary to repair the graft and fuse the bones.
