Lumbar Fusion Overview:
Lumbar fusion surgery, also known as spinal fusion surgery, is a procedure designed to “weld” adjacent vertebrae into one solid bone in the lower back (lumbar spine), eliminating motion and stabilizing the part of the spine that’s causing pain. The goal is to reduce pain and address instability caused by various conditions, such as degenerative disc disease, spondylolisthesis, spinal stenosis, or fractures.
Video: Lumbar ADR (Fusion Alternative) Patient, Jeff
Some patients who should consider spinal fusion include:
- Patients with spondylolisthesis, a condition where one bone of the spine slips over another, out of its proper place. It can lead to symptoms such as back pain and leg pain or weakness, but a fusion can help correct that abnormal movement.
- Patients with degenerative disc disease. The shock-absorbing discs in between vertebrae can wear down over time, causing them to collapse and pinch nerves as they exit the spine. A fusion can restore the proper spacing and relieve the pressure on the nerve.
- Patients who’ve undergone multiple microdiscectomies or decompression surgeries. There may not be enough bone stability left in the spine after repeated procedures of this nature, so a fusion would be a more appropriate choice.
- Patients suffering from a rare condition called spondylolysis, which mostly affects the fifth lumbar vertebra in the lower back. Spondylolysis is a stress fracture in one of the vertebras of the back, and in severe cases the vertebrae can start shifting out of place.
Symptoms that may warrant Lumbar Fusion:
Several symptoms or spinal conditions may indicate a patient is a good candidate for lumbar fusion surgery. These include:
- Chronic Lower Back Pain: Persistent and debilitating pain that does not respond to conservative treatment.
- Spinal Instability: Instability, including abnormal movement or misalignment of the vertebrae, can arise due to age, a stress fracture, or if the small joints that keep the spine straight move out of alignment and it leads to pain and functional limitations.
- Degenerative Disc Disease: Breakdown of the discs between the vertebrae, causing pain and reduced mobility.
- Spondylolisthesis: When one vertebra slips over another, causing nerve compression and pain.
Spinal Stenosis: Narrowing of the spinal canal, leading to pressure on the spinal cord and nerves.
Lumbar Fusion Treatment:
Conservative treatments are often attempted before considering lumbar fusion surgery. Treatments may include:
- Medications: Taking pain relievers, anti-inflammatories, or muscle relaxants to help alleviate pain.
- Physical Therapy: Performing physical therapy exercises targeted for strengthening the core muscles and improving flexibility.
- Injections: Receiving epidural steroid injections or nerve blocks to reduce inflammation and provide temporary relief.
- Rest: Taking a break from physical activities may help reduce pain.
However, if the pain remains debilitating despite conservative interventions, lumbar fusion surgery may be recommended. More and more patients are opting for minimally invasive spinal fusions because they cause less damage to surrounding tissues and results in a smaller incision, reduced blood loss, less pain, and a shorter stay at our surgery center. In a minimally invasive procedure, the muscles are spread gently using a microscope so the surgeon can work around them, reducing spinal fusion complications. The length of spinal fusion recovery time is also greatly reduced, as is the amount of narcotic pain medication needed.
There are three main types of minimally invasive spinal fusion that are based on where the damaged intervertebral disc is located:
- ALIF, where the incision is through the patient’s abdomen
- XLIF, through the patient’s side
- TLIF, through the patient’s back
Lumbar Fusion Recovery:
Recovery from lumbar fusion surgery varies based on the individual, severity of the instability and the treatment provided, but in many cases, it consists of just one week of rest and downtime when the minimally invasive surgical option is performed. After the initial week comes a few weeks of lighter activity such as walking and working, and then by six weeks after the operation, some light exercise.
Most patients get back to life with minimal discomfort, and the vast majority of patients that have a one-level fusion do not experience a real change or reduction in their motion. Most importantly, the pain that they came in with can be eliminated. In fact, top athletes such as Peyton Manning, who had a neck fusion, and Tiger Woods, who had a lumbar fusion, were able to play professionally after their procedures.
It's important to work closely with a reputable spine surgeon to address the patient’s needs and pain when determining the best treatment plan. Schedule a consultation with one of our spine specialists today to learn more about your options and take the steps to feel pain-free.
