What is lumbar spinal fusion?

Lumbar spinal fusion is a surgical procedure used to permanently connect two or more of the vertebrae (spinal bones) in the lower back. The goal of lumbar fusion is to create one single solid bone that is “fused” together. Lumbar fusion is done to eliminate painful motion and to restore stability to the spine. Lumbar spinal fusion should only be considered when your surgeon can pinpoint the exact source of your lower back pain. The experts at BICMD can diagnose the source of your lower back pain through a telemedicine visit and a review of your imaging tests and medical history. Our “Best in class” orthopedic surgeons can give you the best surgical recommendation and second opinion if you are considering a lumbar fusion.

Why would I need a lumbar spinal fusion?

Lower back pain is often the result of a degenerative disc. Over time the discs can continue to degrade and flatten, losing the ability to act as shock absorbers between the vertebrae. Other causes of lower back pain may include a herniated disc. Lumbar fusion is recommended when the source of your lower back pain can be clearly defined. Lumbar fusion is a good option when the patient has symptoms from the following:

  • Degenerative Disc Disease
  • Lumbar disc herniation
  • Lumbar spinal stenosis
  • Fractured vertebrae
  • Severe scoliosis
  • Spinal tumor or cyst

A fusion procedure may be recommended to eliminate painful motion, restore your alignment or posture, or provide stability to your spine. In certain cases, your surgeon may perform a laminectomy in addition to the fusion procedure if you have leg symptoms, such as pain or numbness. Our goal is to identify that your degenerative disc is the cause of your ongoing symptoms. Fusion surgery is one way to treat your symptoms.

How is lumbar spinal fusion surgery performed?

Lumbar fusion surgery is done to mimic the process of a healing broken bone. A lumbar fusion may also include a laminectomy or a discectomy if there is accompanied pain or numbness caused by nerve or spinal impingement. There are several different techniques and approaches used for a lumbar fusion procedure. These may include:

  • Approaches (to access the vertebrae)
    • Anterior Lumbar Interbody Fusion (ALIF) – accessing the spine from the front of the body
    • Posterior Lumbar Interbody Fusion (PLIF) – accessing the spine from the back
    • Lateral Lumbar Interbody Fusion (LLIF) – accessing the spine from the side of the body

Lumbar fusion procedure:

Skilled orthopedic spine surgeons have developed different techniques for performing lumbar fusion surgery. The procedure, or technique will vary, based on the location of the vertebrae to be fused. Patient’s age, health and body shape will also determine the technique for the specific lumbar fusion. In general, the surgeon will perform the following:

  • Incision to access the vertebrae
  • Bone graft preparation
    • Bone grafts can be autografts (from the patient’s own body) or an allograft (donor bone)
    • Synthetic bone graft material has also been developed and may be used, depending on the type of procedure required.
  • Fusion – Metal plates, screws or rods may be used to help the bones heal properly together

How long is the recovery after lumbar spinal fusion surgery?

Patients will spend a few days in the hospital after lumbar fusion surgery. Pain medication should be taken as directed and patients are usually required to wear a brace while the bones fuse together. Proper positioning and techniques for walking, sitting, standing will be taught by a skilled physical therapist. As the bones heal, symptoms improve and strength can be restored. It is typical for physical therapy to begin after 6 weeks, but some patients heal slower and it can take up to 3 months to begin a strengthening regimen. In general, most healthy patients recover from a lumbar fusion surgery in 6 months to 1 year.

For more information and resources on lumbar fusion surgery, or to obtain an expert 2nd opinion before having a surgical procedure, please contact our orthopedic spine surgeons and specialists, by clicking on “Connect With a Doctor.” You will be connected to one of our orthopedic telemedicine experts through our state-of-the-art telemedicine platform.