Dr. Dan Albright, an orthopedic surgeon in Raleigh, North Carolina, discusses lumbar fusion surgery. When do you do it? What does it involve and what happens after a lumbar fusion surgery?
Summary of video:
What is lumbar fusion surgery? When do you do it? What does it involve and what happens after the lumbar fusion surgery?
A patient would need a fusion if they have an unstable spine or if a bone has shifted forwards or sideways and is pinching a nerve. Fusion surgery and decompression surgery together are great for back pain that is shooting into the buttock, the leg or the hip. This is nerve pain and is common in patients that have a shifted bone. It is also seen in patients with scoliosis or a twisted spine. The patient’s is not in good alignment and the alignment worsens over time and pinches a nerve. That’s the main reason to get surgery for a lumbar fusion when the spine is unstable and shifting. Trauma, fractures or cancer may also call for fusion surgery, but these are much more rare.
In recent years surgeons are not fusing the lumbar spine simply for back pain only. If a patient has a stable spine and it’s not shifting, fusions are not done. The general criteria is back pain plus leg pain – nerve pain.
So what does the fusion involve? Fusion surgery connects two vertebrae. Four screws are screwed into the pedicle (which is part of the vertebra bone) of two adjacent vertebrae bones. These are the anchors. Then the bones are connected using rods. The procedure is finished by putting in a bone graft which is bone harvest from the patient or bone from a bone bank from someone else. Over the next three months, those vertebrae melt together, fused together almost like wax. The bones fuse together so there’s no motion. So three months after surgery these two bones are one bone.
After surgery the patient needs three months for the bones to get solid. There is no heavy lifting for three months. Once the patient has healed they can do most activities. Good common sense says if a patient has had a lumbar fusion they won’t be doing gymnastics or any hyper-aggressive activities.
There is very strong research supporting this surgery. Surgeons have gotten very, very picky about which patients they do surgery on. In years past there were too many screws that went in for back pain and that did not work. So many spine surgeons are particularly selective in who they do surgery on and only after all non-surgical treatments have failed.
If you would like more information on lumbar spine surgery, contact Dr. Dan Albright at 919-863-6808.