Spinal fusion is a surgical procedure that is only recommended after conservative treatment methods have failed. There are a significant amount of factors that will be considered prior to Dr. Friesem’s recommendation to proceed with spinal fusion surgery.
Please note: Not everybody with lower back pain will require lumbar fusion surgery. However, if your back pain condition is one that requires surgery, this procedure has a long history as a safe and effective option.
Spinal fusion surgery involves using specialized instrumentation to perform a bone graft and permanently connecting two or more vertebrae together. This type of surgery is performed to provide stability and strength to the vertebrae and to eliminate chronic pain. Spinal fusion is actually one of the most common types of back surgery.
Reasons Lumbar Spinal Fusion Surgery is performed:
- Persistent back pain that has not responded to conservative methods – usually attributed to degenerative disc disease or spinal instability
- A definitive diagnosis of spinal stenosis (where there is an associated deformity)
- A definitive diagnosis of sponylolisthesis
- Prior failed laminectomy surgery
- Abnormal curvatures of the spine, such as scoliosis or kyphosis
- To correct a narrowing of the spinal canal
- Trauma to the spinal vertebrae – one or more fractured vertebrae
- To correct a spinal fracture
- Protrusion of the disc between the vertebrae (slipped disc, herniated nucleus pulposus)
- Weak or unstable spine caused by infection or tumour
There are various spinal fusion techniques including a posterior approach (an incision in the lower back) or an anterior approach (an incision in the abdomen). Sometimes one approach is preferable to another depending on the MRI findings and the age, sex and health of the patient. The types of approach will be thoroughly discussed with the patient prior to surgery.
What exactly happens during Lumbar Spinal Fusion Surgery?
During spinal fusion (which occurs while the patient is under general anesthetic), Dr Friesem will make an incision either directly over the spine or in the abdomen (as previously mentioned, the exact method will vary from case to case and will be thoroughly discussed with you prior to surgery). A bone graft taken from your own body, from a bone bank or synthetic bone is placed between the vertebrae. Metal screws, rods or cages are inserted to stabilize the vertebrae while the bone graft heals.
The goals of Lumbar Spinal Fusion Surgery include:
- Eliminating neurological problems
- Relieving chronic pain (lower back and leg)
- Reducing further weakness
- Restoring healthy nerve function
- Stopping or preventing abnormal motion in the spine
- Realigning the spine to improve posture