Posterior Lumbar Spinal Fusion

One of the most frequent causes of disability that comes with age is lumbar spine (low back) disease which can lead to lumbar spine instability.  Common symptoms of lumbar spinal disease that may indicate the need for posterior lumbar fusion include:

• low back pain
• cramping
• cauda equina syndrome, and
• nerve root compression which causes weakness, numbness, and tingling in the legs that worsens with standing and walking.

Degenerative spinal conditions severely restrict mobility and lead to a poor quality of life. The medical term for spinal fusion is arthrodesis.

What is posterior lumbar fusion?

Posterior lumbar fusion is surgical treatment for lumbar spine disease, most frequently degenerative spinal disease. Lumbar spinal fusion is a broad term used to describe the surgical fusion of two or more vertebrae to:

• eliminate movement between the diseased vertebrae
• prevent stretched nerves and muscles, and
• open the space between the diseased vertebrae to decompress trapped nerve roots.

The majority of spinal fusion surgeries involve only a few segments of the lumbar spine and will not limit mobility much if at all.

Posterior lumbar fusion is a well – established surgical procedure with low risk. The primary goal is to stop the pain and stabilize the spine by fusing the lumbar vertebrae to relieve pressure on the nerve roots or spinal column. The surgery is performed through the low back and may also involve the removal of a degenerated disc or decompression surgery called a laminectomy, the removal of diseased tissues that compress spinal nerves. Spinal fusion is the most reliable way to reduce the pain caused by degenerative spine disease.

What conditions are treated with lumbar spinal fusion?

The most common indication for lumbar spinal fusion is degenerative disc disease. However, lumbar spinal fusion can treat a range of spinal disorders including:

• degenerative conditions of the spine including spinal stenosis
• excessive curvature of the spine (lordosis) from degenerated discs and or osteoporosis
• congenital and degenerative deformities such as spinal curvature (scoliosis)
• spinal tumors
• trauma including vertebral fractures (spondylolysis)
• a degenerated vertebra slips out of alignment (spondylolisthesis)
• infections
• a herniated disk
• spinal stenosis (spinal arthritis that narrows the spinal canal or facets)

When will lumbar spinal fusion be recommended?

Dr. Federico Girardi will only recommend lumbar spinal fusion as the last best option to restore function and eliminate pain in the lumbar spine, after all other options have failed.  Importantly, patients will learn that spinal fusion does not mean motion will be restricted. Instead, most patients do not become aware of limitations.

When Dr. Girardi recommends the procedure, he will explain why he recommends surgery, how your pain will be managed, how to prepare and what to expect. In preparation for surgery, he will conduct extensive preoperative imaging studies including MRI and/or CT scans to map the vital structures.

Lumbar spinal fusion procedures

Lumbar spinal fusion is major surgery that involves the insertion of a structural graft into the disc space between vertebrae to promote bony fusion. This achieves decompression of the spinal nerves by expanding the space for the nerves and the ligaments. It is performed under general anesthetic and recovery will involve hospitalization for several days depending on the surgical procedure chosen. It can take 4-6 months to fully recover with physical therapy.

Various advanced techniques based are available and will be chosen based upon your condition. Each has advantages and disadvantages that will be discussed with you so that you may make an informed decision about proceeding with lumbar spine fusion.

Minimally invasive spinal fusion surgery is faster and safer, and recovery time is reduced when compared to open spinal procedures. Moreover, newer bone graft materials improve success rates, including the use of bone marrow (autografts), stem cells, allografts in combination with ceramics, growth factors and other biologics. Dr. Girardi will determine the best bone graft options for each patient.

The most important decision you will make as a patient is choosing the right surgeon. Dr. Federico Girardi is a world-renowned spinal surgeon in New York, New York. He and his team of spinal surgery experts are leaders in their field, with extraordinary training and experience. Our patients are always treated with respect and compassionate.  You will receive the information and attention you need to feel comfortable and safe in your decision and in your treatment.

When you or a loved one is suffering from lumbar spine pain and disability, you owe it to yourself to contact Dr. Girardi to schedule a consultation and learn about all your options.