Procedure to stabilize the Lower Back and Problems Related to Spondylolisthesis,
Degenerative Disc Disease, Arthritis and Degenerative Scoliosis
The lumbar area of the spine is better known as the lower back. A lumbar
fusion is an operation to stabilize the lower back by creating bony bridges
between at least two vertebrae and eliminating motion between them. It
can be done by fusing the vertebral bodies in front (anterior) or by fusing
the facet joints and lamina in the back (posterior). Bone or bone substitutes
can be placed on and between the lamina and the facet joints. Metal screws
and rods or plates may be attached to the bones to secure the fixation,
while the bony bridge heals.
During the operation, a 4- to 5-inch incision is made in the lower back
and the muscles supporting the spine are divided. A small window is made
in the sheet of bone (lamina) covering the spinal cord. Next, the surgeon
removes any ruptured disc material or bone spurs that are pinching the
nerves or spinal cord.
The site is then prepared for fusion by obtaining bone graft and/or bone
substitute and laying it on the bone. Metal screws and rods or plates
may be attached to the bones to secure fixation while the bone heals.
Who is a candidate?
Lumbar fusion may be recommended to treat a number of spine problems. However,
the majority of people with these conditions will be successfully treated
with conservative measures—that is, without surgery. Only after
conservative measures have failed to relieve symptoms will surgery be
considered. Problems that may be treated with lumbar fusion include:
Spondylolisthesis — With spondylolisthesis, one vertebra has slipped forward over
another. This may cause leg pain, numbness, tingling and/or weakness.
Degenerative Disc Disease — Age and wear and tear can cause the discs that act as cushions
between each vertebrae to shrink, allowing abnormal movement, which compresses
the nerves, causing leg pain and numbness.
Arthritis — Arthritis of the spine can lead to spinal stenosis, a narrowing of
- the spinal canal caused by bony spurs forming on the vertebrae, narrowing
the openings through which the nerves and nerve roots must travel. This
narrowing can cause pressure on the nerves, resulting in pain, numbness,
tingling or weakness down the legs.
Degenerative Scoliosis — Degenerative scoliosis occurs when the combination of age and
deterioration of the spine leads to the development of a curve in the spine.
Where does the bone for a fusion come from?
The bone graft can be taken from you or from a bone bank. If using your
own bone, local bone is saved during the surgery. Bone from a bone bank
is a good option if your own bone is weak or damaged from osteoporosis.
In addition, synthetic bone graft may be used.
How long will it take to recover?
Recovery time after lumbar fusion varies depending on your particular situation,
the number of levels involved, as well as your general health. Many people
will return home after two or three days in the hospital.
The key to a successful recovery is maintaining a positive attitude. You
will be able to take short walks while in the hospital and need to gradually
increase the distance and frequency once at home. It can take up to three
to four months for the bones to fuse together.
To find a physician who specializes in this procedure,
e-mail or call our nurse navigator at (619) 229-4548 or (800) 258-2723.