Posterior Lumbar Fusion

This procedure is typically recommended for patients suffering from:

• Degenerative Disc Disease: The discs between the vertebrae can wear down over time, leading to pain and instability.
• Spondylolisthesis: A condition where one vertebra slips forward over the one below it, which can cause pain and nerve compression.
• Spinal Stenosis: Narrowing of the spinal canal, leading to compression of the spinal cord or nerves, often causing pain, numbness, or weakness in the legs.
• Spinal Fractures: In cases of traumatic injury, where the vertebrae are unstable.
• Spinal Deformities: Such as scoliosis or kyphosis, where fusion helps to correct abnormal spinal curvature.
• Infections: Infections in the bones or soft tissues of the spine.
• Tumors: abnormal masses in the spine may require lumbar stabilization.

Dr. Colman will only recommend a posterior lumbar fusion when he has diagnosed the cause of your symptoms and conservative treatments such as physical therapy, medications, and injections have failed to provide adequate relief from symptoms.

1. Exposure: The patient is under general anesthesia for this procedure. Dr. Colman will access the spine from your back. Sometimes the procedure is performed as open surgery with one large incision, and sometimes it is performed as minimally invasive surgery with several small incisions. Muscles and tissues are moved aside to expose the affected vertebrae.
2. Laminectomy: Commonly, the lamina or “rroof” of the spinal canal is removed to allow nerve decompression and further cleanout of discs or bone fragments to relieve pressure on the spinal nerves.
3. Instrumentation: Screws are placed, with rods connecting the screws in order to realign and stabilize the spine. Sometimes, in cases of severe instability or deformity, a spacer or cage is inserted in the disc space after removal of the damaged disc.
4. Bone grafting and fusion: Typically, bone graft is laid on the sides of the spine to form a “gutter” of bone healing. Bone graft typically consists of the patient’s own bone “recycled” from the laminectomy, combined with synthetic bone or synthetic proteins which stimulate healing. Sometimes, when interbody fusion is employed, graft may be packed into the spacer and disc space itself to create an additional fusion bed. The goal is to have the vertebrae heal together into one solid unit.

Recovery from posterior lumbar fusion can take several months, during which time the bone graft needs to heal and fuse the vertebrae. Patients typically require physical therapy to regain strength and mobility. The outcome of the surgery is typically very positive, with many patients experiencing significant relief from pain and improved function. However, as with any surgical procedure, there are potential risks, including infection, bleeding, nerve damage, and the possibility that the fusion may not be successful (nonunion).

Posterior lumbar fusion is a well-established surgical technique for treating various spinal conditions that cause pain and instability. By stabilizing the spine, the procedure aims to provide long-term relief and improve the patient’s quality of life. Patients considering this surgery should discuss the potential benefits and risks with their healthcare provider to make an informed decision.