Lumbar fusion involves the immobilization of two or more adjacent vertebrae to eliminate abnormal motion that causes pain or compression of the spinal cord or nerves. Fusion surgery may be required in the case of existing instability, as a result of degeneration or trauma, or if a decompression operation requires the removal of stabilizing elements of the spine to relieve pressure on nerves.
Lumbar fusion surgery joins two or more adjacent vertebral segments together to eliminate motion at that point in the spine. In many cases fusion helps to alleviate pain without any perceptible loss of range of motion.
Spinal fusion surgery involves using a bone graft to promote the growth together of two or more bones into one solid piece of bone. Bone graft material may be obtained from a patient’s own bone (iliac crest), a cadaver, or may be made from synthetic materials.
Lumbar fusion is indicated in a wide range of conditions depending on certain factors. In some cases the underlying problem is abnormal motion which causes mechanical pain or pain from nerve compression. In other cases the extent of nerve compression is so great that supporting structures of the spine must be removed to relieve pressure on the nerves, resulting in spinal instability. When decompression surgery causes instability a fusion operation is necessary to prevent painful abnormal motions
Conditions that may require lumbar fusion:
If your doctor recommends lumbar fusion surgery for you there are a variety of approaches which have different benefits and limitations. In some complex surgeries multiple approaches are utilized because of the benefits each provides.
Transforaminal Lumbar Interbody Fusion (TLIF)
TLIF involves the removal of one or both facet joints from the back of the spine, followed by disc removal, and placement of a cage or spacer and bone graft in the disc space. This approach relies on direct decompression of the nerves by removing bone and ligament as well as indirect decompression of the nerves by widening the space between the vertebrae.
Lateral Lumbar Interbody Fusion (LLIF)
LLIF surgery is a minimally invasive technique for fusion above the L5-S1 level. It involves dissecting through the retroperitoneal space, behind the abdominal organs, and using a specialized retractor to reach the disc space while protecting important neighboring structures. The disc or discs are removed and a cage or spacer filled with bone graft is inserted in the disc space. This is a powerful technique to indirectly decompress the nerves by increasing the space between the vertebrae and stretching out the ligaments that are applying pressure to the nerves.
Anterior Lumbar Interbody Fusion (ALIF)
During ALIF, Dr. Ditty works with a vascular surgeon to approach the lower levels of the lumbar spine through the front of your body. After the vascular surgeon safely moves the large arteries and veins that lay across the front of your spine, Dr. Ditty removes the intervertebral disc and places a cage or spacer filled with bone graft. This technique helps to restore normal height and angulation and is effective for indirectly decompressing nerves by stretching the ligaments that have buckled and are pressing on nerves.
Pedicle Screw Fixation
While some fusion techniques derive their stability from the placement of a large spacer alone, many patients will require the insertion of screws and rods to maintain stability while the bony fusion occurs. This is just like an internal cast for a broken bone.
Schedule a consultation with Dr. Ditty to discuss your surgical options. Dr. Ditty and his team will guide you through the steps you need to take for pre-surgical preparation and post-surgical recovery, including nonsurgical lifestyle changes to prevent further pain or complications.
Call (239) 337-2003 today to schedule a consultation or learn more.