Lumbar fusion surgery is a procedure used to correct problems with the vertebrae in the lumbar (lower back) region of the spine. The spine surgeon permanently fuses together the affected lumbar vertebrae so that they heal together into a single, solid bone. The goals of lumbar fusion surgery are to restore nerve function, relieve pain, numbness, tingling and weakness and prevent abnormal motion in the spine.
Several diseases and disorders of the lumbar spine are corrected with lumbar fusion surgery including:
- Sciatic nerve pain – This is the most common reason for lumbar fusion surgery. Sciatic nerve pain radiates down the leg and is usually a direct result of a herniated disc in the lumbar section of the spine. The sciatic nerve runs from the lower back to the legs, linking any pain felt in the lower back to the lower extremities.
- Spondylolisthesis – Consists of one vertebra slipping out of place onto another vertebra. This can be a very painful condition, because the slipped bones grind against each other without the protective cushioning of the intervertebral disc. Spondylolisthesis compresses the surrounding nerves and causes leg pain, numbness, tingling and weakness.
- Degenerative disc disease – This disease can wear out the discs (shock-absorbing cushions between the vertebrae of your spine), causing them to shrink and eventually rupture. The disease can cause instability in the spine, abnormal movement and lower back pain. The surrounding nerves can be affected, causing pain, weakness, numbness and tingling in the legs.
- Lumbar spinal stenosis – The spinal canal or vertebral foramen narrow and cause compression of the nerves, which can lead to very painful symptoms.
If lumbar fusion is performed on the front of the spine, the surgeon removes the affected disc and any other debris from the spine. A bone graft is then placed between the vertebrae where the disc used to be. The bone graft fuses the two adjacent vertebrae into one solid bone to stabilize the spine and stop any abnormal motion. If the lumbar fusion surgery is performed on the back of the spine, then the surgeon will place bone graft material on either side of the affected vertebrae. The bone graft will grow into the vertebrae and ideally stop abnormal motion and create stability for the spine. Sometimes metal rods, screws and/or hooks are used in addition to the bone graft to further ensure stabilization of the spine.
After lumbar fusion surgery, your regular activities will be limited or restricted for an average of two months. Standing, walking and lying down will be the best positions for you in the first few weeks after surgery. Walking is encouraged as early as the same day of surgery, but must be increased very slowly over time.