What Is Lumbar Fusion?

Thu Dec 1, 2022

What Is Lumbar FusionLumbar spinal fusion, also known as Arthrodesis, is a surgery to permanently fuse or join two or more bones (vertebrae) in the lower back to eliminate painful motion, restore stability and prevent movement between them. 

Lumbar spinal fusion aims to stop movement between bones and prevent back pain. When the bones are fused, they cannot move like before, which helps prevent you from stretching nearby nerves, muscles, and ligaments that might have been causing discomfort. 

What Are the Different Methods of Lumbar Spinal Fusion?

  • A bone is used to make a bridge between vertebrae close to each other, and the bone graft helps the new bone growth. This bone may be taken from a pelvic bone, bone bank (allograft), or elsewhere in your body (autograft). It may also be human-made bone.
  • To hold the vertebrae together until the new bone grows between them. Metal implants are usually used.

Why Is Lumbar Spinal Fusion Done?

Lumbar fusion surgery is designed for welding adjacent vertebrae into one solid bone, eliminating motion and providing stability in the part of the spine that’s causing pain. This surgery should be performed due to the following:

  • Remove bone and tissue, narrowing the spinal canal and squeezing the spinal cord or spinal nerves.
  • Weak or unstable spine caused by tumors or infections.
  • Fractures or injuries to the bones in the spine.
  • When one vertebra slips forward on top of another, a condition called spondylolisthesis.
  • Arthritis in the spine, such as spinal stenosis (narrowing of the spinal canal)
  • Abnormal curvatures, like those from kyphosis or scoliosis

How Do You Prepare for A Lumbar Spinal Fusion?

Before coming to the hospital for surgery, you can do some things to prepare your home to make your recovery easier, such as:

  • Place the telephone and phone charger near the bed or a chair.
  • Prepare your kitchen by moving food, pots, and other cooking utensils to high shelves or countertops. Stack canned foods on the upper shelves to avoid bending, twisting, and lifting after the lumber fusion.
  • Place shoes, clothing, and toiletries at a height where you can reach them without bending.
  • Remove or secure any throw rugs so you won’t trip over them.

Other pre-surgery considerations include:

Quit Smoking

You should quit well in advance of the lumber fusion procedure. Smoking substantially interferes with the bone’s ability to fuse together. It causes other postoperative complications, such as poor wound healing.

Medication

Discuss and provide a complete list of all medications and supplements you take with your surgeon. It would be best if you stopped taking nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen and Indocin, two weeks before surgery. Medications that thin the blood, such as Herbals (ginkgo glucosamine), Vitamin E, and blood thinners (Coumadin, Heparin), should be stopped 7-10 days after surgery.

Consume Healthy Foods

Ensure you consume lean proteins, fiber, and plenty of fruits and vegetables. Vitamins and micronutrients are also essential in the healing process.

Obtain Helpful Durable Medical Equipment (DME)

Depending on the location of the surgery, DME may include the following:

  • Walker
  • Long handle reacher
  • Tub seat, bench, or chair to use in the bathroom or shower
  • Elevated commode or toilet seat extender

Enlist The Help of Family and Friends

Inform family and friends in advance to help you drive or get around, prepare meals, pick up prescriptions or perform daily activities when needed immediately after the surgery.

Preadmission Evaluation and Testing

Your health provider will schedule an appointment for a preadmission evaluation which may include the following:

  • Medical history
  • Physical examination
  • Blood and urine tests
  • Electrocardiogram
  • Flexion and extension spine X-ray or chest X-ray

Procedure for Lumber Fusion

Lumbar fusion can be performed using several techniques and approaches to fuse the spine. Your surgeon may approach your spine from the front (anterior approach), which requires an incision in the abdomen. A posterior approach is done from the back, and in a lateral approach, your surgeon approaches your spine from the side. 

Lumbar fusion uses some material, called a bone graft, to stimulate bone healing and increase bone production. After bone grafting, the vertebrae are held together using plates, screws, and rods to help the fusion progress. This process is called internal fixation.

Discharge Instructions After Lumber Fusion

When you are released to go home, you will be given instructions that include:

Pain Medication

  • Take pain medication as directed by your surgeon. Avoid non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen, Advil, Motrin, Nuprin naproxen, and Aleve, without the surgeon’s approval.
  • Laxatives and stool softeners such as Dulcolax, Senekot, Colace and milk magnesia are available without a prescription. 

 Restrictions

  • Avoid strenuous activity, bending, lifting, or twisting your back for the next two weeks.
  • Do not smoke or use nicotine products
  • Do not drink alcohol for two weeks after surgery or while taking medication.

Incision care

  • Wash your hands thoroughly before and after cleaning your incision to prevent infection.
  • If you have Dermond (skin glue) covering your incision, you may shower the day after surgery. Gently wash the area daily with soap and water. Pat dry.
  • If you have staples, steri-strips, or stitches, you may shower two days after surgery. Remove the gauze dressing and gently wash the area with soap and water. Replace the dressing or completely remove it if there is no drainage.
  • Ice your incision 3-4 times per day for 15-20 minutes to reduce pain and swelling.
  • Inspect and wash the incision daily.
  • Do not submerge or soak the incision in water (bath or tub)
  • Do not apply any lotions or ointments over the incision.

Activity

  • Get up and walk 5-19 minutes every 3-4 hours. Gradually increase your walking time. Avoid sitting for long periods.

Risks and Complications

Lumbar fusion is generally safe. But, like any surgery, there are possible risks of complications, such as the following: 

  • Bleeding
  • Infection
  • Blood clots
  • Poor wound healing
  • Pain at the site from which the bone graft is taken
  • Injury to blood vessels or nerves in and around the spine

At The American Neurospine Institute, we understand that living with back pain can be debilitating. We want you to live a pain-free life that does not prevent you from doing the activities you love. Contact us today to learn more about lumbar spinal fusion and how we can help you, or schedule an appointment online.

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