The goal of lumbar spine surgery is to relieve symptoms of weakness, pain, numbness and tingling through creating stability and restoring nerve function.
Most patients with lower back pain will not need to have surgical intervention. Nonsurgical treatments include medications, physical therapy and local injections to the affected site. Generally lumbar spinal fusion should not be considered until pain has persisted and nonsurgical treatment has failed.
Lumbar spinal fusion surgery is back surgery in which an artificial implant replaces the disc between two spinal vertebrae. After the disc injury has been cleared the implant is inserted to promote the vertebrae to fuse together. A fusion is done to decompress the spinal cord or nerve roots and to stop motion between two or more spinal vertebrae causing pain.
An interbody spacer is placed in between two or more vertebrae. This spacer replaces the disc between the vertebrae. An artificial bone graft material will be placed in the spacer to promote new bone growth. This material will help to sup-port any instrumentation that is placed. Titanium screws and rods may be placed into the posterior part of the spinal bones to help stabilize the spinal column. Over the course of several months (3-18 months), the patient’s own bone will grow into and around the bone graft/interbody spacer and incorporate the graft as its own. This process creates one continuous bone surface between the two vertebrae.There are a variety of approaches in which to perform the surgical fusion. Traditional methods involved making an incision in the back thereby causing significant damage to the surrounding muscles. After surgery, patients would experience significant pain and longer recovery times. Today, spinal fusion may involve less invasive methods to decrease injury to the surrounding muscles and create shorter recovery periods. Fusions may be done through the following approaches:
- Posterolateral fusion
- PLIF-Posterior Lumbar Interbody Fusion
- TLIF-Transforaminal Lumbar Interbody Fusion
- ALIF-Anterior Lumbar Interbody Fusion
- Trans-sacral Fusion
- XLIF-Lateral Lumbar Interbody Fusion