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Lumbar spinal fusion is a surgical procedure to fuse two or more of the lumbar vertebrae in the lower back to increase stability and address chronic pain. The procedure requires the skills of a spinal surgeon, and the recovery time can vary but usually includes a period of rest at home before the patient can return to work and other activities. A doctor may recommend this procedure if nonsurgical methods for the management of arthritis, spinal stenosis, and other degenerative spinal conditions are not effective.
In a lumbar spinal fusion, the surgeon operates on a fully anesthetized patient. In addition to an incision at the spine, the surgeon also makes incisions at the hip bone to access bone for grafting. Surgeons select the vertebrae to fuse after they look at medical imaging studies and determine the area of the spine that would benefit most from stabilization. It may be necessary to trim away some bone spurs and thickened tissue before inserting screws or rods along with the bone graft.
Over time, the graft will grow over and around the rods to connect the two vertebrae. It turns them into a solid unit that doesn't articulate and creates much more stability in that area of the spine. Without the movement of the vertebrae, the patient may feel more comfortable. Spinal pain should decrease dramatically after recovery, and the patient may be less prone to falls and other issues caused by a lack of stability.
After lumbar spinal fusion, the patient may need to spend a day or more in the hospital. Health care providers perform periodic assessments to check for damage to the spinal cord and usually start physical therapy as quickly as possible. Early therapy sessions may consist simply of walking or sitting upright for 20 minutes or so to mobilize the patient without incurring a risk of side effects. The patient may also need to wear a brace for spinal support while upright.
At home, a patient recovering from lumbar spinal fusion will need to spend some time on bed rest. The doctor may fit a brace to wear to support the spine in the early stages of the healing process. Some physical therapy may take place at home as well as in a clinic. Gradually, the patient can build up strength and resume normal activity levels. The surgeon may request some follow-up appointments to check on the progress of the healing.
Some potential complications of lumbar spinal fusion can include injuries to the spinal cord, infection, and adverse reactions to anesthesia. Patients can reduce risks by working with an experienced surgeon and clinical staff. It is also important to go over medical history thoroughly to allow a doctor to identify any potential risks before the surgery takes place.