When you’ve experienced a lumbar spinal issue, be it due to an injury, past surgery or a degenerative condition, you know how frustrating the associated symptoms can be. Finding the right treatment to alleviate your symptoms and regain stability is essential so that you can get back to your active, full life.
What Is Lumbar Fusion?
Lumbar fusion is a surgical procedure that helps provide stability and structural integrity in the lumbar spine. The lumbar region of your back is located from the very lowest vertebrae to right beneath your ribs. It consists of five independent vertebrae and the five joined bones known as the sacrum.
Lumbar fusion is done under general anesthesia. Your surgeon will create a small incision or incisions that will allow easy access to the damaged vertebrae. In many cases, only two vertebrae require fusion — in other instances, it may involve three or four.
Once the incisions are made, specialized instruments will be used to perform the surgery. Any damaged or disintegrating bone will be removed and replaced with healthy bone grafts. The disc between the two bones is completely removed and a graft is placed to get the two bones to fuse together. As the bones mend and grow together, a sort of bridge will be created between the vertebrae, making for a stronger and more stable spine.
In some instances, instrumentation will be used to aid in supporting the bone grafts while they heal. Plates and screws are the most common. These are made of surgical-grade metal to help avoid any reactions to the materials.
Recovery After Lumbar Fusion
Once your surgeon has finished with your procedure, you will be moved to the recovery room. Here, specially trained medical staff will observe you and adjust your pain medications while you wake up from anesthesia. Once you’re awake and ready, you’ll be moved to a room for the remainder of your hospital stay.
The average time you can expect to stay in the hospital is 1-3 days following your surgery. This can vary depending on your rate of recovery. During the first day after (and sometimes the day of) surgery, you will be asked to get up and walk around. You’ll also be allowed to eat the first day once your anesthesia has moved out of your system.
When you’re ready to go home you need to be prepared to take it easy. You’ll feel more tired than usual — this is normal and will improve as time passes. Be sure to get plenty of rest and, if you’ve been instructed to do so, exercise (this is often walking for short distances at a slow pace a few times a day, to begin with). If you live alone, consider asking someone to come in and help you with daily duties, such as cooking and cleaning.
Showering is permitted as long as you carefully dry the incision sites. It may help to have someone assist you with this for the first few days.
By week two, you’ll feel much better — you’ll possibly be finished with your pain medications and will have more energy. If you’ve been prescribed physical therapy, be sure to attend all appointments to help speed your recovery and regain mobility in your back.
You can expect to be able to return to a light-duty job by the third week. If you work in a more physically demanding job, you may have to wait longer to allow the grafts to heal properly and avoid injuring yourself.
Within three to four weeks, you’ll need to return to your surgeon for a follow-up exam. This allows your doctor to monitor your healing progress and help you determine if you need to modify your activities. X-rays are typically taken to ensure that the bone grafts are healing as they should be.
Typically, between weeks 8-12, you’ll be able to return to your normal activities. Don’t overdo it, and be sure to work back into them gradually.
Risks of Lumbar Fusion
The risks associated with lumbar fusion are mostly the same as those that can occur with any surgical procedure. These and those more specific to spinal fusion can include:
- Bleeding at surgical site
- Infection
- Blood clots
- Loss of sensation in extremities
- A decrease in mobility in the lower back
- Pain at bone graft harvesting site
- Damage to nerves or blood vessels in the adjacent areas
- Hardware failure or pseudoarthrosis
Is a Lumbar Fusion Right for Me?
By working closely with your surgeon, you can decide if lumbar fusion is the best choice for your lumbar region issues. If you’ve had a discectomy, lumbar fusion may be recommended if your symptoms haven’t abated. It’s also useful if you have an injured or degenerating vertebrae that is beginning to cause you pain, tingling or numbness due to the impingement of surrounding nerves. Only once you’ve talked to your surgeon and had the proper testing, can you both decide together whether lumbar fusion is the right choice for you.