Minimally Invasive Lumbar Spinal Fusion
Medical Author: Jason C. Eck, DO, MS
Medical Editor: William C. Shiel, Jr., MD, FACP, FACR
Introduction to lumbar spinal fusion
The lumbar spine is the lower portion of the spine found at the center of the
curve of the low back. This area can be a common source of pain.
Low back pain
is the second most common reason for visits to the family physician, behind only
the common cold. As people become older, various changes occur in the lumbar
spine that can cause pain. In most cases these changes are normal
degenerative arthritis (wear of cartilage over time). The physician must also rule out other
more serious conditions including tumor, infection, or fracture.
Fortunately, more than 90% of patients with low back pain will have
improvement in their symptoms regardless of treatment within six weeks. During
that time the physician has various treatment options including medications,
physical therapy, or injections that can help ease the symptoms. Some of those
patients that do not improve during the first six weeks may be candidates for
surgery. The spine surgeon has different types of surgical options available
based on the specific cause of pain.
What is lumbar spinal fusion?
Lumbar spinal fusion is an operation that causes the bones of the spine in the lower back to grow
together. The goal of the lumbar fusion is to have the two vertebrae fuse (grow
solidly together) so that there is no longer any motion between them. Removing
the intervertebral disc or bone spurs can reduce some of the pressure on the
nerves, helping to reduce pain. Additionally, by fusing the two vertebrae
together this will stop the formation of bone spurs at that location, further
reducing pain and potential nerve injury.
There are many different specific techniques to try to fuse the vertebrae
together. The surgery can be performed either through an incision in the back,
the abdomen, or a combination of both. In many cases metal screws and rods are
placed from the back into the bones to hold them steady while the fusion occurs.
During an interbody fusion, the surgeon removes the intervertebral disc and
places either a piece of bone or a metal or plastic cage in its place. The
decision on what type of fusion is best for each patient is based on their
specific complaints and the cause of symptoms. Spinal fusion can be very
effective in the properly selected patient.
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