Posterolateral lumbar fusion is a surgical technique that involves correction of spinal problems from the back of the spine by placing bone graft between segments in the back and leaving the disc space intact.

Minimally invasive surgical techniques may be used to perform the procedure.

Indications

Patients with spinal instability in their lower back due to degenerative disc disease, spondylolisthesis or spinal stenosis that has not responded to other non-surgical treatment measures such as rest, physical therapy or medications may be recommended for Posterolateral Lumbar Fusion.

Procedure

In this procedure the patient lies on his or her stomach. The surgeon makes a small incision in the back over the vertebra (e) to be treated. The surgeon dilates the surrounding muscles of the spine to access the section of the spine to be stabilized. The lamina, roof of the vertebra, is removed to visualize the nerve roots and the facet joints that are directly over the nerve roots are trimmed to provide the nerve roots more space.

The bone graft is implemented between the transverse processes in the back of the spine. Screws and rods can also be used to stabilize the spine for better healing and fusion. At the end of the procedure, the incision is closed and usually it leaves behind a minimal scar.

This procedure includes a smaller incision and muscle dilation that allows the surgeon to gently separate the surrounding muscles of the spine rather than cutting them.

Recovery

After the minimally invasive procedure, most patients are discharged the day after surgery, but a few patients may require prolonged hospitalization. Many patients observe immediate improvement of some or all of their symptoms but sometimes the improvement of the symptoms may be gradual.

Contribution of a positive approach, realistic expectations and compliance with your doctor's post-surgical instructions helps bring a satisfactory outcome to the surgical procedure. Most patients can resume their regular activities within several weeks.

Risks or Complications

The complications include infection, nerve damage, blood clots, blood loss, bowel and bladder problems and any problem associated with anesthesia. The underlying risk of spinal fusion surgery is failure of fusion of vertebral bone and bone graft which usually requires an additional surgery.

Discuss with your spine surgeon if you have any questions regarding the procedure.

  • American Association of Neurological Surgeons
  • American Board of Neurological Surgery
  • American Medical Association
  • The Congress of Neurological Surgeons
  • College of Physicians and Surgeons of Newfoundland & Labrador
  • North American Skull Base Society
  • North American Spine Society