Lumbar Spinal Fusion

Spinal fusion is surgery to permanently connect two or more vertebrae in your spine, eliminating motion between them.

Spinal fusion can be a very good treatment for some spinal conditions; however it does not return your spine to “normal” as the normal spine has some degree of motion between vertebrae.

 

Spinal fusion may be performed for a variety of different reasons including:

  • Treatment of a fractured (broken) vertebrae
  • Correction of deformity
  • Spinal curves such as scoliosis
  • Spondylolisthesis (a condition whereby one of the vertebra in the lower part of the spine slips forward or backward compared to the next vertebra)
  • Elimination of painful movement
  • Treatment of instability
  • Treatment of some disc herniations or bulge
  • There are a number of things you can do to prepare yourself for spinal surgery. In the weeks before your surgery it is advisable to eat a balanced diet as this can help the healing process.

    If you need to lose weight it may be advisable to see a Dietician who will instruct you on how best to achieve this. You can talk to your Consultant about this.

    If you smoke, stop as far in advance of surgery as possible. Smoking may cause complications with the anaesthetic and nicotine can delay or interfere with healing and bone growth.

    As there are many restrictions to various daily activities immediately following spinal fusion surgery, most people find that preparing for their post-operative recovery before admission to hospital is helpful.

     

    Pre-Operative Assessment Clinic

    Within one month before your operation, you may be invited to attend the Pre-Operative Assessment Clinic.

    During this visit you will asked about your medical history and any medications you are taking.

    You will have blood tests done and may have an ECG and x-ray.

    This clinic is also an opportunity for you to see the Physiotherapist and Nurse, to ask any questions you may have and to plan for your discharge from hospital.

    If you have a history of MRSA or have been in contact with someone with MRSA, please let us know as soon as you have a surgery date. We will need to take some swabs to ensure you do not have any MRSA that might get into your wound at the time of surgery.

  • During surgery bone grafts are placed around the spine. This bone graft is either taken from the patient’s own pelvis, from a bone bank or is manufactured synthetic bone. The bone is used to make a bridge between adjacent vertebrae and stimulates the growth of new bone. This new bone will take several months to grow and will continue to fuse and evolve over the next couple of years.

    Metal implants, such as plates, screws or cages, are often used to secure the vertebrae to hold them together until new bone grows between them.

    Spinal fusion can be done by itself or in combination with spinal decompression which is performed to alleviate pain in the leg (sciatica) caused by pinched nerves.

    • When your surgery is completed, you will be moved to the recovery room where you will be observed and monitored by a nurse until you awake from the anaesthetic. You will then be transferred to a ward where the ward team will work closely with you to aid your recovery. In the case of multi-level fusions you may be transferred to the Intensive Care Unit for monitoring and your Consultant will discuss this with you before your operation.
    • You will have a drip for intravenous fluids through a vein into your arm or hand which will continue for a number of hours after your surgery. You may eat when you are fully awake but we advise that you start with sips of water and then a light meal.
    • You may have a catheter inserted into your bladder to make urination easier. There may be a drain tube in your back which is normally taken out 1-2 days after surgery.
    • The immediate discomfort following spinal fusion is generally greater than with other types of spinal surgery. Fortunately there are excellent methods of pain control available for after your surgery and your Anaesthetist and Nurse will work closely with you to manage your pain.
    • You will get out of bed and on your feet the day after surgery. This is safe and it is the best way to get your muscles moving and prevent post-operative complications. A Nurse or Physiotherapist will be with you to advise you on how to move your back carefully and comfortably.
    • Depending on what technique is used you may be fitted for a brace.
    • Recovery following fusion surgery is generally longer than for other types of spinal surgery. Patients normally stay in hospital for 4-6 days but a longer stay after more extensive surgery is not uncommon. You will gradually increase your movement over your stay.
    • You will not be discharged until all the members of the team who treated you are confident that you are well enough. Elderly or debilitated patients who are having extensive surgery may wish to consider convalescence.
    • The fusion process takes time and varies in each patient. It takes approximately 6 weeks for the bones to begin to fuse. It will be several months before the bone fusion is solid, although your level of comfort will improve much faster.