Lumbar Fusion

By: Ehren Allen, PT, Certified Manual Therapist

Spinal Fusion Image of a Lumbar Spine


What is a Lumbar Fusion?


A Lumbar Fusion is a surgical procedure performed by Orthopedic Spine Surgeons.  During the procedure, 2 or more bones (vertebrae) in the Low back are connected together.  The disk between the vertebrae is typically removed and an artificial spacer is placed between the bones to maintain the space for the nerves.  A Lumbar fusion may also involve bone grafts used to fuse the vertebrae and stop movement.

A fusion may be used to treat severe spinal stenosis with knee or leg pain, severe degenerative disk issues, or instabiliity issues.

There are several types of Lumbar Fusion surgeries.  The surgeon may select from a variety of options depending on the spine levels involved and structural issues in the spine.  They may access the spine from the front, the back, and even the side.  


Read “Fix the Back from the Side” by Dr. Sunday Ero to learn more about side fusion options.

Spinal Fusion SurgeryImage of a surgery

What is the Success Rate of Spinal Fusion Surgery?

Studies on the success rate of Spinal fusion surgery vary.  The average is about 60 to 70% success rate for increased function.  The vast majority of patients are pleased with the results after a fusion of the spine.  Like any surgery, there is risk involved.  
After a Lumbar Fusion, there is the possibility of issues developing at the spine level above or below the Fusion. This is called Adjacent Segment Disease.  The Adjacent Spine segments may be stressed more after a Fusion. This can lead to degeneration and issues at those spine levels.


To learn more about the spine, watch this educational video.

Anatomy of the SpineAnatomy of the Spine


What is the Recovery Time for Lumbar Fusion Surgery?

Lumbar Fusion surgery is a complicated procedure which requires time for healing.  It's not the same a lumbar strain recovery.  Most people take 3 to 6 months to recover.  Complete healing can take up to a year.  
Movement of the Low back is usually limited for the first 8 to 12 weeks to allow the fusion to heal and allow for bone growth of bone grafts and around the screw rivets.


What happens after Spinal Fusion Surgery?

A fusion surgery can take several hours.  Most patients remain in the hospital over night.  Physical therapy may have them walk in the hospital and make sure that they can get to the bathroom when they get home.  Patients may receive home health nursing care as needed.  Physical therapy is not usually ordered until 4 to 6 weeks after the surgery.  This is usually outpatient.
Occasionally, patients will wear a brace for a month or 2 after the lumbar fusion surgery.  This may vary depending on the surgeon’s preference.

Tiger Woods is probably the most famous athlete who has had a lumbar fusion.  To learn more about Tiger Woods story, go to: https://rediscovermylife.org/tiger.php.

Dr. Keller of JOI San Marco is certified to perform this Centinel Spinal Fusion. 


Is there an Alternative to Spinal Fusion?

Spinal Fusion is only an option for most patients once all other conservative options have been tried.  A Spinal fusion is invasive and involves risk.  It is important to exhaust other treatment options first.  Conservative treatment options may include:


Is Disc Replacement better than Fusion?

A Lumbar Disk Replacement is another option to repair a spine level which is severely degenerated or unstable. With a Disk Replacement procedure, the old disk is removed and an artificial disk is placed between the bodies on the Lumbar Vertebrae.  Unlike with a fusion, motion is still available at the surgical site after the procedure. This may decrease the risk of adjacent segment issues.  
There is risk that the disk replacement will not alleviate the symptoms after the surgery.  Not all insurance companies authorize the disk replacement either.  

If you would like to learn more about the Anatomy of the Spine, follow this link: https://www.joionline.net/library/show/anatomy_of_the_spine/


Can you Climb Stairs after Spinal Fusion?

Yes, you should be able to climb stairs after a spinal fusion, as long as there are not other issues limiting stair activity.   It may be better to limit stairs for the first several weeks to avoid irritating the surgical site.  


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