Mark W. McFarland, DO
As a busy spine surgeon, I routinely perform Lumbar Spine Fusion surgery. In this article, I will discuss this procedure and how it is used to improve function and relieve pain in patients with certain spinal conditions.
The lumbar spine is made up of five bone segments, called vertebra, which extend from the thoracic (middle spine) to the sacral spine. These bones carry most of a person’s body weight and comprise the skeletal structure of the lower spine. Intervertebral discs, which provide shock absorption and assist with motion, are situated between the vertebra.
Issues in the lumbar spine can be caused by various conditions, such as:
- Spondylolisthesis (slipped bone)
- Spondylosis (arthritis)
- Spinal stenosis (narrowing of the spinal canal)
- Bulging or herniated spinal disc(s)
- Bone spurs (Osteophytes)
- Traumatic Spinal Injury (accidents, falls, etc.)
- Congenital Misalignment (birth defects)
Whenever the spinal cord or nerves are compressed in the lumbar spine, pain, weakness, numbness or tingling can occur in the buttocks, thighs, calves, feet or toes. The symptoms may be felt on one or both sides of the body. “Drop foot” (dragging of the toes when walking), and difficulty walking or standing may also occur. Bladder or bowel incontinence or constipation also may be reported. If the spinal nerves are impinged too much or for an extended time without treatment, the symptoms may become permanent.
Depending on the severity of the patient’s symptoms and disability, I typically try conservative treatment options first. These include Physical Therapy, oral or injected steroids, muscle relaxants or nerve calming medications, behavioral and activity modifications, and sometimes bracing or the use of assistive devices. Surgical intervention is considered after conservative treatment fails to provide symptom relief and return of function.
Your lumbar fusion surgery may be performed with an incision through the front (anterior) or the back (posterior) of your body so that your surgeon can gain access to your spine. There are specific clinical considerations for the use of either approach during surgery. Depending on the severity of your problem and how many levels must be fused, you may have your surgery as an outpatient or may be required to spend a night in the hospital.
Lumbar fusion surgery begins with removal of the injured or degenerative spinal disc between the vertebrae. Then I insert cadaver bone, your own bone, or a biologic bone substitute in the place where the disc used to be. Then I stabilize the lower back vertebra with plates, screws and/or rods. In time, the inserted bone or bone substitute will grow or fuse into your own bone. The fused level of the spine is unable to move; however, the levels above and below will move as they normally do.
Recovery time from Lumbar Spine Fusion varies, but you can expect to be at home resting for at least two weeks. Post-surgical discomfort will be managed with prescription pain medication, Tylenol and rest. I often send a Home Health Nurse and Physical Therapist to your home for several visits while you recuperate, to ensure you’re making progress with your recovery. During this period, you’ll be asked to wear your back brace most of the time when not sleeping.
You’ll be scheduled for a follow-up visit with me ten days to two weeks after surgery. At that time, I’ll remove your stitches or staples, review your progress with you and determine what activities can be resumed. Because lumbar spine fusion is a major surgery, you may need more time to heal in order to return to work, driving, etc. Most patients can return to work after four to six weeks of recuperation. You may also be given a prescription for Outpatient Physical Therapy to help you build strength, increase your range of motion and build stamina.
Make an appointment with Dr. McFarland or another OSC provider by clicking the “Request Appointment” button below or by calling (757) 596-1900.