Posterolateral Lumbar Fusion
In many areas, nonessential orthopaedic procedures that were postponed due to COVID-19 have resumed. For information: Questions and Answers for Patients Regarding Elective Surgery and COVID-19. For patients whose procedures have not yet been rescheduled: What to Do If Your Orthopaedic Surgery Is Postponed.
Spinal fusion is a surgical procedure used to correct problems with the small bones in the spine (vertebrae). It is essentially a "welding" process. The basic idea is to fuse together the painful vertebrae so that they heal into a single, solid bone. Spinal fusion is a treatment option when motion is the source of the pain—the theory being that if the painful vertebrae do not move, they should not hurt.
There are several different types of spinal fusion surgery; your doctor will talk with you about which one is appropriate in your situation. This article focuses on posterolateral lumbar fusion—the most common type of spinal fusion—and discusses only the surgical component of the procedure.
For a complete overview of spinal fusion, including approaches, bone grafting, complications, and rehabilitation, please go to Spinal Fusion.
In a posterior approach to lumbar fusion, the surgeon makes an incision down the middle of the lower back. To see the vertebrae, the surgeon will pull back the muscles that surround the spine.
In many cases, the surgeon will remove arthritic bone and any other structures, such as a herniated disk, that may be putting pressure on spinal nerves. This procedure is called a decompression, or laminectomy.
After the decompression, the surgeon will place graft material along the sides of the vertebrae to stimulate bone growth. The bone graft material is typically placed over the transverse processes of the vertebrae. This is called a posterolateral fusion.
Titanium screws and rods are often used to provide immediate stability to the spine until a solid fusion has been achieved. These screws typically are not removed even after the bone graft has healed.
AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific orthopaedic advice or assistance should consult his or her orthopaedic surgeon, or locate one in your area through the AAOS Find an Orthopaedist program on this website.