Lumbar Spinal Fusion (Arthrodesis)
Lumbar spinal fusion is surgery to join, or fuse, two or more vertebrae in the low back.
Spinal fusion is major
surgery, usually lasting several hours. There are different methods of spinal
- Bone is taken from the pelvic bone or from a bone bank. The bone is used to make a bridge between vertebrae that are next to each other.
This bone graft helps new bone grow.
- Metal implants
are usually used to hold the vertebrae together until new bone grows between
What To Expect After Surgery
You will need to be watched in the
hospital for a few days after surgery.
Bed rest is
not usually needed while you recover at home.
doctor may recommend that you wear a back brace while you recover.
Rehabilitation can take a long time. It includes walking, riding a
stationary bike, swimming, and similar activities.
Why It Is Done
Spinal fusion may be done by itself
or along with surgery to remove bone and tissue that are narrowing the spinal canal and squeezing the spinal cord and/or the spinal nerves.
may be done as a follow-up after surgery that was done to
problems such as spinal stenosis,
herniated discs , injuries, infection, and tumors.
Spinal fusion was first used to treat fractures or other problems. It is now also used to treat age-related spinal problems and spinal stenosis.
How Well It Works
fusion is often needed to keep the spine stable after injury,
infection, or a tumor.
But there is not a lot of research about how well it works for other spinal problems. In general, studies do not show a clear difference between spinal fusion and intense
rehabilitation for treating chronic low back pain from degenerative changes in the spine.1
As you decide about having spinal fusion, talk with your doctor about the benefits and risks. The surgery costs a lot and has serious risks. Although this type of surgery is common, there is no
guarantee it will work to relieve your pain.
The risks of this surgery depend on your age and overall health, what you're having the surgery for, and the type of
procedure you have.
- Pain at the bone graft
- Failure of the fusion, breakage of metal
implants, or both.
- Blood clots that may also
- Graft rejection.
What To Think About
Because there are so many things
to consider when spinal fusion is recommended, seek a
second opinion before making a decision.
Complete the surgery information form (PDF) (What is a PDF document?) to help you prepare for this surgery.
Chou R, et al. (2009). Interventional therapies, surgery and interdisciplinary rehabilitation for low back pain: An evidence-based clinical practice guideline from the American Pain Society. Spine, 34(10): 1066–1077.
William H. Blahd, Jr., MD, FACEP - Emergency Medicine
Robert B. Keller, MD - Orthopedics
February 13, 2012