Am I A Candidate for Lumbar Spinal Fusion Surgery?

By Gregory C. Keller, MD

Candidates for a spinal fusion typically have instability between 2 or more spinal segments (vertebrae) that cause severe pain, neurological involvement, and impaired function.  However, there are other issues that can cause these symptoms as well. A thorough evaluation by a board–certified spine surgeon is necessary to determine whether the symptoms are due to an unstable spine.


How do I Know if I Need Surgery for My Back Pain?

Back pain is extremely common in our world. A large percentage of people will have severe back pain at some point in their lifetime.  The majority of back pain improves with time and conservative treatment.  But more serious back pain may require more involved treatment, such as injections or surgery.

When a patient comes to my office with back pain, there are many factors to consider before determining which direction to go with treatment. One of the most common problems that cause pain in the back is a pinched nerve.  A pinched nerve can cause pain down the leg, as well. In some cases, a pinched nerve causes loss of sensation and/or strength in the leg.  In these cases, we have to get pressure off the nerve.  This may involve steroid injections, and in some cases, a decompression surgery. Pinched nerves do not typically require a spinal fusion.

Another cause of severe back problems is instability.  Instability is when one or more segments slide forward on one another. Instability can cause severe pain and radiating symptoms into the leg.  In these cases, a fusion procedure may be needed to stabilize the spine.


What is a Spinal Fusion Surgery?

A spinal fusion is a surgical procedure to join two or more segments of the spine together permanently. We join the spinal segments by placing bone graft material between the spine levels. The bone graft grows and connects the spine segments together. It takes time for the graft to grow, so the segments must be held still during this process. We place instrumentation like hardware in the spine to maintain proper positioning of the spinal segment while the graft heals and fuses the segments together. Once the bone graft has healed, the instrumentation can be removed but it is typically left in place to avoid a subsequent procedure and bodily trauma.


Is Spinal Fusion Considered Major Surgery?

The quick answer is yes, spinal fusion surgery is major surgery. It requires time to recover.  Most fusion procedures require at least an overnight hospital stay.  In complex cases, there may be multiple nights spent in the hospital after the procedure. Advances in surgical procedures have helped to improve the precision and safety of the procedure. Additionally, we now use robotic assistance and computer guidance to help with surgical accuracy.


How Many Hours Does a Spinal Fusion Surgery Take?

A spinal fusion surgery can take anywhere from 2 to 8 hours. The time of the surgery varies depending upon how many spinal segments need to be fused together. The surgical time can also vary depending upon the complexity of the spinal issues.


What Can I Expect During Recovery After a Spinal Fusion?

There is usually pain after spinal fusion, but our ability to manage the pain has improved significantly over the past 5 to 7 years.  Pain after surgery is typically controlled well with medication.

Patients may need physical therapy in the hospital to get them up and walking.  Physical therapy may be needed several weeks after surgery to help activate core muscles and help with reconditioning.  Most patients can return to work about a month after a lumbar fusion.

You can typically return to activities such as golf or tennis after about 4 to 6 months after surgery.  The length of recovery varies depending upon the type of lumbar fusion and the complexity of the surgery.


To Learn More...

For more information about Lumbar Spinal Fusion Surgery, watch these Educational Videos.

Important Note: The patient information presented is for general education purposes only. As with any spine surgery, there are potential benefits, complications, and risks associated with disc replacement and spinal fusion procedures. Individual results may vary. It is important that you discuss the possible risks and potential benefits of various procedures with your doctor prior to receiving treatment, and that you rely on your physician’s best judgment. Only your doctor can determine whether you are a suitable candidate for a specific surgical procedure.

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