Spinal fusion is a technique used to stabilize the spinal bones or vertebrae. The goal of lumbar fusion is to create a solid bridge of bone between two or more vertebrae. Spinal fusion may be recommended when the natural disc space has decreased or the spine is unstable.
Interbody fusion involves placement of fusion implants and bone graft into the area between two vertebral bodies and is an effective method for achieving fusion. The intervertebral implant may be made from a variety of materials including metal, plastic, or bone. Bone graft and bone healing protein may be placed within the implant and within the interbody space to encourage bony healing. The implant helps by separating and holding the two vertebrae apart. This increases the opening around the nerve roots at that level, relieving pressure on the nerves. The intervertebral implants can also be used to correct spinal deformity and restore proper alignment. Intervertebral implants can be placed from the front, side or back of the spine. The location of the surgery is dependent on the specific anatomy of each patient, as well as the location and amount of pressure that may be occurring around the nerves in the spinal canal. The decision is based on many factors including the patient’s anatomy, location of the levels that need to be fixed, degree of spinal instability, and prior abdominal surgery.
When the implant is placed from the:
- Front to the lumbar spine, it is called an Anterior Lumbar Interbody Fusion (ALIF).
- Side to the lumbar spine, it is called a Lateral Interbody Fusion (XLIF/DLIF).
- Back to the lumbar spine, it is called a Posterior Lumbar Interbody Fusion (PLIF) or a Transforaminal Lumbar Interbody Fusion (TLIF).
In some cases, the surgeon will use additional surgical instrumentation in the front for stability. This is usually a plate and screws in the front of the spine. If support is also needed from the back of the spine, a series of screws and rods may be used. This is called a posterior instrumentation fusion and helps to achieve a posterior fusion in addition to an interbody fusion.
The goal of surgery is to decrease pain, correct spinal deformity, and improve stability. Complications may occur but are not common. The majority of patients are satisfied with their pain relief and the results of their surgery. It is important that all patients are physically and psychologically prepared. All patients should stop smoking prior to any surgery, as smoking is extremely detrimental to your spine health, potential bone healing and successful surgical outcomes.
Please review additional details with your surgeon prior to your surgery. Surgical information for Virginia Spine Institute patient's is available here.