Lumbar Fusion

Fusion is a big operation and I only recommend this as a last resort. Fusion can be performed well or badly and the experience of the surgeon is paramount.

I fuse the spine most commonly to stop excessive painful spinal movement at one or more levels of the spine.

Instrumentation (metal work – rods and screws) is used to fix the spine together allowing the spine to fuse.

Uses

We fuse the spine for several different reasons including spinal instability or deformity (spondylolisthesis or scoliosis) where other simpler conservative treatments have not worked.

Procedure

I can fuse your spine in different ways accessing the spine from the front, side, or back. Our choice depends on the level of the spine being fused and the problem being treated.

The most versatile and commonly performed fusion is through the skin of the back (posterior).

I specialise in minimally invasive techniques to reduce damage to the muscles.

Typically I place titanium screws into the spine and connect these with a strong metal rod which holds everything securely.

Sometimes it is helpful to remove the disc and replace this with a block of material (called a cage). This may provide more support to the spine and helps me to correct a spinal deformity better.

I use a combination of your own bone and synthetic bone graft to encourage the spine to fuse together. Fusion between the bones will prevent any further movement at the treated level.

A single level fusion operation can take anything from 2 – 4 hours to perform.

Success

Generally fusion is a successful procedure with around an 80% chance that you will be better.

However we must take great care in deciding that this is the appropriate treatment for you, and the operation must be performed well.

Re-creating the natural curvature (lordosis) in your back is really important because it helps you to stand up straight and reduces the chance of problems at other levels of your back after 5 -10 years.

Risks

There is a 10-15% chance that you improve but are still not quite as good as you would wish to be.

Overall there is a 5% or 1 in 20 chance that you could be worse off by having a fusion.

Like all operations there are some risks. These amount to a 1-2% chance of infection, nerve injury, spine fluid leak, infection, failure of metalwork or fusion, blood clots, bleeding, medical problems.

Patients understandably worry about being paralysed but thankfully the chance is very very low (<1 in 18,000) and not something which I have thankfully experienced.

Recovery

I use minimally invasive techniques to reduce muscle damage and post-operative pain.

However your back will still feel sore and we will give you strong painkillers which you may require over the first few weeks.

We will get you up and walking within a few hours of surgery and you should be able to go home on the same day.

You may have a small drain in your back which we simply remove after a few days. I usually use dissolvable stitches or sometimes a stitch which we remove at two weeks.

We will encourage you to take regular short walks each day building this up over six weeks.

You can return to work from 6 – 12 weeks or when you feel ready.

You will continue to improve over at least 12 months and I would expect you to return to doing everything and a better quality of life.

I will follow you up in the clinic until one year.

Further information

Fusion is a very carefully considered operation and we will discuss everything beforehand to help you make the best decision.

I am here to support you before and after your operation and you can talk to me or the team at any time.

I recommend you read the comments from my patients of their experience under my care.