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Spinal Fusion: Posterior Lumbar

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Lumbar vertebrae

Fusing vertebrae in the lumbar curve may help ease lower back and leg pain. Posterior lumbar fusion is done through an incision in your back. The graft is put between the vertebrae in one of two places: in the disk space or between the transverse processes. Depending on how many vertebrae are fused, the surgery may take from 3 to 8 hours.

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Fusing the Transverse Processes

  • Bone graft is packed between the transverse processes (“wings”) on the sides of the vertebrae. Occasionally, other nearby parts of the vertebrae are fused as well.

  • To help keep your spine steady and promote fusion, extra support (see below) may be used.

  • The incision is closed with sutures or staples.

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Fusing the Disk Space

  • The disk between the vertebrae is removed.

  • Bone graft is packed in the now-empty space between the vertebrae. In time, the graft and the bone around it grow into a solid unit.

  • To help keep your spine steady and promote fusion, extra support may be used.

  • The incision is then closed with sutures or staples.

If Extra Support Is Needed

Metal supports called instrumentation may be used to help steady your spine while it fuses:

  • A cage may be used when fusing the disk space.

  • Screws and rods may be used when fusing the transverse processes. In rare cases, these supports may be removed after fusion is complete.

Publication Source: Aminoff MJ, Cecil medicine, 23rd ed., Chapter 423 – Mechanical and other lesions of the spine, nerve roots and spinal cord, 2007, pp 2646-2659
Online Source: U.S. Agency for Healthcare Research and Quality (AHRQ), National Guideline Clearinghouse (NGC), Rockville, MD http://www.guideline.gov/summary/summary.aspx?ss=15&doc_id=10181&nbr=5365
Online Medical Reviewer: Bhattacharyya, Tim MD
Date Last Reviewed: 1/1/2008
Date Last Modified: 7/9/2002