Lumbar fusion surgery – Lumbar fusion of the spine is designed to stop the movement at a painful, unstable spinal joint. The procedure can be performed at any painful region of the spine. By joining (fusing) two or more of the vertebrae, the motion that occurs within that portion of the spine is halted. The fusion prevents nerves from rubbing on the disc and stops the inflammation that occurs from rubbing bones, facet joints or nerves. Once a segment of the spine is stabilised the patient usually experiences some relief of pain. The surgeon may opt to use specialised spinal instruments (screws, rods, plates) to immobilize the spine, this immobilisation will enhance the healing process. Spinal instrumentation acts as an internal splint.
Surgeons use this procedure when patients have spinal vertebrae injuries, protrusion and degeneration of the discs, curvature of the spine or a weak spine caused by infections or tumours.
Mr Mo Akmal is a specialist in Lumbar Fusion surgery through a keyhole approach.
Anyone with chronic pain due to spondylosis, scoliosis, fracture or disc degeneration could benefit from the decompression and fusion of spinal vertebrae. Once conservative treatment has been attempted, the patient and doctor should assess whether stretching and strengthening exercises will solve the problem without surgery. If these conservative treatments are insufficient and the patient needs relief from debilitating arm or leg pain, a spinal decompression and fusion procedure may be recommended. A fusion is generally only performed in the setting of instability or deformity.
Surgery is an option if:
The week before your surgery, you will have some blood tests and spinal X-rays if you haven’t had any recently.
Your doctor may wish to go through the main points of your procedure. Do not be afraid to raise queries if you don’t understand anything. Your MD needs you to be ready.
Here are some things to do before your surgery:
Lumbar fusion can be carried out with an anterior (from the front) approach or a posterior (from the back) approach. Your surgeon will determine which approach is the best method for you. An anterior approach does carry a slightly higher risk of complication, but generally gives a better result and quicker healing time. Both procedures are performed under general anaesthetic and sometimes be done as day surgery but usually require a one night stay in hospital.
A 10-12cm incision is made into the abdomen. Organs and blood vessels are expertly moved aside by thesurgeon, revealing the front of the lumbar spine. The degenerate discs are carefully removed and replaced with a spacer. The spacer may be a fusion cage or a prosthetic disc replacement. If a cage is used, it is filled with synthetic bone material (bone putty) and then inserted into disc space. The cage holds the upper and lower vertebra tightly together, while the bone material aids to fuse it all together. Screws may also be fixed in place to keep it all secure and stable.
A 10-12cm incision is made into the back. They surgeon must cut through layers of muscle to reach the spine. The degenerate discs are carefully removed and replaced with a spacer. The spacer may be a fusion cage or a prosthetic disc replacement. If a cage is used, it is filled with synthetic bone material (bone putty) and then inserted into disc space. The cage holds the upper and lower vertebra tightly together, while the bone material aids to fuse it all together. Screws may also be fixed in place to keep it all secure and stable.
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