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Posterolateral Lumbar Fusion

What is Posterolateral Lumbar Fusion?

Posterolateral lumbar fusion is a surgical technique that involves correcting spinal problems from the back of the spine by placing bone graft between segments in the back and leaving the disc space intact. 
Minimally invasive surgical techniques may be used to perform the procedure.

Indications of Posterolateral Lumbar Fusion

You may be recommended posterior lumbar fusion in the following cases: 
Spinal instability in their lower back due to degenerative disc disease 
Spondylolisthesis or spinal stenosis that has not responded to other non-surgical treatment measures such as rest, physical therapy or medications 

Posterolateral Lumbar Fusion Procedure

  • In this procedure, you will be made to lie on your stomach. Your surgeon makes a small incision in your back over the vertebra(e) to be treated.
  • Your surgeon dilates the surrounding muscles of the spine to access the section of the spine to be stabilized.
  • The lamina, roof of the vertebra, is removed to visualize the nerve roots and the facet joints that are directly over the nerve roots are trimmed to provide the nerve roots more space.
  • The bone graft is implemented between the transverse processes in the back of the spine. Screws and rods can also be used to stabilize the spine for better healing and fusion. At the end of the procedure, the incision is closed.
  • This procedure includes a smaller incision and muscle dilation that allows your surgeon to gently separate the surrounding muscles of the spine rather than cutting them.

Postoperative Instructions for Posterolateral Lumbar Fusion

After the minimally invasive procedure, you will be mostly discharged on the day after the surgery, but a few cases may require prolonged hospitalization. You may observe immediate improvement of some or all of your symptoms but sometimes the improvement of the symptoms may be gradual. 
Contribution of a positive approach, realistic expectations, and compliance with your doctor’s post-surgical instructions help to bring a satisfactory outcome to the surgical procedure. Usually, you can resume your regular activities within several weeks. 

Risks or Complications of Posterolateral Lumbar Fusion

The potential complications may include infection, nerve damage, blood clots, blood loss, bowel and bladder problems and any problem associated with anesthesia. The underlying risk of spinal fusion surgery is the failure of fusion of vertebral bone and bone graft which usually requires an additional surgery. 

  • Oregon Medical Association
  • American Academy of Orthopaedic Surgeons
  • Scoliosis Research Society
  • North American Spine Society