(Spinal Arthrodesis; Vertebral Interbody Fusion; Posterior Lumbar Interbody Fusion; Transforaminal Lumbar Interbody Fusion; Anterior Lumbar Interbody Fusion; Posterolateral Lumbar Fusion )
Reasons for Procedure
- Incomplete fusion of the bones
- Blood clots
- Hematoma—a build-up of blood in the wound
- Nerve damage causing pain, numbness, tingling, or paralysis
- Impaired bowel and/or bladder function
- Reaction to anesthesia
What to Expect
Prior to Procedure
- Physical exam, especially of the back and neck
- Imaging studies to examine the structures and plan surgery, including:
- Talk to your doctor about your medications. You may be asked to stop taking some medications up to 1 week before the procedure.
- Arrange for a ride home and for help at home.
- Eat a light meal the night before surgery. Avoid eating or drinking anything after midnight.
Description of Procedure
- Posterior lumbar interbody fusion (PLIF)—the incision is made in the back. To access the spinal bones, the surgeon must move muscles and nerves out of the way. Part of the spinal bone covering the spinal column, called the lamina, may be removed so the surgeon can access the area between the vertebra. The cage is inserted from the back of the spine.
- Transforaminal lumbar interbody fusion (TLIF)—the incision is made from the side. This allows access to the vertebra without a lot of movement to the muscles and nerves. It also does not require removal of any bone covering the spinal column.
- Anterior lumbar interbody fusion (ALIF)—the incision is made in the lower abdomen. Organs and blood vessels are moved aside so that the surgeon can access the vertebra. The muscles and nerves of the spine do not have to be moved. The cage is inserted through the front part of the spine. No surgery is done on the outside of the vertebra.
|A metal cage filled with bone graft is placed between lumbar vertebrae.|
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How Long Will It Take?
How Much Will It Hurt?
Average Hospital Stay
- Pain medication
- Back brace or cast
- Lessons on how to properly move, sit, stand, and walk
- Lessons on how to turn in bed without twisting the spine
- Physical therapy
- Special socks or boots to help prevent blood clots
- You will be shown how to move and exercise your legs while in bed
- You will be encouraged to get up and walk around several times a day
- Washing their hands
- Wearing gloves or masks
- Keeping your incisions covered
- Washing your hands often and reminding visitors and healthcare providers to do the same
- Reminding your healthcare providers to wear gloves or masks
- Not allowing others to touch your incisions
- Education on tools or devices to help with daily activities during recovery
- Exercises to strengthen your back
- Low-impact aerobic exercises, such as walking or swimming
|Healed Lumbar Fusion|
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Call Your Doctor
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
- Persistent nausea and/or vomiting
- Pain that you cannot control with the medications you've been given
- Cough, shortness of breath, or chest pain
- Joint pain, fatigue, stiffness, rash, or other new symptoms
- Numbness, tingling, pain, or weakness, especially in the arms, hands, legs, or feet
- Pain, swelling in your feet, legs, or calves
- Loss of bladder or bowel function
- Pain, burning, urgency, frequency of urination, or persistent blood in the urine
North American Spine Society http://www.spine.org
Ortho Info—American Academy of Orthopaedic Surgeons http://www.orthoinfo.org
Canadian Orthopaedic Association http://www.coa-aco.org
Canadian Orthopaedic Foundation http://www.canorth.org
Anterior lumbar interbody fusion. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00595. Updated June 2010. Accessed November 13, 2014.
Deyo RA, Nachemson S, et al. Spinal-fusion surgery—the case for restraint. N Engl J Med. 2004;350(7):722-726.
Kim CW, Siemionow K, et al. The current state of minimally invasive spine surgery. J Bone Joint Surg Am. 2011;93(6):582-596.
Lindström D, Omid Sadr A, et al. Effects of a perioperative smoking cessation intervention on postoperative complications: A randomized trial. Ann Surg. 2008;248:739-745.
Lipson SJ. Spinal-fusion surgery—advances and concerns. N Engl J Med. 2004;350(7):643-644.
Posterolateral lumbar fusion. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00594. Updated June 2010. Accessed November 13, 2014.
Posterior lumbar interbody fusion and transforaminal lumbar interbody fusion. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00596. Updated June 2010. Accessed November 13, 2014.
Spinal fusion. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00348. Updated June 2010. Accessed November 13, 2014.
Spine surgery: Lumbar interbody fusion. Hospital for Special Surgery website. Available at: http://www.hss.edu/conditions%5Fspine-surgery-lumbar-interbody-fusion.asp#.VJMAvsAKA. Updated May 9, 2011. Accessed December 2, 2014.
- Reviewer: Warren A. Bodine, DO, CAQSM
- Review Date: 11/2015 -
- Update Date: 12/20/2014 -