Lumbar posterior fusion (PF) surgery is a type of lower back spinal fusion procedure that utilizes a posterior approach to the surgical area. Spinal fusion is often recommended to individuals with degenerative disc disease or other conditions that have weakened fusion or support in sections of the spinal vertebra.
The basic definition of spinal fusion involves the connection or fusing together of two vertebral discs to create one longer bone structure. Grafting is necessary for this procedure. Bone grafts are often taken from the patient's own hip, known as an autograft.
Individuals with one damaged or weakened vertebra are the best candidates for spinal fusion surgical procedures. This situation is called a one-level spine fusion. Those experiencing pain may benefit from this procedure. More than two bones or vertebral sections are generally not fused together because range of motion along the lower back becomes limited and places too much pressure against the lumbar portion of the spine.
Lumbar posterior fusion surgery describes the procedure performed along the back. This procedure may also be formed through an anterior or frontal approach through the abdominal cavity.
Prior to the surgical procedure, you will be put to sleep under a general anesthetic. You'll be placed face down on the surgical table. An incision will be made in the lower back and the lumbar vertebra exposed. Your surgeon may perform decompression surgery, which may involve a laminotomy, laminectomy, or foraminotomy. Each of these procedures gives the spinal cord more room, as well as nerves extending away from the cord more room, relieving pressure.
Following this, the surgeon we'll begin the bone grafting procedure. A small bone graft may be harvested from your hip or artificial or synthetic bone graft extenders may be used. You and your doctor and surgeon should discuss what type of bone graft that will be used during your surgery.
The surgeon will use a tool that roughens the surface of the exposed vertebra of your spine to encourage a better bonding surface with the graft material. The bone graft is held and place with a special type of surgical bone cement or with screws, rods or other fixation or fusion devices, again depending on the surgeon, the surgical approach, and the overall condition of the vertebrae.
Screws, rods, plates, or other pieces of metallic hardware may be used temporarily to support and immobilize the spine during the healing process as the bone grafts meld together. These are called internal splints. You may also be required to wear an external cast or brace following the surgery, but again, this will be up to your surgeon.
If the mobilizing rods, screws or plates do not affect mobility or cause you pain, they may remain even after the fusion process is completed.
You may be required to remain in the hospital for up to five days, depending on how your body reacts to the surgical procedure. Healing of both the spinal surgery area and the bone graft harvesting location may take several weeks. You will be encouraged to get up and about as soon as possible in order to encourage faster healing and mobility.
With the cost of hospital stay, medications, surgery fees and anesthesia the spinal fusion procedure is expensive. In the United States, prices range anywhere from $50,000- $100,000, while in India costs range from $8,400 - $10,250. In Malaysia, costs are anywhere from $6,700 - $8,250. In many cases, some portions of the cost of spinal fusion treatments may be covered by medical insurance, though it's wise to always ask your healthcare provider exactly which services will be covered.
When deciding on an orthopedic surgeon for the spinal fusion procedure, it is important to find an experienced and qualified professional who has experience with different techniques for spinal fusion procedures. Be sure to check the facilities before settling on a surgeon, and make sure that they are accredited, and that surgeons and their staff are trained, experienced and certified in their field.
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