What Is Lumbar Spinal Fusion

In cases of spinal instability secondary to degeneration, spondylolisthesis, trauma or tumors, a lumbar decompressive procedure such as a laminectomy may be combined with a fusion procedure. Spinal fusion is a surgical technique used to join two or more vertebrae. Supplementary bone tissue, either from the patient (autograft) or a donor (allograft), is used in conjunction with the body’s natural bone growth (osteoblastic) processes to fuse the vertebrae. This procedure is used primarily to eliminate the pain caused by abnormal motion of the vertebrae by immobilizing the vertebrae themselves. There are two main types of lumbar spinal fusion, which may be used in conjunction with each other:

About Lumbar Fusion

Posterolateral fusion places the bone graft between the transverse processes in the back of the spine. These vertebrae are then fixed in place with screws and/or wire through the pedicles of each vertebra attaching to a metal rod on each side of the vertebrae.

Interbody fusion places the bone graft between the vertebra in the area usually occupied by the intervertebral disc. In preparation for the spinal fusion, the disc is removed entirely, for example in ACDF. A device may be placed between the vertebra to maintain spine alignment and disc height. The intervertebral device may be made from either plastic or titanium. The fusion then occurs between the endplates of the vertebrae. Using both types of fusion is known as 360-degree fusion. Fusion rates are higher with interbody fusion. Three types of interbody fusion are:

  • Anterior lumbar interbody fusion (ALIF)- the disc is accessed from an anterior abdominal incision
  • Posterior lumbar interbody fusion (PLIF) – the disc is accessed from a posterior incision
  • Transforaminal lumbar interbody fusion (TLIF) – the disc is accessed from a posterior incision on one side of the spine

In most cases, the fusion is augmented by a process called fixation, meaning the placement of metallic screws (pedicle screws often made from titanium), rods or plates, or cages to stabilize the vertebra to facilitate bone fusion.

Conditions That Can Be  Treated With  Spinal Fusion:

  • Fractures
  • Degenerative disk disease
  • Spondylolisthesis
  • Spinal stenosis
  • Tumors
  • Infections
  • Scoliosis
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