Posterior lumbar fusion (spinal fusion)

General information

Spinal fusion is surgery to permanently connect two or more vertebrae in your spine, eliminating motion between them. This is done by placing an additional section of bone in the space between the vertebrae, usually taken from the hip or donated bone. This helps to prevent excessive movements between 2 adjacent vertebrae, lowering the risk of further irritation or compression of the nearby nerves and reducing pain and related symptoms.

Spinal fusion can be a very good treatment for some spinal conditions; however, it does not return your spine to “normal” as the normal spine has some degree of motion between vertebrae. To improve the chance of fusion being successful, some surgeons may use screws and connecting rods to secure the bones.

Spinal fusion may be performed for a variety of different reasons including:

• Lumbar spinal stenosis
• Lumbar degeneration (wear and tear) of the spinal structures leading to narrowing of the spinal canals
• Lower limb radiculopathy and neurogenic claudication
• Treatment of fractured (broken) vertebrae
• Correction of deformity
• scoliosis
• Spondylolisthesis – a condition whereby one of the vertebra in the lower part of the spine slips forward or backward compared to the next vertebra
• Elimination of painful movement
• Treatment of instability
• Treatment of some disc herniations or bulge

Before the surgery

Things you can do to prepare weeks prior to your surgery 

• Eat a balanced diet – helps the healing process
• Cease smoking – can cause complications with anaesthesia and can also delay the healing process 

Pre-operative assessment clinic

• During this visit, you will be asked about your medical history and any medications you are taking. You will have blood tests done and may have an electrocardiogram (ECG) and x-ray.
• This clinic is also an opportunity for you to ask any questions you may have and to plan for your discharge from hospital.
• If you have a history of MRSA or have been in contact with someone with MRSA, please let us know as soon as you have a surgery date. We will need to take some swabs to ensure you do not have any MRSA that might get into your wound at the time of surgery.

Post-operative care

When your surgery is completed, you will be moved to the recovery room where you will be observed and monitored by a nurse until you awake from the anaesthetic. You will then be transferred to a ward where the ward team will work closely with you to aid your recovery. 

You will have a drip for intravenous fluids through a vein into your arm or hand which will continue for a number of hours after your surgery. You may eat when you are fully awake but we advise that you start with sips of water and then a light meal.

You may have a catheter inserted into your bladder to make urination easier. There may be a drain tube in your back which is normally taken out 1-2 days after surgery.

The immediate discomfort following spinal fusion is generally greater than with other types of spinal surgery. Fortunately, there are excellent methods of pain control available for after your surgery and your anaesthetist and nurse will work closely with you to manage your pain.

You will get out of bed and on your feet the day after surgery. This is safe and it is the best way to get your muscles moving and prevent postoperative complications. A nurse or physiotherapist will be with you to advise you on how to move your back carefully and comfortably.

Recovery following fusion surgery is generally longer than for other types of spinal surgery. Patients normally stay in hospital for 4-6 days but a longer stay after more extensive surgery is not uncommon. You will gradually increase your movement over your stay.

You will not be discharged until all the members of the team who treated you are confident that you are well enough.