Lumbar Fusion

Severe impact due to a car accident can shove bones, muscles, and tissues out of their normal positioning. While all of these results are highly painful, accidents that affect the spine can also cause far reaching symptoms. The spinal column is made up of 24 vertebrae, each separated by a disc to provide cushioning and separation of the bones. The lowest five vertebrae are called the lumbar vertebrae and make up the lower portion of the back. Many people complain of lower back pain as they age. A car accident can push this pain to a new level and can introduce it to young individuals as well.

A sudden impact can force a lumbar disc out of its proper positioning. This results in the bones grinding against each other and rubbing against the spinal nerves. The resulting symptoms are lower back and leg pain, and numbness, tingling, and weakness in the legs. These pains can be debilitating when persistent and severe. There are many types of treatment that attempt to relieve the pain, but in many cases these do little to help the individual's situation. When this is the case, many physicians turn to lumbar fusion. This is a procedure that fuses two of the lumbar vertebrae together. By fusing the vertebrae it is believed that the area will be stabilized and the nerves will have a clear unencumbered pathway thereby reducing the opportunity and persistence of pain.

In lumbar fusion procedures, the surgeon removes the intervertebral disc that is causing problems. Access to the spinal column can be achieved from the front (anterior lumbar fusion) or from the back (posterior lumbar fusion). Once the disc is removed, the surgeon will remove any bone spurs that may be in the area and irritating the spinal cord. The surgeon then inserts a bone graft between the two vertebrae to maintain the original amount of space between the vertebrae. This piece of bone can come from the hip bone of the patient or from a bone bank. Both options have their benefits and obstacles. The fusion of the bones is slightly more successful in cases of an autogeneous bone graft (coming from the patient's own body). However, this requires an additional step to the surgical process whereby the donor bone is harvested (usually from the hip), resulting in more pain and recovery time. An allograft (a piece of bone from a bone bank) reduces the healing time, but might not fuse as well with the other bones. In either case, the surgeon is likely to insert screws and metal plates to hold the vertebrae in place while the bones fuse together. This fusion occurs in largely the same manner as the healing of a bone fracture. Once fused, the vertebrae make up one larger bone, which reduced the chances for painful movement.

Lumbar fusion procedures are highly successful at stabilization. Fusion occurs in over 80% of all cases. However, successful fusion does not necessarily indicate the elimination of all pain. In fact a fusion can often lead to increased pain. Full recovery from lumbar fusion procedures usually takes six to eight months.