Lumbar Spinal Fusion
Lumbar spinal fusion is the procedure which is used for the treatment of lumbar spinal instability.
Indications for Surgery:
- Severe pain.
- Pain more than 3 weeks, not relieved by medications.
- Progressive weakness in lower limbs.
- Difficulty in passing urine and stools or inability to control urine and stools.
Procedure
Anaesthesia: The surgery is performed under general anaesthesia with the patient lying face down on the operating table.
Surgery: After cleaning the area of surgery thoroughly, the level of surgery is confirmed under X ray machine. An incision is made of about 4-5 cm at the level of surgery. Muscles are retracted to one side by dissection to expose the bone. Pedicle screws are inserted into the bones of the involved spinal level. A small portion of bone is removed (laminotomy or laminectomy) along with the ligaments to enter into the spinal canal and expose the spinal nerves and achieve decompression of the spinal nerves. The screws are connected with help of rods and an interbody cage inserted to restore alignment of the spinal column. The bone which is removed during the surgery in crushed into small pieces and is placed along the rods to induce fusion between the two bones.
After Surgery
In the recovery room: Immediately after surgery the patient is shifted to recovery room, where the patient is monitored for some time. Medications are provided for pain to control post operative pain relief. Once the patient is comfortable the patient is shifted to ward.
In the ward: The patient is allowed to have liquids 6 hours after the surgery. Once the pain has reduced and the patient is comfortable, patient is allowed to sit and walk on the same of the surgery. The patient is discharged 2-3 days after the surgery.
After Discharge: It is necessary to stay active after surgery and patient can walk as per his comfort with in his home or nearby. The patient should follow healthy eating habits avoid weight gain and obese patient should try to reduce weight. The patient should refrain from smoking cigarettes, chewing tobacco and drinking alcohol as these can lead to recurrence of symptoms later. Patient should do exercise atleast for 45 mins to 1 hour daily to get good result after spine surgery and avoid future spine related problems.