Posterior lumbar fusion, also known as arthrodesis, is a surgical procedure performed to join multiple vertebrae into one solid bone.
While a small posterior fusion is often used to supplement interbody fusions, posterior fusion is also a technique that is used to address complex deformities of the lumbar spine. The procedure is called a posterior fusion because the surgeon works on the back of the spine.
The goals of deformity correction include realigning the spine to its natural position, decompressing the nerves to alleviate radiating buttock and leg pain, and stabilizing the spine with rigid instrumentation to prevent recurrence of the deformity.
Spinal deformities can cause progressive pain and disability. There are multiple causes of spinal deformities. Kyphosis and loss of normal contour of the lower back can cause difficulty with standing upright and ambulating, which can result in severe pain and fatigue. Degenerative scoliosis can cause progressive back pain, and severe scoliosis can eventually cause compression of the spinal nerves, resulting in radiating leg and buttock pain.
Recovery from deformity correction surgery is typically prolonged. It takes 6-9 months to fully heal after a large operation. However, many patients feel significantly better within a few weeks of the surgery. Activity level, including bending and twisting of the back as well as lifting heavy objects, is limited for the first three months to allow the spine to heal. A brace is usually utilized for the first three months as well to help stabilize the spine as it heals. While the long-term outcomes of spinal deformity corrections are very good, patients should always have an educated discussion with their surgeon to understand the magnitude of the surgery and the expected length of the recovery.