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Spinal Fusion: Posterior Lumbar

Fusing vertebrae in the lumbar spine may help ease lower back and leg pain. Posterior lumbar fusion is done through an incision in your back. Spacers and/or a bone graft are put between the vertebrae. Depending on how many vertebrae are fused, the surgery may take from 3 to 8 hours.

Side view of lumbar vertebrae.

Fusing the transverse processes

Fusion has several steps:

  • The bone graft is packed between the transverse processes (“wings”) on the sides of the vertebrae.

  • To help keep your spine steady and promote fusion, extra support may be used. This may be metal screws and rods. Sometimes, bone cement is added around the screws.

  • A wound drain is often placed in the wound and left in for a few days.

  • The incision is closed with stitches or staples.

    Back view of lumbar vertebrae showing bone graft between transverse processes.

Fusing the disk space

This involves the following:

  • An incision is made in the middle of or on each side of your spine.  

  • The disk between the vertebrae is removed.

  • A bone graft, a spacer (cage), or both are placed in the now-empty disk space between the vertebrae. In time, the graft or spacer and the bone will grow into a solid unit.

  • To help keep your spine steady and promote fusion, metal screws and rods may be placed to provide extra support and promote healing. Sometimes, bone cement is added around the screws.

  • A wound drain is often placed in the wound and left in for a few days.

  • The incision is then closed with stitches or staples.

    Cross section of lumbar vertebrae showing bone graft between vertebrae.Cross section of lumbar vertebrae showing fused bone between vertebrae.

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