Spinal fusion is a surgical technique used to join two or more vertebrae in the spine and to minimize the pain caused by movement of these vertebrae. Fusion of vertebrae in lumbar portion of the spine is called as lumbar fusion and the surgery can be done as an open or minimally invasive procedure.
Several techniques are practiced for minimally invasive surgery and they include
- Anterior lumbar interbody fusion, ALIF – accessing the spine from the front
- Posterior lumbar interbody fusion, PLIF – approaching the spine from the back
- Transforaminal lumbar interbody fusion, TLIF – approaching from the side
In PLIF surgery, several 1-2 inch incisions are made on the back, a series of increasingly larger dilators are used to spread the muscles apart and to provide access to the spine. The rods and screws are placed through the dilator tubes. In some cases, an operating microscope may be used to provide a better view.
During the surgery, a piece of bone harvested from other parts of the body or collected from a bone bank is transplanted between the adjacent vertebrae. As the healing occurs, the bone fuses with the spine. This stimulates growth of solid mass of bone which helps in stabilizing the spine. In some cases, metal implants such as rods, hooks, wires, plates or screws are used to hold the vertebra firm until new bone grows between them.
A minimally invasive lumbar fusion technique is used to treat fractured vertebra, lumbar instability, spine deformities—scoliosis or kyphosis, cervical disc hernias, tumors, back pain and failed back syndrome. Spondylolisthesis, a painful condition of the spine caused by disc displacement or slipped disc, can be treated with minimally invasive lumbar fusion technique.
Minimally invasive technique of fusion carries many advantages and they include:
- Minimal damage to the adjacent tissues
- Reduced post-operative pain
- Reduced hospital stay
- Faster recovery
- Diminished blood loss