Spinal Fusion: Posterior Lumbar

Lumbar vertebrae

Fusing vertebrae in the lumbar curve may help ease lower back and leg pain. Posterior lumbar fusion is done through an incision in your back. The graft is put between the vertebrae in one of two places: in the disk space or between the transverse processes. Depending on how many vertebrae are fused, the surgery may take from 3 to 8 hours.

Fusing the Transverse Processes

• Bone graft is packed between the transverse processes (“wings”) on the sides of the vertebrae. Occasionally, other nearby parts of the vertebrae are fused as well.

• To help keep your spine steady and promote fusion, extra support (see below) may be used.

• The incision is closed with sutures or staples.

Fusing the Disk Space

• The disk between the vertebrae is removed.

• Bone graft is packed in the now-empty space between the vertebrae. In time, the graft and the bone around it grow into a solid unit.

• To help keep your spine steady and promote fusion, extra support may be used.

• The incision is then closed with sutures or staples.

If Extra Support Is Needed

Metal supports called instrumentation may be used to help steady your spine while it fuses:

• A cage may be used when fusing the disk space. This is a plastic or metal “basket” that is packed with bone graft. It’s inserted into the empty space where the disk was removed. The cage remains in the body and is not removed.

• Screws and rods may be used when fusing the transverse processes. In rare cases, these supports may be removed after fusion is complete.