For suffers of back pain, everyday activities can become difficult or impossible. However, some patients' back pain can be helped with a lumbar fusion.
For a lumbar fusion, a laminectomy is performed. A laminectomy means that the upper portion of the lamina is removed, which exposes the thecal sac and allows the disk to be removed if needed. During the laminectomy, the facet joints are removed and arthritic tissue surrounding the exiting nerve roots can also be removed. The facet joints are the weightbearing portions of the spine; removing them makes the spine unstable at this level, which necessitates the need for instrumentation. Any bone spurs can be removed at this time as well.
After this is done, Dr. Boone typically begins the instrumentation process. Screws are placed into the pedicle portion of the vertebra into the body of the vertebra, one at each level. Then Dr. Boone switches sides and repeats the process. The lamina bone that was removed is saved and is crushed up and can be placed into an interbody spacer. This spacer is placed into the space where the disk was removed, which allows the vertebral bodies to grow together. This is called a posterior lumbar interbody fusion.
A needle is then introduced into the iliac crest, and bone marrow is aspirated. The bone marrow contains stem cells from your body and is then put on a strip of calcium phosphate. The calcium phosphate acts as a scaffolding for the bone to grow on and is placed on the transverse processes next to the screws. A titanium rod is placed onto the screws, and the rod is secured with a locking screw which keeps the area stable while the bone heals. The process is then repeated on the other side. The remaining half of the bone marrow is placed onto another strip of calcium phosphate. The calcium phosphate strip is placed on the transverse processes of the two levels being fused. The titanium rod is placed on the screws and then the rod is locked down with locking screws. The laminectomy defect is covered with a small strip of moistened Gelfoam.
The incision is then closed, and the patient is taken to the recovery room where they are awakened from anesthesia. Patients are typically walking the same day of surgery. They spend the next two to three days in the hospital and are generally discharged to home.
If you are suffering from back pain, call (800) 283-3662 to schedule an appointment with one of our spine specialists.