Most lower back pain can be effectively managed with a variety of helpful interventions. Physical therapy, weight loss, smoking cessation, chiropractic treatment, steroid injections, and traction are just a few examples of conventional treatments that can improve back pain.

In special circumstances where these treatments fail, a doctor can discuss with you the possibility of achieving the best long-term result through a lumbar fusion. There are several important things to understand about lumbar fusion surgery.

  • Under what circumstances could a merger be recommended?
  • How does the pain really improve?
  • How does a surgeon perform a lumbar fusion?

Causes of back and leg pain

In order to understand why fusion can work, one must understand the possible mechanisms of back and leg pain. A physician may recommend a lumbar fusion in circumstances where the main cause of back pain is assumed to be a severely degenerated disc between two vertebrae or a “slippage” of the vertebral bones (referred to as ” spondylolisthesis “). Sliding of the bones results in misalignment of the spine and possible entrapment of the vertebral nerves. There are other circumstances in which a fusion may be the best treatment for back and leg pain. In referring to which discs are involved, a doctor will speak in medical jargon of the “levels involved.” A fusion of one level, joins or fuses the two vertebrae on either side of the affected disc. A two-level fusion joins or fuses three vertebrae with the two involved discs. A fusion is a truly solid bone bridge created through surgery that joins the bones together to maintain alignment and provide stability and strength. The pain is believed to originate at the levels of the spine where the bones move or where the discs or joints become damaged and cause pain. This can be due to irritation of the nerve endings around the disc, in the bones or in the joints themselves, or because the nerves in the spine are truly trapped in that region. By eliminating movement at the damaged level, the pain can be soothed.




A lumbar fusion may be recommended for diagnoses such as recurrent disc herniation, spondylolisthesis, scoliosis or curvature of the spine, severe disc degeneration or for a traumatic spinal injury such as a fracture. All of those different conditions can cause back and leg pain.How to treat spinal stenosis

Aspects of the surgical procedure. A lumbar fusion can be achieved in several ways and through different approaches to the spine. What this means for the patient is that an incision will be made in their abdominal wall, their side, their butt, or a combination of these approaches. “Front” means from the front and “back” means from the rear. The surgeon will study your X-rays and determine which approach you require (in less frequent circumstances you may require both). Although you may know of people who have had a fusion, keep in mind that there are many possible options and that your surgeon will choose the method and technique best tailored for your spine.

You will also decide whether the use of titanium screws would be beneficial. They are usually placed through the “pedicle” bone of your spine, thereby allowing traction on the back, middle, and front parts of your vertebral bones. These screws are attached to a rod or plate that follows the shape of your spine. This type of spinal “instrumentation” provides immediate strength to your spine during the bone fusion process.

In other cases, a titanium “cage” or bone cylinder can be used that screws into the disc space. This is called interbody fusion because it takes place between the “bodies” of the vertebrae and is done through the affected disc space. It can be done from the front (front) or from the rear (rear). An approach through the abdomen (anterior) can be done “laparoscopically” through small incisions or “open” through a single incision. Your surgeon can discuss with you the advantages and disadvantages of both techniques, as well as what has worked best based on his own experience. Usually these “cages” or metal or bone casts are filled with bone grafts taken from your pelvis (ileum) or coccyx (spinous processes and lamellar bone). The bone graft serves as a source for the bone cells to help them start the fusion process at the surgery site. In some cases, cages can be used in conjunction with pedicle screws. Other techniques include spinal cord placement or “graft” along the sides of the spine (with or without screws). This type of “posterolateral” lumbar fusion is another effective way to fuse one level of the lumbar spine. The place where the bone graft material was removed in your pelvis (ileum) may continue to hurt for weeks to months after surgery, but improves in most patients. The bone graft serves as a source for bone cells to help them start the fusion process at the surgery site. In some cases, cages can be used in conjunction with pedicle screws. Other techniques include the placement of the spinal cord or “graft” along the sides of the spine (with or without screws). 



This type of “posterolateral” lumbar fusion is another effective way to fuse one level of the lumbar spine. The place where the bone graft material was removed in your pelvis (ileum) may continue to hurt for weeks to months after surgery, but improves in most patients. The bone graft serves as a source for the bone cells to help them start the fusion process at the surgery site. In some cases, cages can be used in conjunction with pedicle screws. Other techniques include spinal cord placement or “graft” along the sides of the spine (with or without screws). This type of “posterolateral” lumbar fusion is another effective way to fuse one level of the lumbar spine. The place where the bone graft material was removed in your pelvis (ileum) may continue to hurt for weeks to months after surgery, but improves in most patients. Other techniques include spinal cord placement or “graft” along the sides of the spine (with or without screws). This type of “posterolateral” lumbar fusion is another effective way to fuse one level of the lumbar spine. The place where the bone graft material was removed in your pelvis (ileum) may continue to hurt for weeks to months after surgery, but improves in most patients. Other techniques include spinal cord placement or “graft” along the sides of the spine (with or without screws). This type of “posterolateral” lumbar fusion is another effective way to fuse one level of the lumbar spine. The place where the bone graft material was removed in your pelvis (ileum) may continue to hurt for weeks to months after surgery, but improves in most patients.Common misconceptions about sciatica

Surgery: risks and recovery

The risks of lumbar fusion surgery are similar to those of other spinal operations and should be discussed well with the surgeon.

After the operation, you will likely be asked to wear a plastic brace or a cloth girdle for a certain time (weeks or months). Some surgeons do not use the devices at all, and what your surgeon recommends will probably be based on what he has found to be most successful in his practice.

The healing process of a fusion can take many months or more than a year to complete. For these reasons it is important to realize before the operation that the positive results will take time to materialize and that patience will be needed after the operation. A merger is not a quick fix; rather, it is a compromise between patient and surgeon for a long process that will improve back and leg pain. Total or 100% cures are rare. To be realistic, patients can expect dramatic and long-lasting improvement in their back and leg pain. Although many patients are concerned that a lumbar fusion will deprive them of the ability to bend and turn, most eventually regain the ability to bend in all directions. This mobility can allow a return to work and to enjoy many recreational activities. Lumbar fusion success rates may be lower in patients who smoke or are overweight, have diabetes, or other significant illnesses, and in those who have osteoporosis or have received radiation treatments that included the lower back. Good nutrition and slow increase in activity (as recommended by your doctor) in the recovery period can help achieve success. and in those who have osteoporosis or have received radiation treatments that included the lower back. Good nutrition and slow increase in activity (as recommended by your doctor) in the recovery period can help achieve success. and in those who have osteoporosis or have received radiation treatments that included the lower back. Good nutrition and slow increase in activity (as recommended by your doctor) in the recovery period can help achieve success.




In the future, lumbar joint or disc replacement may be a response to the debilitating back and leg pain associated with lumbar spine problems. Current surgical techniques allow for a variety of approaches to problems in the lumbar spine and are an increasingly safe and effective means of achieving bone fusion. The goal: to improve back and leg pain.

Recommended exercise

The benefit of exercise for your lower back depends on three key principles. First, you must achieve a satisfactory aerobic state. Second, you should focus part of your exercises on the muscle groups that support your back. Third: You should avoid exercises that put too much pressure on your back.

Ideal aerobic exercise engages the large muscle groups in your body (arms and legs) in a gentle, cyclical fashion. Some of the recommended exercises are swimming, brisk walking, cycling, and using a ski machine or elliptical exerciser. You should achieve the proper heart rate for 30 minutes at least three times a week. Of course, you should consult with your GP and review the aerobic program before starting. Your practitioner will be able to set the appropriate target for your heart rate during aerobic exercise. It’s always optimal to approach your aerobic goals slowly, especially if you haven’t done any gymnastics lately. Part of your exercise should stretch and strengthen the muscles in your lower back, abdomen, pelvis, and thighs. Flexibility in these areas will greatly decrease the chance of further injury to your back. By strengthening these muscle groups, you improve body weight distribution and posture, resulting in less stress on the lower back. It is best to do these exercises and the aerobic routine after a good “warm up.” Seek instructions from your gym staff or physical therapist for specific stretching and strengthening exercises for those areas. These exercises and aerobic routine are best done after a good “warm-up.” Seek instructions from your gym staff or physical therapist for specific stretching and strengthening exercises for those areas. It is best to do these exercises and the aerobic routine after a good “warm up.” Seek instructions from your gym staff or physical therapist for specific stretching and strengthening exercises for those areas.

While the merits of good preparation cannot be overstated, the wrong kinds of exercises can actually make your lower back problem worse. Activities that put excessive stress on the back, such as heavy lifting, bending, and climbing are not advisable. Additionally, high-impact exercises such as running, jumping, and step aerobics can exacerbate lower back problems. For walking, wear well-cushioned shoes with good arch support and work on a treadmill or track used for athletics. Cycling on a recumbent stationary bike can relieve stress on your back.

With the help of your doctor, physical therapist, and your gym staff, you can achieve proper fitness. Your lower back pain may decrease and your life expectancy may increase!


Categories: Back pain

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