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Lumbar Fixation and Fusion

Lumbar spine fixation is a surgical procedure performed to restrict movement of the spine due to excessive instability. A restriction in vertebral movement reduces pain produced by irritation of surrounding soft tissues and structures. Lumbar fixation involves insertion of screws and rods, and growth of a bony bridge provides spinal fusion.

Back pain caused by impairment of the lumbar discs or vertebreaAbove: Back pain caused by impairment of the lumbar discs or vertebrea

Lumbar Fixation and Fusion Indications

Lumbar fixation is indicated when there is excessive instability of the spine, causing pain on many activities of daily living.

This may be due to the following:
  • Degeneration of the spine
  • Trauma
  • Cancer

Mobilisations of the vertebrea in the lower backAbove: Mobilisations of the vertebrea in the lower back

Investigations such as an x-ray or MRI scan can confirm the cause of the instability following physical examination. Conservative management is the primary treatment of instability including strengthening of the core and lower back muscles to increase control around the spine in order to compensate for the instability. If conservative management fails or significant instability remains, surgery is indicated to fix or fuse the spine is indicated.

Lumbar Fixationand Fusion Procedure

The lumbar fixation and fusion surgical procedure is usually performed under general anaesthetic.

The procedure involves the following stages:
  • An incision is made over the area of vertebral instability and the spinal segments are exposed.
  • Sometimes removal of the posterior arch of the vertebrae (lumbar laminectomy) is needed to decompress the nerves.
Then the spinal stabilisation is performed.
  • The bone for the fusion is taken from the iliac crest.
  • The site for the pedicle screws is identified and screws inserted accurately.
  • The bone is transplanted across the unstable vertebral segments.
  • The screws are connected with metallic rods to provide the fixed stability.
  • The operated site is then closed in multiple layers.
Following surgery you will remain in hospital for several days and be given pain control medication.

Trigger point massage of the muscle and connective tissue in the lower backAbove: Trigger point massage of the muscle and connective tissue in the lower back

The Benefits Post-Surgery

There are many benefits following lumbar fixation and fusion.

Benefits of lumbar fixation and fusion include:
  • Stability of the previously unstable spinal segments
  • Reduced lower back pain
  • An increase in function
  • Improved wellbeing
  • Greater quality of life
The potential of benefits post-lumbar fixation and fusion surgery are maximised following commitment to physiotherapy rehabilitation.

Physiotherapy Rehabilitation Post-Surgery

Following lumbar fixation and fusion surgery, you will be encouraged to mobilise in hospital the day after surgery and physiotherapy will begin.

Physiotherapy rehabilitation post-lumbar fixation and fusion surgery will include:
  • Mobility
    Ambulation is the only activity advised for 4-6 weeks following surgery.
  • Range of movement exercises
    At a later date you will begin gentle range of movement exercises to mobilise structures surrounding the spinal fusion to regain spinal movement.
  • Stretching
    Gentle stretching is important for decreasing stiffness of the spine and tightness of surrounding muscles.
  • Core strengthening exercises
    You will be taught core strengthening exercises by your physiotherapist to further increase spinal stability.
If you would like to book a physiotherapy assessment following lumbar fixation and fusion please e-mail or call 0330 088 7800.

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