Pros and cons of lumbar fusion surgery

The lumbar spine plays a very critical and important role in the human body. When there is a problem with the lumbar spine, it means that the person's entire back will not be able to support the body, and may even face the risk of paralysis. Lumbar fusion surgery is necessary, but the surgery will also cause some positive and negative effects of pros and cons, which everyone needs to understand clearly.

1. Why is lumbar fusion necessary?

The stability of the spine plays an important role in maintaining the physiological functions of the human body. All diseases that lead to loss of lumbar stability require spinal stability reconstruction. These conditions or diseases include spondylolysis, degeneration, trauma, congenital diseases, pathological destruction, excessive articular process resection during intervertebral disc herniation surgery, and extensive laminectomy and decompression for spinal stenosis.

No matter how strong various internal fixations are, the stability they establish is only temporary. As time goes by, its fixing effect will gradually weaken until it is lost, and the stability established by it will also be lost. Only through bone grafting and fusion can permanent stability be achieved and truly stable reconstruction be obtained. Therefore, bone graft fusion plays a key role in reconstructing lumbar spine stability, and the success of fusion has become one of the important indicators of the success of spinal surgery.

2. What are the commonly used surgical procedures for lumbar fusion?

Commonly used lumbar fusion procedures and their characteristics:

There are many different lumbar fusion techniques, which can be roughly divided into three categories according to the fusion site: posterior fusion, posterolateral fusion and interbody fusion.

(1) Posterior lumbar fusion: Posterior lumbar fusion was first reported by Hibbs in 1911, so it is also called Hibbs fusion. It is a fusion between the bilateral vertebral lamina and articular process. Its indications are very limited and can only be used when the vertebral lamina remains intact. It is rarely used now and has been basically eliminated.

(2) Posterolateral lumbar fusion: also known as intertransverse process fusion. Compared with Hibbs fusion, PLF has a wider range of indications and was once used as the standard procedure for lumbar fusion. However, it has serious defects such as large trauma, severe paravertebral muscle damage, inability to effectively restore the intervertebral height and lumbar physiological curvature, inability to reduce lumbar spondylolisthesis, inability to effectively restore the supporting function of the anterior column of the lumbar spine, difficulty in handling the bone graft bed, need for a large amount of bone graft, low fusion rate, low fusion strength and difficulty in evaluating bone graft fusion.