When spinal instability in the lumbar (lower back region) occurs due to a condition such as spondilolisthesis—where a vertebra in the spine slips forward due to a weakness in the joint or a fracture and begins to impact or compress a nerve, causing pain not only in the back but down into the legs and feet—oftentimes a surgeon will recommend that a posterolateral lumbar fusion be performed. This procedure implants a bone graft between affected vertebrae to “fuse” them together into one single and much more stable bone, and may also be recommended for sufferers of scoliosis (abnormal curvature of the spine), disc herniation or a fracture to the spinal column.
During a posterolateral lumbar fusion, a surgeon will make an incision in the center of the lower back, pushing aside muscle and tissue to expose the affected vertebrae. A removal of the lamina—a thin layer of bone over the spinal cord—is also necessary to relieve compression of the nerves causing the patient pain. Then, the surgeon removes any fragments of broken disc or bone that may also be pressing on nerve roots before inserting the bone graft to the sides of the spine to form a solid bridge of bone. Lastly, a combination of rods and screws are inserted and fixed into place to secure the graft and provide stability for the spinal column and vertebrae and to prevent a recurrence of disc slippage.
Post-surgery, a physician will recommend rest and an avoidance of activities that may delay healing. The application of a brace device is also common as it gives spinal support during the period in which the graft completes fusing—which can take several months—and can prevent injuries to the affected area during the recovery process.