Who performs lumbar fusion?

An orthopedic surgeon or a neurosurgeon performs lumbar fusion. An orthopedic surgeon specializes in surgical treatment of diseases and conditions of the muscles and bones, including the spine. A neurosurgeon is a doctor who specializes in the surgical treatment of diseases and conditions of the nervous system, including the nerves of the spine.

How is lumbar fusion performed?

Your lumbar fusion will be performed in a hospital or surgical center. The surgery involves placing a bone graft material in strips along your vertebrae, in pieces between your vertebrae, or packed into a special cage that goes between your vertebrae.

Surgical approaches to lumbar fusion

Lumbar fusion surgery is performed using one of the following approaches:

  • Minimally invasive surgery involves inserting special instruments and an arthroscope through small incisions in your back. An arthroscope is a thin, lighted instrument with a small camera. The camera transmits pictures of the inside of your body to a video screen viewed by your doctor while performing surgery. Minimally invasive surgery generally involves a faster recovery and less pain than open surgery. This is because it causes less damage to tissues. Your surgeon will make small incisions instead of a larger one used in open surgery. Surgical tools are threaded around muscles and tissues instead of cutting through or displacing them as in open surgery.
  • Open surgery involves making a large incision in your back (posterior approach), abdomen (anterior approach), or side (lateral approach). Open surgery allows your surgeon to directly view and access the surgical area. Open surgery generally involves a longer recovery and more pain than minimally invasive surgery. Open surgery requires a larger incision and more cutting and displacement of muscle and other tissues than minimally invasive surgery. Despite this, open surgery may be a safer or more effective method for certain patients.

Your surgeon will advise you on which procedure is best for you and how long you need to stay in the hospital based on your diagnosis, age, medical history, general health, and possibly your personal preference. Learn about the different lumbar fusion procedures and ask why your surgeon will use a particular type for you.

Types of anesthesia that may be used

Your surgeon will perform lumbar fusion using general anesthesia. General anesthesia is a combination of intravenous (IV) medications and gases that put you in a deep sleep. You are unaware of the procedure and will not feel any pain.

You may also have a peripheral nerve block infusion in addition to general anesthesia. A peripheral nerve block infusion is an injection or continuous drip of liquid anesthetic. The anesthetic flows through a tiny tube inserted near your surgical site to control pain during and after surgery.

What to expect the day of your lumbar fusion

The day of your surgery, you can generally expect to:

  • Talk with a preoperative nurse. The nurse will perform an exam and ensure that all needed tests are in order. The nurse can also answer questions and will make sure you understand and sign the surgical consent form.
  • Remove all clothing and jewelry and dress in a hospital gown. It is a good idea to leave all jewelry and valuables at home or with a family member. You care team will give you blankets for modesty and warmth.
  • Talk with the anesthesiologist or nurse anesthetist about your medical history and the type of anesthesia you will receive.
  • A surgical team member will start an intravenous (IV) line.
  • The anesthesiologist or nurse anesthetist will start your anesthesia.
  • A tube will be placed in your windpipe to protect and control breathing during general anesthesia. You will not feel or remember this or the surgery as they happen.
  • The surgical team will monitor your vital signs and other critical body functions. This occurs throughout the procedure and your recovery until you are alert, breathing effectively, and your vital signs are stable.