What are the risks and potential complications of lumbar fusion?  

As with all surgeries, lumbar fusion involves risks and possible complications. Complications may become serious and life threatening in some cases. Complications can develop during surgery or recovery.  

General risks of surgery 

The general risks of surgery include: 

  • Anesthesia reaction, such as an allergic reaction and problems with breathing 
  • Bleeding
  • Blood clot, in particular a deep vein thrombosis that develops in the leg or pelvis. A blood clot can travel to your lungs and cause a pulmonary embolism. 
  • Infection and septicemia, which is the spread of a local infection to the blood

Potential complications of lumbar fusion

Complications of lumbar fusion include:

  • Nerve and blood vessel damage
  • Pain at the graft site
  • Pseudoarthrosis is a condition in which there is not enough bone formation to support the graft. This complication is more common in people who smoke. If it occurs, a second surgery may be needed to correct it.
  • Lack of pain relief, worsening of your back pain, or recurrent spinal symptoms 
  • Lumbar fusion for degenerative arthritis is a somewhat controversial area with a limited success rate.  

Reducing your risk of complications

You can reduce the risk of certain complications by following your treatment plan and:

  • Following activity, dietary and lifestyle restrictions and recommendations before surgery and during recovery
  • Informing your doctor if you are nursing or if there is any possibility of pregnancy
  • Notifying your doctor immediately of any concerns, such as bleeding, fever, increase in pain, or wound redness, swelling or drainage 
  • Taking your medications exactly as directed
  • Telling all members of your care team if you have any allergies 

How do I prepare for my lumbar fusion? 

You are an important member of your own healthcare team. The steps you take before surgery can improve your comfort and outcome.

You can prepare for a lumbar fusion by:

  • Answering all questions about your medical history and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.
  • Getting preoperative testing as directed. Testing varies depending on your age, health, and specific procedure. Pre-operative testing may include a chest X-ray, EKG (electrocardiogram), blood tests, and other tests as needed.
  • Losing excess weight before the surgery through a healthy diet and exercise plan
  • Not eating or drinking before surgery as directed. Your surgery may be cancelled if you eat or drink too close to the start of surgery because you can choke on stomach contents during anesthesia.
  • Stopping smoking as soon as possible. Even quitting for just a few days can be beneficial and help the healing process.
  • Taking or stopping medications exactly as directed. This may include not taking aspirin, ibuprofen (Advil, Motrin), and blood thinners. 

Questions to ask your doctor

Facing surgery can be stressful. It is common for patients to forget some of their questions during a brief doctor’s office visit. You may also think of other questions after your appointment. Contact your doctor with concerns and questions before surgery and between appointments.

It is also a good idea to bring a list of questions to your appointments. Questions can include:

  • Why do I need a lumbar fusion? Are there any other options for treating my condition?
  • Which type of lumbar fusion procedure will I need?
  • How long will the surgery take? When will I be able to go home?
  • What restrictions will I have after the surgery? When can I return to work and other activities?
  • What kind of assistance will I need at home?
  • What kind of rehabilitation and physical therapy will I need?
  • What medications will I need before and after the surgery? How do I take my usual medications?
  • How will you treat my pain?
  • When should I follow up with you?
  • How should I contact you? Ask for numbers to call during and after regular hours.

What can I expect after my lumbar fusion?