Lumbar spinal fusion is a surgical procedure that corrects problems involving the lumbar vertebra in order to elimination pain.
Background on Spinal Fusion Surgery
Treatment by spinal fusion is based on a concept that pain is generated from a segment of the lumbar spine (Szpalski & Gunzburg, 2007). Using bone grafts, metal rods and screws, this procedure facilitates stabilization of the lumbar spine by fusing two or more vertebrae together, thereby, eliminating motion between the vertebral segments. The ultimate goal of lumbar spinal fusion is to achieve a solid union between two or more vertebra (North American Spine Society, 2006). Forming a strong union allows for relief of low back pain, tingling sensations, numbness and weakness, restoration of nerve functions and prevention of abnormal spinal motions. Lumbar spinal fusion is an extensive and invasive surgical procedure. It usually takes around six or more months for the fusion to become stable (University of Pittsburg Medical Center, 2008; Bradford & Zdeblick, 2004).
Details about Spinal Fusion Surgery
In contrast to other surgeries of the spine, such as discectomy or laminectomy, lumbar spinal fusion is considered a more complicated procedure. Spinal fusions involve the removal of the surface layer of the bone and placement of implants. In addition, this procedure requires more extensive and invasive dissections and longer surgical operative time (Deyo, Nachemson, & Mirza, 2004). Thus, spinal fusion is associated with more complications compared to other types of spinal surgery. According to Deyo and colleagues (2004), in most studies, around 15% of spinal fusion surgeries resulted in pseudoarthrosis, a condition where the fusion does not take place or the vertebrae do not fuse completely. Additionally, persistence and worsening of low back pain can still occur after the surgery. In fact, according to the study of Juratli and colleagues (2009), 21% of mortalities occurring years after lumbar fusion surgery are related to pain medications. Of the 22 analgesic-related mortalities, 19 lost their lives to accidental overdoses and 3 due to suicides (Juratli, et al., 2009). The risk of analgesic-related mortality was especially common among middle-aged workers diagnosed with degenerative disc disease.
Exercise and Spinal Fusion
Through appropriate exercises, exercise can help with the speed of recover from spinal fusion. After the surgery, there is no degree of motion between the fused vertebrae. The spine is composed of a series of joints; thus, the adjacent segments have to compensate for fusion at one or more levels to restore pre-surgical mobility. This can cause the adjacent segments to become hypermobile, resulting in pain above or below the fusion (Hall & Brody, 2005). The role of exercises after spinal fusion is valuable as it can help the achieve faster recovery time. The muscles supporting the lumbar vertebrae must be activated, endurance built and strength restored.
Lumbar spinal fusion is only the beginning of a long process of treating the pains and discomforts caused by lumbar spine pathologies or deformities. Through a regimen of exercises, the muscles that support the spine are strengthened to promote and maintain the alignment and balance of the spine, ensuring that the effects of the fusion are as positive as possible.
If you are recovering from spinal fusion or have a client with spinal fusion. I would recommend the spinal fusion exercise program that I give my clients that are recovering spinal fusion. CLICK HERE to get more details.
Rick Kaselj, MS