Lumbar posterior fusion surgery is the most likely and commonly conducted fusion surgery for treating the low back problems. Basically, fusion surgery has the objective of joining two or more than two bones into a single solid bone. The procedure is called as posterior lumbar fusion, as the surgeon accesses the spine from the back or posterior. Posterior fusion procedure performed in the lumbar spine is useful for treatment of fractures, severe and prolonged degenerative disc diseases and spine instability related to the lumbar spine. Other alternative procedures to be considered are removing the bone spurs, removing the injured portions from the discs present in the low back. Some of the surgeons consider using rods, screws instrumentation for secure hold of the fuse.

Objective of Lumbar Posterior Fusion

The major objective of the spinal fusion is stopping the vertebrae movement. When the fused section is kept from moving, the mechanical pain can be stopped. Usually, the mechanical pain is experienced when joints and the discs that are damaged and connect the vertebrae tend to become inflamed caused from the excessive motion seen in between the vertebrae. This kind of pain is usually experienced at the low back and also would radiate towards upper thighs and buttocks.

When there is too much motion of the vertebrae, the spinal nerves would also be affected. They would start rubbing each, through the way, they are passed towards the neural foramina and the result would be irritation or the swelling. If the vertebra slides longer distances backward or forward the vertebra below, neural foramina would be narrowed. The result of it will be pinching of the nerves, through neural foramina, where they are passed through. Finally neurogenic pain is felt because of the irritation, pinching and nerve swelling. This pain does not stop here, but radiates downwards to the knees and legs, below the knees. When fusion is performed, it stops the harm happening to the nerves. When the vertebrae are fused together, the degeneration process could be slowed down at the segments of fuse and future problems can also be prevented.

Before the Surgery

After determining to go for the surgery, physical examination might be suggested to be done by the regular doctor. It is important to ensure that the candidate is in the perfect condition to go through the procedure. The candidate has to stop eating or drinking from the midnight of the day before the surgery.

Procedure

General anesthesia is given to make the patient to sleep. Breathing is assisted with the help of the ventilator. The procedure starts with incision that is made just towards down of the middle of the low back. The tissues present below the skin are then separated. Small muscles found at the low back sides are lifted off from the vertebrae to expose the spinal column back. Then an X-ray would be taken to ensure that the right vertebrae is considered for the procedure. The pressure is removed from the nerves that are nearby. Any of the disc fragment is then taken and scrapped off the bone spurs, nearby. It helps to relieve the additional pressure and tension from the nerves present in the spinal canal. If the nerve roots can’t move freely, the larger openings would be done in the neural foramina. And this procedure performed here is called foraminotomy. Then a bone graft is then taken from the hip. This bone strips are then laid at the back part of the spinal column. When posterior spinal fusion is done, the bones are fixed in place with the help of right combination of rods, metal screws and plates. Finally a small drainage pipe is placed at the wound. The soft tissues and muscles are then put back to the place and the incision is closed. A rigid brace might also be kept by the surgeon for supporting the spine.

Complications

• Infection
• Nerve damage
• Anesthesia problems
• Thrombophlebitis
• Muscle disruption
• Continued pain
• Nonion
• Problems with either hardware or graft

Cost of Lumbar Posterior Fusion (PF) Surgery in India

The above Package Cost is a tentative Approximate Package Estimate for Lumbar Posterior Fusion (PF) Surgery in India, which includes initial investigations & specialists screening, stay in a Private Room wherein patient’s assistant or relative can also stay with patient, doctor / surgeon fee, nursing care, medicines & consumables, Airport Pick-Up & Drop. 

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