Posterior fusion surgical procedure requires a posterior incision in your back, over the lumbar spine. Depending on how many spinal levels are diseased, the surgical technique may be performed using a smaller incision or longer incision.
The incision is carried into the bony structures of the spine to expose spinous processes, lamina, facet joints, and transverse processes. Soft tissues and cartilage are removed in the area where the bony fusion is desired.
Depending on the disease of a patient, decompression and freeing up the nerve roots, and/or a discectomy are fundamental to relieve pain and increase function that is caused by compression of the nerves.
For stabilization pedicle screws (metal) and rods are placed to optimize lordosis and hold the spine in place. The bony surfaces are roughened and prepared prior to bone graft placement. Bone graft is then laid over the bony surfaces. Various types of bone graft may be utilized. Recently, ‘local bone’ autograft from the dissection will be placed, along with products of Bone Morphogenic Protein (rhBMP-2/ACS, Infuse), Demineralized Bone matrix (DBMs), and or synthetic graft extenders.
This type of fusion surgery requires healing and consolidation of the bone graft materials with the native bone. The bone graft heals to a solid mass of bone (much like a fracture heals). Once healed, the solid bony mass provides mechanical stability.