Incorporating Posterior Interbody Fusion into Surgical
Interventions for Degenerative Lumbar Spine Conditions
If spine pain becomes severe enough to disrupt daily activities or is accompanied by swelling, tenderness, or redness, seeking medical attention is essential.
At Complete Orthopedics, our skilled spine specialists excel in treating spine pain using both surgical and non-surgical methods. We evaluate symptoms, identify the problem, and suggest suitable treatments, including surgery if necessary.
We cater to New York City and Long Island and work with six hospitals, offering state-of-the-art spine surgery and comprehensive orthopedic services. Consultations with our orthopedic surgeons can be scheduled online or by phone.
Learn about common causes of spine pain and the treatment options available, including when surgery is the best choice.
Overview
For different degenerative lumbar spine ailments, posterolateral spinal fusion has been a well-established therapy for a long time. After its original explanation, only a few other methods have been introduced to accomplish lumbar spine fusion, such as posterior lumbar interbody fusion (PLIF) and unilateral transforaminal posterior lumbar interbody fusion (TLIF).
By expanding the compressed disc space and enhancing fusion in the load-bearing vertebral bodies that have ample blood supply, the integration of interbody fusion (PLIF/TLIF) enables nerve root decompression.
There are two approaches to performing interbody fusion: anterior and posterior. In comparison to posterolateral fusion (PF), incorporating posterior interbody fusion (PIF) is more intricate, has a greater likelihood of complications, and prolongs the duration and cost of the procedures.
Radiologic Parameters
Studies have demonstrated that incorporating the PIF approach indicates an increase in disc height and slip percentage, but there was a tendency for correction to diminish over time. Inadequate sagittal balance after surgery can result in degeneration of adjacent segments and unfavorable outcomes.
By utilizing multiple functional outcome assessments and conducting a thorough postoperative evaluation, the group treated with posterolateral fusion (PF) demonstrates better functional outcomes than those who received interbody fusion. The reason for this is ascribed to selection bias based on factors such as age, sex, degree of listhesis, and disc degeneration, as well as the retraction and scarring of the nerve roots and thecal sac.
Literature has demonstrated that interbody fusion achieves a high rate of fusion. The TLIF technique has yielded a 90% rate of fusion and an 85% rate of satisfactory clinical outcomes.
While PIF enhances the fusion rate, correction of disc height, and reduction of spondylolisthesis slip percentage, there are no notable distinctions in functional outcomes, final segmental or lordotic angles, and complication rates in comparison to PF.
If you are interested in knowing more about incorporating Posterior Interbody Fusion into surgical interventions for Degenerative Lumbar Spine conditions you have come to the right place!
Do you have more questions?
How do I prepare for posterior cervical fusion surgery?
Preparation includes medical evaluations, discontinuing certain medications, arranging post-surgery care, and following specific preoperative instructions from your healthcare team.
What are the alternative treatments to posterior cervical fusion?
Alternatives include physical therapy, medications, steroid injections, and other surgeries like anterior cervical discectomy and fusion (ACDF).
What are the risks of not undergoing the surgery?
Risks include worsening symptoms, increased pain, potential permanent nerve damage, and loss of function.
How long does the posterior cervical fusion surgery take?
The procedure typically lasts 2-4 hours, depending on the complexity and the number of levels being fused.
What are bone grafts, and where do they come from?
Bone grafts are materials promoting bone fusion, sourced from your body (autograft), a donor (allograft), or synthetic alternatives.
Will I have scars after the surgery?
Yes, there will be a scar at the incision site on the back of your neck. Its size and visibility depend on the surgical approach used.
How long will I need to stay in the hospital after surgery?
Most patients stay in the hospital for 2-3 days post-surgery for monitoring and initial recovery.
What should I expect in terms of pain after surgery?
Post-operative pain is common but manageable with medications, typically subsiding significantly within a few weeks.
When can I resume normal activities after the surgery?
Light activities can resume within a few weeks, but strenuous activities should be avoided for 3-6 months.
How will I know if the fusion was successful?
Success is assessed through follow-up appointments, imaging tests, and the resolution of pre-surgery symptoms.
Can the hardware used in the fusion cause problems later?
Rarely, hardware complications such as loosening or breakage can occur, potentially requiring additional surgery.
Will I lose any range of motion in my neck after the surgery?
Some loss of range of motion is expected, especially with multi-level fusions, but most patients adapt well.
Are there long-term restrictions after the surgery?
Long-term restrictions might include avoiding high-impact activities that strain the neck.
What is the success rate of posterior cervical fusion?
Success rates are high, with significant pain relief and improved function reported in over 80-90% of cases.
Can I still experience neck pain after the surgery?
Some patients may experience mild residual neck pain, but it is generally much less severe than before surgery.
What are the most common complications of this surgery?
Common complications include infection, nerve damage, non-union of the vertebrae, and hardware issues.
What are the signs of a post-surgery infection?
Signs of infection include redness, swelling, increased pain at the incision site, drainage or pus, fever, and chills.
How is a non-union treated if the bones don’t fuse properly?
Non-union may require additional surgical intervention to re-stabilize the spine, possibly involving new bone grafts or revised hardware placement.
What can I do to minimize the risk of complications?
To minimize risks, follow all post-operative care instructions, avoid smoking, maintain a healthy diet, and attend all scheduled follow-up appointments.
How often will I need to follow up with my surgeon after the surgery?
Follow-up appointments are typically scheduled at 2 weeks, 6 weeks, 3 months, 6 months, and 1 year post-surgery to monitor progress and address any issues.
I am Vedant Vaksha, Fellowship trained Spine, Sports and Arthroscopic Surgeon at Complete Orthopedics. I take care of patients with ailments of the neck, back, shoulder, knee, elbow and ankle. I personally approve this content and have written most of it myself.
Please take a look at my profile page and don't hesitate to come in and talk.
