Low Back Pain and Sciatica and Spinal Fusion

Spinal fusion is a procedure that joins two bones (vertebrae) in the spinal column together to eliminate pain caused by movement. This, and any other surgery, is a major procedure and should only be used after other treatment options for low back pain and sciatica have been tried and proven to be unsuccessful.

Most of the time when a patient has a laminectomy and disc removal, a spinal fusion is not done. If a spinal fusion is to be performed, the adjacent vertebral bones are joined together with bone harvested either from the patient or a bone donor bank. Additional internal devices, such as metal rods and pins, may be used to provide further stability. The actual "fusing" of the vertebral segments occurs as the body stimulates new bone growth between the vertebrae over the course of the healing period, which can last 3 to 6 months or even longer.

Read more details about Spinal Fusion.

Possible Complications

Complications are rare, but no procedure is completely free of risk. If you are planning to have a spinal fusion, your doctor will review a list of possible complications, which may include:

• Bleeding
• Infection
• Incomplete fusion of the bones
• Blood clots
• Hematoma (build-up of blood in the wound)
• Nerve damage causing pain, numbness, tingling, or paralysis
• Impaired bowel and/or bladder function
• Reaction to anesthesia

Factors that may increase the risk of complications include:

• Smoking
• Poor nutrition
• Obesity
• Advanced age
• Pre-existing medical condition

Call Your Doctor

After you leave the hospital, contact your doctor if any of the following occurs:

• Signs of infection, including fever and chills
• Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
• Nausea and/or vomiting that you cannot control with the medicines you were given after surgery, or which persist for more than two days after discharge from the hospital
• Pain that you cannot control with the medicines you have been given
• Cough, shortness of breath, or chest pain
• Joint pain, fatigue, stiffness, rash, or other new symptoms
• Numbness, tingling, pain, or weakness, especially in the arms, hands, legs, or feet
• Pain, swelling in your feet, legs, or calves
• Loss of bladder or bowel function
• Pain, burning, urgency, frequency of urination, or persistent blood in the urine

In case of an emergency, CALL 911.

Bhagia SM. Slipman CW. Nirschl M. Isaac Z. El-Abd O. Sharps LS. Garvin C. Side effects and complications after percutaneous disc decompression using coblation technology. American Journal of Physical Medicine & Rehabilitation . 85(1):6-13, 2006 Jan.

Bridwell KH. Anderson PA. Boden SD. Vaccaro AR. Wang JC. What's new in spine surgery. Journal of Bone & Joint Surgery - American Volume. 90(7):1609-19, 2008 Jul.

Cohen SP. Williams S. Kurihara C. Griffith S. Larkin TM. Nucleoplasty with or without intradiscal electrothermal therapy (IDET) as a treatment for lumbar herniated disc. Journal of Spinal Disorders & Techniques . 18 Suppl:S119-24, 2005 Feb.

Conn's Current Therapy 2001. 53rd ed. WB Saunders Company; 2001.

Pain. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.n... . Accessed October 27, 2008.

Sciatica. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00351 . Accessed October 27, 2008.

Textbook of Primary Care Medicine. 3rd ed. Mosby, Inc.; 2001.

Updated Disketomy section on 6/7/2007 according to the following study, as cited by http://www.ebscohost.com/dynamed/what.php : Peul WC, van Houwelingen HC, van den Hout WB, et al. Surgery versus prolonged conservative treatment for sciatica. N Engl J Med. 2007;356:2245-2256.

Weinstein JN, Tosteson TD, Lurie JD, et al. Surgical vs nonoperative treatment for lumbar disk herniation: the Spine Patient Outcomes Research Trial (SPORT): a randomized trial. JAMA . 2006;296:2441–50.

Weinstein JN, Lurie JD, Tosteson TD, et al. Surgical vs nonoperative treatment for lumbar disk herniation: the Spine Patient Outcomes Research Trial (SPORT) observational cohort. JAMA . 2006;296:2451–9.

Zindrick MR. Tzermiadianos MN. Voronov LI. Lorenz M. Hadjipavlou A. An evidence-based medicine approach in determining factors that may affect outcome in lumbar total disc replacement. Spine . 33(11):1262-9, 2008 May 15.