Lumbar Spinal Fusion

Types

Spinal fusion may also involve:

• Diskectomy (removal of a herniated or damaged portion of a disk in the spine)
• Laminectomy (removal of the back part of the bone that covers the spinal canal)
• Removal of bone spurs or other spinal growths

Mayo Clinic surgeons work together to treat all your problems in a single operation, if possible.

In spinal fusion, it's important to determine precisely where screws need to be placed to stabilize the bone graft. At Mayo, specialists use CT scans during surgery (intraoperative CT) and sophisticated image guidance to pinpoint screw placement. A Mayo study of image guidance in upper spinal fusion found that more than 90 percent of screws were perfectly placed using this method.

Mayo surgeons perform these types of spinal fusion:

Posterior

Most spinal fusion surgeries at Mayo Clinic are done through the posterior (back) surface of the spine. Surgeons remove the lamina (a thin layer of bone covering the vertebrae) so they can reach the disk space. The disk is removed and bone is packed into a cage device that is inserted into the disk space.

Anterior

Some spinal fusion surgeries at Mayo Clinic are done through the anterior (front) surface of the spine. The abdominal (stomach muscles) are pulled back to reach the spine. Anterior lumbar spinal fusion requires smaller incisions but the procedure is usually more complex.

360-degree (circumferential) reconstruction

Disks and bones are removed, and bone graft inserted, through the front surface of the spine. Screws or pins are then inserted through the back of the spine, to lock the graft in place. Although the 360-degree surgery is more extensive than traditional approaches, a Mayo Clinic study found it to be safe and effective.

Minimally invasive surgery

People who need only one or two spinal levels fused, and who don't have scar tissue from previous back surgery, are good candidates for minimally invasive surgery. It involves shorter hospital stays than traditional surgery.