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Keeping Lumbar Fusion "Simple"

Sometimes back pain just won't go away, even with medications, rest, or exercise. For chronic low back pain, surgery may be the next step. When it comes to back surgery, doctors have several options. The choice may be decided by the where the pain is coming from.

Sometimes back pain comes from the joints of the spine or the disc between the spinal bones. For some patients, pain comes from both of these areas. Preventing motion in the spine by fusing two bones together often helps reduce painful symptoms.

There are at least three ways to fuse spine bones together. The simplest way is to lay bone graft along the back edge of the spine. This technique is called posterolateral fusion. Another way is us use screws or metal plates to hold the bones together and improve healing of the bone graft. Bone graft can also be placed in front, back, or all the way around two or more spine bones. It would be very helpful if the surgeon knew which one had the best results, with the fewest problems.

Doctors in Sweden have joined together to look at cases of spinal fusion. The three methods of fusing the spine were studied and compared based on pain, disability status, and number of patients who returned to work. It turns out that all three methods reduce pain and disability equally. This means that the surgeon may be able to use the simplest of the three methods, posterolateral fusion. This approach has the shortest operation time. No blood transfusion is needed, and the patient stays fewer days in the hospital.

References: Peter Fritzell, MD, et al. Chronic Low Back Pain and Fusion: A Comparison of Three Surgical Techniques. A Prospective Multicenter Randomized Study From the Swedish Lumbar Spine Study Group. In Spine. June 1, 2002. Vol. 27. No. 11. Pp. 1131-1141.

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