What kind of results are people getting from their lumbar fusions? I have a degenerative disc problem that I’m considering fusion for. What are my chances for a good, solid fusion?

Many people with chronic, severe low back pain from degenerative spinal conditions have come to depend on a lumbar fusion procedure to reduce pain, restore function, and improve quality of life.

A common solution is to remove the disc (a procedure called discectomy) and fill the hole (disc space) with a metal cage filled with bone chips. Then bone grafting is done around the spinal segment above and below the disc space. This type of fusion is referred to as an interbody fusion.

Fusion rates in general are very good (as high as 100 per cent) with the interbody method. Interbody fusions have been so successful, surgeons are now focusing their concentration on improving the technique and reducing complications.

One of those changes that has taken place has been a shift in how the surgeon gets to the spine in order to perform the fusion procedure. In the past, an anterior approach (from the front of the spine) or posterior (from the back of the spine) approach was used most often. Now surgeons are moving more toward a lateral approach.

A lateral approach means the surgeon enters the body and spine from an angle between the front and back. There is also an extreme lateral approach to the interbody fusion procedure. The surgeon comes in from the front and side of the spine. A special tube is placed through the lateral abdomen, through the psoas (anterior hip muscle), and to the spine. With this portal (pathway), the surgeon avoids major blood vessels, organs, the spinal cord, and nearby spinal nerve roots.

So, now we have excellent fusion rates with fewer complications and problems. And studies show that even when X-rays show a failed fusion (movement is seen at the fusion site), many people still get the pain relief they were seeking. They show no adverse signs or symptoms linked to the failed fusion.

It is expected that outcomes for fusion procedures will continue to improve over time as surgeons’ technical skills improve. With newer techniques like the extreme lateral interbody fusion procedure, better surgical tools, and advanced technology, we can expect to see even better outcomes reported for lumbar fusions in the coming years.