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Spinal Fusion: Posterior Lumbar

Fusing vertebrae in the lumbar spine may help ease lower back and leg pain. Posterior lumbar fusion is done through an incision in your back. Spacers and/or a bone graft are put between the vertebrae. Depending on how many vertebrae are fused, the surgery may take from 3 to 8 hours.

Side view of lumbar vertebrae.

Fusing the transverse processes

Fusion has several steps:

  • The bone graft is packed between the transverse processes (“wings”) on the sides of the vertebrae.

  • To help keep your spine steady and promote fusion, extra support may be used. This may be metal screws and rods. Sometimes, bone cement is added around the screws.

  • A wound drain is often placed in the wound and left in for a few days.

  • The incision is closed with stitches or staples.

    Back view of lumbar vertebrae showing bone graft between transverse processes.

Fusing the disk space

This involves the following:

  • An incision is made in the middle of or on each side of your spine.  

  • The disk between the vertebrae is removed.

  • A bone graft, a spacer (cage), or both are placed in the now-empty disk space between the vertebrae. In time, the graft or spacer and the bone will grow into a solid unit.

  • To help keep your spine steady and promote fusion, metal screws and rods may be placed to provide extra support and promote healing. Sometimes, bone cement is added around the screws.

  • A wound drain is often placed in the wound and left in for a few days.

  • The incision is then closed with stitches or staples.

    Cross section of lumbar vertebrae showing bone graft between vertebrae.Cross section of lumbar vertebrae showing fused bone between vertebrae.

Online Medical Reviewer: Anne Fetterman RN BSN
Online Medical Reviewer: Luc Jasmin MD
Online Medical Reviewer: Raymond Kent Turley BSN MSN RN
Date Last Reviewed: 11/1/2021
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