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• Posterolateral Fusion

Posterolateral Fusion

Posterolateral fusion is surgery to promote spinal stability in patients suffering from conditions such as degenerative disc disease, spondylolisthesis, and spinal stenosis. To that end, vertebrae associated with an impinged or irritated nerve root are permanently connected, or fused, using metal screws and rods that are attached to bony protuberances on the vertebrae called transverse processes.

Posterolateral fusion is similar to posterior lumbar interbody fusion (PLIF) in that both procedures involve spinal fusion and are performed with access through the back. Where posterolateral fusion differs is that the damaged intervertebral disc material is not removed and replaced by a bone graft, as in PLIF. Rather, the bone graft is attached between the transverse processes in a way that will encourage it to grow across the back of the vertebrae.

These are the steps involved in posterolateral fusion:

• Bone is harvested, usually from the pelvis, or a bone substitute is acquired to use as a bone graft
• A 3- to 6-inch incision is made in the middle of the lower back
• Muscles, ligaments and tendons are moved and the laminae are removed to allow access to the nerve roots; facet joints might also be trimmed to give nerve roots more space
• The bone graft is implanted, and then muscles and ligaments are replaced to help keep the graft secure
• Metal screws and rods are attached to the transverse processes to provide stability while the bone graft grows and the vertebrae fuse

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Posterolateral fusion, like any traditional open back surgery, carries the risk of infection and excess bleeding. It can take a year or more for the bone graft to completely fuse, and a patient generally can expect a long recuperation period. Laser Spine Institute (LSI) offers an alternative to highly invasive open back operations like posterolateral fusion. The award-winning surgeons at LSI perform minimally invasive, outpatient procedures using gentle, endoscopic techniques to treat a range of spine conditions. Contact LSI for a free review of your MRI or CT scan and to learn how to rediscover a life without pain.

Please note: Laser Spine Institute currently does not perform endoscopic procedures on the thoracic spine.