What does a posterolateral fusion involve?

Posterolateral fusion is a lumbar (lower back) spine surgery that is used to treat certain spine conditions, such as degenerative disc disease, spondylolisthesis and spinal stenosis. The procedure is very similar to a posterior lumbar interbody fusion (PLIF) because they are both lumbar spinal fusions that access the spine through the back and help treat degenerative spine conditions.

During a posterolateral spinal fusion, a bone graft is fused around a damaged disc, permanently attaching the two vertebrae surrounding the disc. Because this procedure does not remove the damaged disc, the disc is encouraged to grow back with the aid of the bone grafts that hold the spine in alignment and stabilize the vertebrae while the disc naturally regenerates.

Though this procedure promotes great possible benefits, such as disc regrowth, the possible risks of a failed surgery should also be considered before moving forward with the procedure. It is important for patients to make a fully informed decision when it comes to spine surgery and overall spine health.

What to expect during traditional posterolateral fusion

Before moving forward with a surgical procedure, you should always research what’s involved to make sure you are comfortable. Below is a list of the steps taken during a traditional posterolateral fusion:

  • Bone harvest. Bone is harvested, usually from the pelvis, or a bone substitute is acquired to use as a bone graft.
  • Incision. A 3- to 6-inch incision is made in the middle of the lower back.
  • Adjustment. Muscles, ligaments and tendons are moved, and the laminae (spinal archways) are removed to allow access to the nerve roots. Facet joints may also be trimmed to give nerve roots more space.
  • Implant. The bone graft is implanted, and then muscles and ligaments are reattached to help keep the graft secure.
  • Stabilization. Metal screws and rods are attached to the bone graft to provide stability while the bone graft grows and the vertebrae fuse.

The risks of infection and excessive blood loss, as well as postoperative complications, are significant during traditional open back procedures thanks to the use of a large incision and the detachment and reattachment of the muscles surrounding the spine. These can all lead to excessive scar tissue, which can develop internally and prevent the fusion from being successful, resulting in failed back surgery syndrome.

Minimally invasive alternatives to posterolateral fusion

A traditional lumbar fusion is not your only option for pain relief after months of unsuccessful conservative treatment. At Laser Spine Institute, we offer several types of minimally invasive lumbar stabilization procedures that help relieve pressure on impacted nerve roots and stabilize the spine.

Our minimally invasive lumbar fusion is performed through a small incision and muscle-sparing techniques, thus reducing the risk of complications and infection.^ Once the spine is accessed, the damaged disc is replaced with a bone graft and/or surgical implant to stabilize the region.

For more information, please contact Laser Spine Institute today. When you call, be sure to ask about receiving a free MRI review,* which will help us determine whether you’re a candidate for our minimally invasive spine surgeries.