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LUMBAR ARTHRODESIS

Degenerative disc disease is endemic in our society. Genetic and environmental factors as well as today’s lifestyle have a decisive influence on the premature aging process of the disc.

Once the degeneration process has set up, it sometimes evolves to a last stage consisting in the degradation and rupture of the disc, with the leaking-out of its content into the spinal canal. The extruded fragments of the disc press on the adjacent nerve roots to a greater or a lesser extent, thus triggering the typical episode of lumbosciatalgia.

On other occasions arthritis causes a progressive narrowing of the spinal canal, thus resulting in the so-called stenosis of the spinal canal. In the worst cases the patient is unable to walk distances longer than 50 to 100 m.

If the conservative therapy with anti-inflammatory medication, bed rest, physical therapy or epidural injections fails, surgery becomes the only alternative. Lumbar fusion normally is the best option if f the rest of the joints in the vertebral segment are involved, if the patient presents an inflammation of the vertebral plates or if there is displacement of a vertebral body over the vertebra below (listhesis).

In lumbar fusion the unstable vertebral segment is fixated with special devices like screws, mini-rods and/or small metallic interbody cylinders. This technique is associated with the use of bone substitutes with growth factors in order to achieve the biological fusion of the vertebrae and occasionally the widening (decompression) of the narrow spinal canal.

Two days after having undergone this invasive procedure, patients can start walking. Four or five days after surgery they can be discharged. Patients will have to wait between six to eight months to reach full recovery allowing them to carry out physically challenging activities, including sports. During the three first months after surgery it is advisable to use a lumbar brace or a corset. If correctly indicated, the success rate of this surgical technique regarding pain relief and functional recovery exceeds 85%.

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