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Spinal Fusion: Posterior Lumbar

Side view of lumbar vertebrae.
Lumbar vertebrae

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. The graft is put between the vertebrae in one of two places: in the disk space or between the transverse processes. Depending on how many vertebrae are fused, the surgery may take from 3 to 8 hours.

Cross section of lumbar vertebrae showing fused bone between transverse processes.
Bone graft is used to fuse transverse processes.

Fusing the disk space

This involves the following:

  • A midline incision is done over your spine, or two incisions on each side of your spine.  

  • The disk between the vertebrae is removed.

  • A bone graft is placed in the now-empty disk space between the vertebrae. In time, the graft and the bone around it 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. Occasionally, bone cement is added around the screws.

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

  • The incision is then closed with sutures or staples.

Fusing the transverse processes

This process involves several steps:

  • 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 consists of metal screws and rods. Occasionally, bone cement is added around the screws.

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

  • The incision is closed with sutures or staples.

Cross section of lumbar vertebrae showing fused bone between vertebrae.
Over a few months, the bone graft and vertebrae fuse into a solid unit.

Cross section of lumbar vertebrae showing bone graft between vertebrae.
Bone graft is packed into the now-empty space between the vertebrae.

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