Why is this procedure done?
A spinal fusion joins two or more bones in the spine together. This surgery permanently joins the bones. Then, there is no movement between them anymore. This is done to lessen pain and irritation to the nerves. ‚
An extreme lateral interbody fusion is a type of minimally-invasive spine surgery. Your surgery is done through your side rather than your front or back. You may need to have surgery to help with long-term pain and disability. This may be caused by: ‚
- Wear and tear of the discs between the spinal bones. This is called degenerative disc disease.
- Narrowing of the canal where the spinal nerves exit the spine. This is spinal stenosis.
- A vertebra that is out of line with the others. This is spondylolisthesis.
- Pressure on the spinal cord. This is called cord compression.
- An abnormal curve in the spine. This is scoliosis.
- Herniated disc
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What will the results be?
- Less pain
- Greater ease of movements and activities
- Spine lined up better
This type of fusion can have a quicker surgery time with less blood loss and faster healing. You may have a shorter hospital stay, less, pain and smaller scars than with anterior or posterior fusions. ‚
What happens before the procedure?
- Your doctor will take your history. Talk to the doctor about:
- All the drugs you are taking. Be sure to include all prescription and over-the-counter (OTC) drugs, and herbal supplements. Tell the doctor about any drug allergy. Bring a list of drugs you take with you.
- Any bleeding problems. Be sure to tell your doctor if you are taking any drugs that may cause bleeding. Some of these are Coumadin ‚ ®, ibuprofen, Aleve ‚ ® (naproxen), or aspirin. Certain vitamins and herbs, such as garlic and fish oil, may also add to the risk for bleeding. You may need to stop these drugs as well. Talk to your doctor about them.
- When you need to stop eating or drinking before your procedure.
- Your doctor will do an exam and may order:
What happens during the procedure?
- Once you are in the operating room, the staff will put an I.V. in your arm to give you fluids and drugs. You will be given a drug to make you sleepy. It will also help you stay pain free during the surgery.
- When you are asleep, the doctors put a tube in your mouth to help you breathe. You will have a tube in your bladder to drain urine.
- You will be positioned on your side.
- Your doctor will make a cut on the side of your body based on the area for surgery. Your doctor will use x-rays and nerve monitoring (EMG) during the surgery to help do the operation safely. Your doctor will carefully remove the disc, spread the spinal bones apart, and fuse the spine. Different methods can be used to fuse the spine. Either of these may be placed in the spine to help it fuse together. Your doctor will decide which is best based on your history. The doctor may use:
- Bone or bone substitute. The bone may be taken from your hip. Other times, it is from a specially prepared bone from a donor.
- Screws and plates. This is known as an instrumented fusion.
- A drain tube may be placed in your back close to the cut site. This will get rid of any extra fluid or blood from around the cut site. The drain tube is hooked to a bulb. The bulb is emptied every day until the doctor removes it.
- Your doctor will close the cut with staples or stitches. The whole procedure may take 1 to 2 hours.
What happens after the procedure?
- You will go to the Recovery Room after surgery. The staff will take out your breathing tube when you are awake and strong enough to breathe. You may have a sore throat afterwards.
- Your nurses and caregivers will roll you in bed from side to side every couple of hours after your surgery to prevent problems such as blood clots and pressure sores.
- Your doctor may have you wear special stockings to prevent blood clots. You will be given these stockings in the hospital.
- Many times you will get out of bed to a chair on the same day of surgery. The staff will help you begin to walk around. Doing coughing and deep breathing exercises will help keep your lungs clear.
- Your doctor will give you pain relief. Take the pain pills or shots to help you to move better.
- You may or may not have a back brace.
- Your physical therapy may start the day after surgery.
- You will stay at the hospital for about 1 to 3 days.
What lifestyle changes are needed?
- Exercise your legs while in bed.
- Practice good ways to lift things so that you do not hurt your spine. Part of your physical therapy will be to teach you better ways to move and lift.
What drugs may be needed?
The doctor may order drugs to: ‚
- Help with pain
- Prevent infection
- Prevent blood clots
- Help with other problems you may have like trouble sleeping or hard stools
What problems could happen?
- Pain
- Bleeding
- Infection
- Incomplete fusion of the bones
- Blood clots
- Nerve or spinal cord damage
- Damage to the sac covering the nerves (dural tear)
- Problems with bowel or bladder function
- Need for more surgery in the future
Where can I learn more?
American Academy of Orthopaedic Surgeons ‚
http://orthoinfo.aaos.org/topic.cfm?topic=A00601 ‚
Consumer Information Use and Disclaimer
This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚
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