ICAC | Médicos especialistas en artrodesis lumbar posterior

What is the Posterior lumbar arthrodesis?

The lumbar arthrodesis is the surgical procedure that consists of fuse two lumbar vertebrae permanently to prevent the movement of a vertebral segment that is the cause of low back pain, generally due to instability of the vertebral bodies and joints.

At each level of the spine there is a intervertebral space in the anterior part and a pair of facet joints in the posterior part. These structures work together, defining a segment of movement and allowing various degrees of it. 

Herniated disc operation through arthrodesis

The L5-S1 intervertebral segment, also known as the lumbosacral joint, is an area in which low back pain and sciatica are usually common, affecting the quality of life of patients.

 

Posterior Lumbar Arthrodesis Surgery Information

Some of the most frequently used surgical techniques are:

  • Instrumented posterolateral arthrodesis: This procedure is carried out from the back of the spine.
  • Posterior lumbar interbody arthrodesis (Posterior lumbar interbody fusion, PLIF): The procedure is performed from the back and involves removal of the disc between two vertebrae and insertion of bone graft/implants into the space created between the two vertebral bodies.
  • Transforaminal lumbar interbody arthrodesis (Transforaminal lumbar interbody fusion, TLIF): Similar to PLIF, this type of surgery is also performed from the back of the spine.
  • Anterior lumbar interbody arthrodesis (Anterior lumbar interbody fusion, ALIF): This operation is carried out from the anterior, involving the removal of the disc between two vertebrae and inserting bone graft/implants into the space created between the two vertebral bodies.
  • Anterior/posterior vertebral arthrodesis– This procedure addresses both the front and back of the spine.
  • Extreme lateral interbody arthrodesis (Extreme Lateral Interbody Fusion, XLIF): This interbody arthrodesis technique is performed with a lateral approach.

Arthrodesis is a traumatic intervention that must be indicated by a team of traumatologists specializing in the lumbar area.

Surgical intervention becomes necessary in patients who suffer from the following injuries or pathologies:

  • lumbar spondylolisthesis
  • Lumbar canal stenosis
  • Lumbar degenerative disc disease
  • Fractures, infections and/or tumors in the lumbar vertebrae

This intervention is considered when these pathologies generate pain in the bones of the spine, putting pressure on the nerves, which can radiate along the legs. The decision to carry out this surgery is made in situations where chronic spinal cord damage, after having tried other non-invasive techniques that have not been effective.

The time of the intervention will depend on the number of affected segments. Typically, arthrodesis is performed on one or two levels. The surgical duration of one level arthrodesis is usually 3 hours and 4 hours two levels.

The anesthesia performed is general and the patient's position on the operating room table is in a prone position (face down). After locating the level to be arthrodesed radiologically, the surgical approach is performed, depending on the technique to be performed (posterior or anterior approach).

The technique used and the duration of the intervention may vary. However, in any case, it will be necessary to implant a bone implant in the affected part of the spine.

Before perform a posterior lumbar arthrodesis, our team needs to know the following patient information:

  • Current medications: It is required to know if the patient is taking any type of drug, whether with or without a prescription. It is important to note that approximately two weeks before carrying out surgery, the use of medications that affect blood clotting may be prohibited, such as acetylsalicylic acid, ibuprofen, naproxen and others similar.
  • Detailed medical history: The patient should inform the doctor about chronic diseases, such as diabetes, heart disease or other conditions. Furthermore, any pathology or symptoms immediately before the operation, such as cold, fever, flu or herpes outbreak, must be reported immediately.
  • Cessation of tobacco consumption: Quitting smoking before posterior lumbar arthrodesis surgery significantly contributes to reducing potential complications during surgery.

After the intervention, the patient will remain in the hospital for 3 or 4 days, during which they will gradually resume their physical activities. During this time, analgesics are administered orally or intravenously.

Some guidelines to follow after posterior lumbar arthrodesis operation include:

  • Increase physical activity progressively: It is recommended to gradually increase activity without exaggerating, thus promoting optimal recovery.
  • Avoid excessive forces on the spine: During the first weeks after the operation, it is essential to refrain from exerting excessive force in the spinal area, avoiding traction or flexion that could compromise recovery.
  • Abstain from tobacco consumption: It is advisable to avoid tobacco consumption, as it can affect bone fusion.

For optimal recovery after the intervention, it is essential to have the experience of a specialist traumatologist with an extensive professional career.

Accurately following the guidelines and exercises recommended by the doctor or physical therapist is crucial.

The main key to recovery from posterior lumbar arthrodesis lies in taking gradual and regular walks. Likewise, some physiotherapy and rehabilitation sessions may be necessary, which the traumatologist will communicate to the patient.

The Return to work takes place between 4 and 8 weeks after the arthrodesis procedure.

Habitually, There are no sequelae after the posterior lumbar arthrodesis operation. These sequelae often depend on the habits and age of the patient. Therefore, rehabilitation takes on special importance, since in some cases the patient may experience lower back pain again.

When surgery is performed to address the chronic back pain, recovery expectations are highly favorable, with the possibility of achieving total or major elimination of the discomfort.

The column radiofrequency It is another surgical treatment that consists of the application of heat through radioelectric waves to the affected nerves, seeking to effectively relieve pain in the patient.

Although hePosterior lumbar arthrodesis is a safe intervention, is not free of possible complications. These include postoperative infections, blood loss during surgery and, in exceptional cases, neurological complications.

The prevention of these complications involves rigorous monitoring of medical indications. and the selection of expert professionals who minimize any possible risk.

During posterior lumbar arthrodesis, fusion of vertebrae may result in some restriction in flexion and rotation of the spine.

It is crucial that patients evaluate the benefits obtained after the intervention, how to relieve pain, in the face of possible limitations in mobility.

Depending on the patient's condition, there are alternatives to posterior lumbar arthrodesis. Conservative therapies, such as physical therapy or pain management, as well as less invasive procedures, are presented as viable options to surgery.

It is essential to evaluate and determine, together with the professional, the most appropriate alternative. that not only treats, but improves the patient's condition.

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Important announcement

The ICAC, now at Teknon in Barcelona

This month of June, We have begun our collaboration with the prestigious Barcelona clinic TMEH to offer spine services at the famous Teknon Medical Center, one of the leading healthcare hospitals in Europe. Thanks to this alliance, we provide a comprehensive and specialized approach with the best solutions for those suffering from back problems.

The ICAC human team, known for being at the vanguard of innovation in traumatology, now brings his talent and advanced ultra-minimally invasive surgery techniques to Barcelona.

This collaboration with TMEH at Teknon Medical Center not only allows us to treat more patients more effectively, but also reinforces our commitment to innovation and excellence in healthcare.

We are excited to be able to offer these services in one of the most important cities in Europe and continue leading the field of traumatology and, in this specific case, in the treatment of the spine.