Orthopedics

Decompression lumbar posterior and fusion spine

Description

Posterior lumbar decompression and fusion is a surgical procedure which can be done to relieve pressure on the spinal cord and nerve roots in the lower back. The lower back, or lumbar region, is made up of the five lowest vertebrae (L1 - L5) that are just above the base of the spine. The common area of back pain, that is the lumbar region supports the bulk of the weight of the upper body in lumbar region.

When lower back pain is the result of nerve compression, due to wear and tear, degenerative circumstances such as disc disease or arthritis or congenital deformities, the pressure needs to be relieved in order for the symptoms to be reduced. Worsening neurological deficits can take place if the nerves sustain prolonged damage.

If there is no response to conservative therapies, surgery as an option will be considered.

In a posterior lumbar decompression and fusion, both sides of the lamina are usually reduced to expand the size of the spinal canal, taking pressure off of the spinal canal and nerve roots.

The surgery is done through the posterior, of the body. It is supported by spinal fusion to link the vertebrae together. During the surgery, grafts are put into place to fuse the vertebrae and stop the pain in the area. Titanium metal screws or a titanium metal cage can be used to hold the new bones together and give them the spinal stability.

COMPLICATIONS :

  • Some of the risks & complications are as below:
  • Problems from anesthesia.
  • Deep infection in the surgical wound.
  • Skin infection.
  • Blood clots.
  • Unstable spine.
  • Injury included weakness, numbness, or paralysis
  • Tears in the fibrous tissue that covers the spinal cord and the nerve near the spinal cord, sometimes requiring a second surgery.
  • Trouble passing urine, or loss of bladder or bowel control.
  • Long-term (chronic) pain, which develops after surgery in some cases.
  • Death from problems caused by surgery, but this is rare.
  • Usually complications increase in diabetics and smokers.

Post-Operative Care:

  • As soon as possible you can come to your routine diet.
  • Walking is recommended and you can climb stairs also.
  • You can join you office after about a fortnight post discharge.
  • You should take your medicines on regular basis & on time as directed to you.

For about six weeks post the surgery, avoid

  • Bending and twisting at the waist.
  • Not carry anything more than 10 pounds.

Dressing and Wound Care:

Incase dissolving tissues are used, there are no stitches to remove, just the dressing needs to be kept dry..

if the dressing becomes wet it would need to be changed without disturbing the

steri-strips underneath. If there is any redness on the injury, it should be reported as soon as possible.

Showering:

Sponge bath is recommended followed by a shower three days after surgery

Walking:

Walking three times a day is encouraged but not for more than half an hour at one time.

Prescriptions: OTC pain killers as pain improves and muscle relaxants can be used after discussing with the doctor once the pain becomes better.

Follow up appointments/ Return to work:

Appointment two weeks post surgery should be set up for a consult.