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What Is a Posterolateral Fusion of the Lumbar Spine?

In posterolateral fusion of the lumbar spine, the surgeon uses a bone graft to connect, or fuse, two or more vertebrae in your lower back. Posterolateral refers to the back and side of the spine.

  1. Incision

    • In a posterolateral fusion of the lumbar spine, the surgeon makes an incision in the midline of your lower back.

    Harvesting Bone

    • The surgeon usually obtains bone for the bone graft from your pelvis, although bone graft substitutes are also available.

    Placing Bone

    • The surgeon then places the harvested bone in the posterolateral area of the vertebrae being fused by attaching the graft to the extension of the vertebrae called the transverse processes. The surgeon then places the back muscles over the bone graft to create tension that holds the bone graft in place.

    Recovery

    • After posterolateral fusion surgery, the spinal fusion occurs as the bone graft grows and adheres to the transverse processes. To improve the chances of a successful fusion, do not smoke because nicotine is a toxin that can prevent the bone from fusing and avoid bending, lifting and twisting for three months after surgery.

    Considerations

    • Most spine fusions will be complete within three months and continue to get stronger for one to two years, according to Spine Health. Failure to fuse may occur in between 10 and 40 percent of cases. Failure rates are higher for people who have had previous surgery, are obese, smoke, have more than two vertebrae fused or have received radiation treatment for cancer.

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