There are several types of spinal fusion surgery options. The most commonly employed surgical techniques include:
- Posterolateral gutter fusion - the procedure is done through the back
- Posterior lumbar interbody fusion (PLIF) - the procedure is done from the back and includes removing the disc between two vertebrae and inserting bone into the space created between the two vertebral bodies
- Anterior lumbar interbody fusion (ALIF) - the procedure is done from the front and includes removing the disc between two vertebrae and inserting bone into the space created between the two vertebral bodies
- Anterior/posterior spinal fusion - the procedure is done from the front and the back
- Transforaminal lumbar interbody fusion (TLIF) - Similar to the PLIF, this procedure is also done from the back of the spine
- Extreme Lateral Interbody Fusion (XLIF) - an interbody fusion in which the approach is from the side
It is important to note that with any type of spine fusion, there is a risk of clinical failure (meaning that the patient's pain does not go away) despite achieving a successful fusion.
Multilevel Spinal Fusion
In the vast majority of cases, a lumbar spinal fusion surgery is most effective for those conditions involving only one vertebral segment. Most patients will not notice any limitation in motion after a one-level spine fusion.
When necessary, fusing two levels of the spine may be a reasonable option for treatment of pain. However, spinal fusion of more than 2 levels is unlikely to provide pain relief because it removes too much of the normal motion in the lower back and places too much stress across the remaining joints.
Fusing 3 or more levels of the spine is usually reserved for cases of scoliosis and lumbar deformity.
Obtaining a successful result from a spine fusion requires a number of factors, including an accurate preoperative diagnosis, a technologically adept surgeon, and a patient with a reasonably healthy lifestyle (non smoker, non obese) who is motivated to pursue rehabilitation and restoration of his or her function.