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.

See Endoscopic Transforaminal Decompression Interbody Fusion (ETDIF)

Multilevel Spinal Fusion

Multi-level Spinal Fusion Video

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.

See Multilevel Spinal Fusion for Low Back Pain

Successful Fusion

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.

See Endoscopic Transforaminal Decompression Interbody Fusion: Step-by-Step

Dr. Peter Ullrich is an orthopedic surgeon who retired from practice with more than 20 years of experience specializing in spine surgery. Dr. Ullrich previously practiced as an orthopedic spine surgeon at the NeuroSpine Center of Wisconsin.