Doctors often recommend posterior lumbar fusion to get the best results for workers with herniated discs. Posterior (back side) lumbar fusion is the most common type of back surgery fusion for the low back. Surgery should never be the first option or ever taken lightly. But if fusion surgery is necessary, it is important to have lawyers knowledgeable about the medicine as well as the law. Most of the injured workers seeking workers compensation benefits represented by McCormick Law Office attorneys have had cervical or lumbar fusions.
Posterior lumbar fusion treats herniated discs, spine instability, severe degenerative disc disease, and fractures in the lumbar spine.
The main goal of the spinal fusion (also known as arthrodesis) is to prevent movement of the vertebrae to help stop mechanical pain. Mechanical pain occurs from wear and tear inflammation due to excessive motion between the vertebrae.
With a herniated disc, the fusion is for neurogenic pain, when a nerve is inflamed, squeezed, or pinched by the damaged disc. Fusion can create space and stabilize the area for the nerves.
By fusing the vertebrae together, surgeons hope to slow down the process of degeneration at the fused segments and prevent future problems. Factors that may make obtaining a solid fusion more difficult include:
• Revision surgery (previously failed grafts)
• Smokers/smokeless tobacco product users
• Multiple level fusions
• Disease states that inhibit bone healing or require medications to do so.
To prepare the area to be fused, the surgeon shaves a layer of bone off the back surfaces of the spinal column. The cut bone bleeds. The surgeon makes a second incision at the hip. Small strips of bone are removed from the top rim of the pelvis. This is called a bone graft. The surgeon lays the bone strips over the back of the spinal column. When the bone graft contacts the bleeding area, the body heals (or fuses) the bones together just as it would a fractured bone. Occasionally, surgeons use bone grafts from cadavers or bone graft substitutes. This is something to be researched and clearly understood by the patient before surgery.
Other procedures are usually done along with the spinal fusion to take the pressure off nearby nerves: removing the damaged disc (discectomy), trimming bone spurs, enlarging the neural foramina (foraminotomy). Surgeons may also use metal screws and rods, plates or cages to hold the bones securely while they fuse.
Following healing and rehabilitation, the doctor may assign return to work restrictions. If a worker cannot return to work due to back surgery restrictions, we see if there are workers’ compensation benefits such as loss of earning capacity or vocational retraining.