Lumbar fusion is a common type of surgery for workers with a serious low back injury. A fusion is a surgical procedure that joins two or more bones (in this case vertebrae) together into one solid bone. The procedure is called a posterior fusion because the surgeon works on the back, or posterior, of the spine. Posterior fusion procedures in the lumbar spine are used to treat work-related spine instability, severe degenerative disc disease, and fractures in the lumbar spine.
Other procedures are usually done along with the spinal fusion to take the pressure off nearby nerves. They may include removing bone spurs and injured portions of one or more discs in the low back. Surgeons may apply metal screws and rods, called instrumentation, to hold the bones securely while they fuse.
Surgeons perform this procedure through an incision in the low back. The incision reaches to the spinous processes, the bony projections off the back of the vertebrae. The surgeon must move aside the muscles along the spine, called the paraspinal muscles. The fusion itself involves the lamina bone, the protective roof over the back surface of the spinal cord.
The main goal of the spinal fusion (also known as an arthrodesis) is to stop movement of one or more vertebrae. Keeping the fused section from moving helps stop mechanical pain. Mechanical pain occurs when damaged discs and joints that connect the vertebrae become inflamed from excessive motion between the vertebrae. This type of pain is commonly felt in the low back and may radiate into the buttocks and upper thighs.
The spinal nerves are also affected by too much vertebral motion. They begin to rub where they pass through the neural foramina and become swollen and irritated. Also, the neural foramina narrow when a vertebra slides too far forward or backward over the vertebra below. This immediately pinches the nerves where they pass through the neural foramina. Nerve swelling, irritation, and pinching produce neurogenic pain. This type of pain often radiates down one or both legs below the knee. Fusion stops this harm to the nerves.
By lumbar fusion, surgeons hope to slow down the process of degeneration at the fused segments and prevent future problems. In Milwaukee Wisconsin workers comp claims a fusion is worth a sum of money without permanent work restrictions. However, if an injured worker is unable to return to work due to work-related permanent restrictions, then the worker has a case for loss of earning capacity benefits under the law, Wis. Stats. Chapter 102. Call our office for a free lumbar fusion telephone conversation to see if it is the type of case we can help with.