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Posterior Lumbar Fusion Risks and Success Rate in Portland, Oregon

What Are the Risks of Posterior Lumbar Fusion?

One of the two most common complications of posterior lumbar fusion is spinal fluid leak. This occurs in about 3% of patients who have never had prior surgery and up to 10% of patients who have had prior surgery. Spinal fluid leaks are repaired but may add 1–2 days to the hospital stay.

Nonunion, or failure of the vertebrae to fuse, occurs in up to 5% of nonsmokers for a one level fusion and up to 20% of smokers. Nonunion rates rise with the number of levels of the spine to be fused. Nonunions can require more surgery.

Infection rates average 1-2% and may require further surgery and antibiotics. Nerve damage is rare and is generally limited to one nerve going to one leg and not a cause of paralysis.

Complications associated with placement of the screws include bone breakage and nerve damage. Dr. Button uses live x-ray imaging to help minimize risks associated with hardware placement.

Epidural hematomas are collections of blood that can put pressure upon the nerves and cause severe pain. They occur in less than 1% of cases and are usually recognized in the hospital and resolve with another surgery to evacuate the blood collection. Dr. Button places drains during surgery to minimize the chance of an epidural hematoma.

What is the Success Rate with Posterior Lumbar Fusion?

Fusion rates in non-smokers are usually greater than 95% for one level fusions. Significant pain relief is seen in about 85% of patients with spondylolisthesis or scoliosis as the cause of their pain.

When Can I Go Home and What Will I be Able to Do?

Most patients are ready to go home by the second or third day after surgery. Within the first few weeks following discharge we encourage you to begin walking for one half hour to two hours each day. If you were given a brace, you must wear it during the day although you can remove it to sleep or shower. You should be able to go up and down stairs, drive, and perform basic daily activities without too much of a problem. Activity limitations and other details are found in Dr. Button’s aftercare instructions.

When Should You Have a Posterior Lumbar Fusion?

Lumbar fusion is generally an elective surgery. Therefore, it is your choice to proceed based on your current level of discomfort and disability. We recommend that you do not have surgery if you can live with your current level of pain or can make changes in your lifestyle to decrease the pain. If you have made a valiant effort and the pain still persists, surgery may be your next step.

Dr. Button is experienced in posterior lumbar fusion and if you would like to schedule an appointment to discuss this or other procedures further, click here.

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