Decompression and Posterolateral Fusion
What is it?
Decompression and Posterolateral Fusion surgery is a sophisticated and often necessary intervention for specific spinal conditions that cause both nerve compression and spinal instability. This dual surgery approach skillfully combines alleviating pressure on spinal nerves (decompression) with stabilizing the spine (fusion), addressing two critical aspects of spinal health in a single procedure. This procedure is typically recommended for patients suffering from conditions like spinal stenosis, herniated discs, or spondylolisthesis, where nerve compression is accompanied by spinal instability or misalignment. The goal is to relieve pain and other symptoms caused by nerve compression while ensuring the long-term stability of the spine.
Before surgery, patients undergo extensive evaluation, including imaging tests like MRI or CT scans, to determine the exact nature of the spinal issue and plan the surgical approach.
Patients typically stay in the hospital for a few days post-surgery. Pain management, complication monitoring, and initial mobilization are key focus areas. Recovery involves physical therapy to regain strength and flexibility. Patients may be advised to wear a brace and avoid certain activities during healing.
Procedure
The surgery is performed under general anesthesia. The surgeon makes an incision in the back over the affected vertebrae to access the spine.
The first step in this combined procedure, decompression, involves removing or trimming parts of the vertebrae or herniated disc material that are pressing on the spinal nerves. Techniques such as laminectomy (removal of the lamina), laminotomy (removal of a portion of the lamina), or foraminotomy (widening the nerve root exit spaces) are common. This process alleviates symptoms like pain, numbness, or weakness in the limbs.
Following decompression, the fusion process begins. In posterolateral fusion, the surgeon places bone graft material on the affected vertebrae’s posterior (back) sides. This material, which can be sourced from the patient’s body (autograft), a donor (allograft), or synthetic substitutes, encourages bone growth between the vertebrae. Over time, this growth leads to fusion, effectively stabilizing the spine.
Often, the fusion process is supported using surgical hardware such as rods, screws, and cages. These devices provide immediate stabilization and maintain proper alignment while the bone graft heals and fuses the vertebrae.