Method
The stiffening of the lumbar spine by means of spondylodesis is a complicated and costly operation using various techniques and methods. For the sake of clarity, only the basic principles are discussed below. In principle, a distinction is made between the access routes (e.g. from the side) and whether adjacent vertebral bodies are braced together either from behind (dorsal), from the side (lateral) or from the front (ventral).
The different methods usually have in common that the intervertebral disc is removed and a metallic basket, usually made of titanium, steel or carbon, is implanted. Previously, the basket was filled with autologous bone material, usually taken from the patient’s iliac crest. The removal of the bone material involves considerable risks, which is why possible alternatives such as artificially produced bone proteins are currently being discussed.
By fixing the mobile segment to be stiffened with screws, it is hoped that the vertebral bodies will fuse together during the healing process. This process is called bony fusion. Spondylodesis of the lumbar spine is a major operation and is associated with corresponding risks. These include: Injuries to nerve roots, spinal cord sheath (dura) and spinal cord Paraplegia Vascular injury, especially of the aorta and vena cava Infections and wound healing disorders Loosening, bending and fracture of screws and implants Residual complaints or increased pain Pseudoarthrosis Damage and weakening of the back muscles
- Injuries of nerve roots, spinal cord sheath (dura) and spinal cord
- Paraplegia
- Vascular injury, especially of the aorta and vena cava
- Infections and wound healing disorders
- Loosening, bending and fracture of screws and implants
- Residual symptoms or increased pain
- Pseudoarthroses
- Damage and weakening of the back muscles
Aftercare
After the surgery, patients stay in hospital for about 7-10 days. In order to minimize the risk of suffering a thrombosis, thrombosis prophylaxis (e.g. heparin) is administered for about 14 days. To stabilize the operated lumbar spine, it may be advisable to wear a support corset.
If the pain allows it, you can already start to stand up carefully on the first day after the operation. Heavy lifting and carrying of loads as well as physical exercise should be avoided for about 3 months. Close physiotherapeutic care is very important during the post-operative treatment!
With the help of back training, patients learn to strengthen their abdominal and trunk muscles and to avoid damaging movements. After the hospital stay, the treating orthopedist controls the healing process. In most cases, an x-ray is taken after a few months for control purposes.
