Lumbar spine fixation is a surgery in which two or more vertebrae are combined to reduce the spine's movement and protect the spinal cord. It is one of the back straightening operations.
It is no longer commonly thought of as lumbar spine surgery vertebral fixation Lead to a reduction in the movement of the back for life true; Patients can return to their everyday lives after a certain period of surgery; it may be essential in some severe cases that cannot be treated conservatively due to its importance in protecting the spinal cord from harm and reducing structural deformities, so what are these injuries? What are the latest methods of operating? What are the most important instructions that the patient should follow after the surgery?
Information about Lumbar spine fixation
The spine consists of several vertebrae, ، number of them 33 bony vertebrae (7 cervical vertebrae, 12 thoracic vertebrae, 5 lumbar vertebrae, 5 sacral vertebrae, and 4 coccygeal vertebrae). The upper twenty-four vertebrae are separated by the intervertebral discs, and the lower nine vertebrae fuse with each other. Where it forms These bony vertebrae are the spinal canal in which the spinal cord connected to the brain is located.
Anterior and lateral view of a normal spine
is made Spinal fixation surgery Through the back of the body, at first the patient is given general anesthesia while lying on his stomach on the operating bed, then a vertical incision is made on the lumbar region in the back and the soft tissues and muscles are removed to expose the spine area, and the doctor removes some bone fragments resulting from fractures and removes Osteomas If any.
After that, the doctor places special screws for the operation in the strong sections of the bone and fixes hard wires on the heads of the screws specially designed for these wires. X-ray imaging can be used to ensure correct fixation and evaluation. In the end, soft tissues and muscles are returned to their usual place and the incision is sutured.
When do we resort to the process of fixation of the vertebrae?
The most common illnesses and injuries that need Lumbar spine fixation surgery she:
Sliding vertebrae
Spinal fractures
Reducing movement and structural abnormalities in the spine
There are many advantages when performing lumbar spine fixation, including:
It is useful in the treatment of several diseases, such as fracture of the bony vertebrae, such as the fifth lumbar, herniated disc, or scoliosis And many different diseases, but we resort to surgery for such diseases after the failure of conservative treatments.
Pain relief is evident after the operation for individuals suffering from spinal pain.
It helps to stabilize the spine in patients who suffer from instability of the vertebrae, such as disc displacement between the bony vertebrae, and they are more susceptible to fractures and damage to the roots and nerves. It increases the stability and durability of the spine.
It is essential for the return of daily work and physical activities that the patient can no longer do because of the spinal pain caused by the movement of the discs between the vertebrae, which causes a limitation in the movement of the spine.
Before lumbar spine surgery
There are essential measures that are taken before the surgery to protect the patient and avoid complications, which are:
Comprehensive examinations for diseases and medical problems and their treatment before spinal fixation.
Performing some x-rays to confirm the diagnosis and detect deformities that threaten the spine stabilization process.
Knowing all medical history, allergies, and the medications he takes regularly.
Stopping blood-thinning medications such as aspirin and anti-inflammatory drugs for one to two weeks before spinal fixation.
Refrain from eating food and drinking liquids for at least 8 hours before the operation.
Instructions after lumbar spine fusion
Post-operative steps for fixation of the vertebrae, whether the vertebrae are lumbar or non-lumbar:
The patient is transferred from the operating room to the recovery room in the hospital after vertebral surgery, and vital signs are constantly monitored.
The patient may need to stay in the hospital for two to three days, according to health indicators, before returning home.
Antibiotics are description to protect against the risk of infection.
Feeding initially consists of only liquids, and solid foods should be avoided during recovery.
Eat foods rich in calcium for Osteoporosis treatment And restore several vertebrae more quickly.
Follow the instructions for taking care of the surgical site in stabilizing the vertebrae and avoiding movements harmful to the spine. You must refrain from carrying heavy weights for two weeks, refrain from bending or rotating the back during the first six weeks, and stay away from tiring and arduous work and housework for at least one month.
Sometimes a supportive belt or corset may be recommended to reduce abnormal back movement or re-slipping of the lumbar spine.
Walking is an important exercise to strengthen the leg muscles and lower back muscles, improve their function and speed up recovery from Spinal fixation procedure.
In the end, the period of complete recovery differs from one person to another because it is related to age, health status, and the type of work in which he works.
Radiograph after lumbar spine surgery
The seriousness of the lumbar spine fixation
The fixation process is relatively safe and does not contain significant complications and risks. Although it is rare, there are some risks. What are the damages of vertebral fixation operations:
Sensitivity to anesthetics and immune reactions
Infections
Bleeding
blood clots
Injury to a blood vessel
Nerve injury
Persistent pain
Member failure
Surgical techniques for lumbar spine fixation
There are several types of lumbar fixation surgery to treat the problems of the mobile vertebrae, the most important of which are:
The process of fixing the vertebrae with screws
Fusing the vertebrae with slides and screws
The process of fixing the vertebrae through an external telescope
Cartilage removal and vertebrae fixation
Features of endoscopic fixations
Is characterized by Arthroscopic lumbar spine fixation with the following:
Reducing the surgeon's stress and protecting the patient from the doctor's hands trembling
A significant decrease in the incidence of infections
It also reduces the rate of injury to blood vessels and nerves
Speed in recovery, as the patient may be going out on the same day of back operations
It does not cause significant tissue damage
Aesthetically beneficial, the incision area is smaller
In conclusion, we find that the spine's stability is one of the most important goals of the fixation of the lumbar vertebrae to protect the central nervous system because its injury may lead to paralysis. The operation seeks to straighten the back by linking the vertebrae and providing support for the axial structure. It is easy and simple when performed by an experienced doctor with Modern tools and does not carry serious complications when adhering to the teachings and instructions directed by the surgeon.
This is related to the patient's condition, the number of vertebrae that must be fixed, the severity of the injury, and the reason for the spinal fixation process. In general, the period of the surgical work may be no less than three hours or may reach seven hours, depending on the case.
There may be some pain within several months, but it usually goes away after four weeks of spinal fixation.
Pregnancy should be postponed until the vertebrae fuse completely, and that period varies from one patient to another, and on average pregnancy is allowed after about a year of surgery.
The majority of patients can leave the hospital and return home after about 3 days of lumbar fixation, then he must rest, and he can drive a car and do some very simple work after two weeks. As for office work and tiring work, it takes 4 to 6 weeks. As for sports and business activities Strenuous physical activity and carrying weights, it takes 3 months or more.
He can sit in the first two weeks after the lumbar spine fixation surgery for only 20 minutes each time, this period is increased to 40 minutes in the next four weeks, then he must rest from 30 to 60 minutes or more and sitting periods can be repeated a number of times a day You should pay attention to the sitting position, so that the height of the knees is slightly lower than the level of the hips, and the feet are fixed on the ground, and the legs are not lifted or held.
The success rates of fixation of the lumbar and sacral vertebrae differ from one patient to another because they depend on the severity of the injury or the patient’s health problem and age, but in general they are safe operations and their success rate ranges between 70 to 90 (%).
Walking exercises are very useful and are one of the most important types of physical therapy after lumbar spine stabilization surgery. Where the walking program begins gradually due to its benefit in improving the movement of the spine, activating muscles, improving heart and lung functions, and stimulating blood circulation.
