COVID-19 update:  Our hospital is still fully open for appointments and admissions, however visitors are not permitted.

Lumbar Fusion Surgery

In the backbone, spongy pads of tissue called discs lie between the small bones (called vertebrae). The disc helps absorb pressure and keeps the bones from rubbing against each other. They have a tough outer ring and a soft jelly-like inside. Acute disc herniation, which is more commonly called a slipped disc, happens when the tough outer ring of a disc tears. The jelly-like middle bulges out through the tear and this may press on nearby nerves, causing pain and weakness in the muscles. One may also experience symptoms including severe back pain, shooting leg pain and weakness in the lower limbs.

What is lumbar fusion surgery?

Lumbar fusion of the lumbar spine is designed to stop the movement at a painful, unstable spinal joint. By linking together (fusing) two or more of the vertebrae, your surgeon is trying to eliminate the motion that occurs within that portion of the spine. Once a segment of the spine is stabilized the patient usually experiences some relief of pain. The surgeon may opt to use specialised spinal instruments (screws, rods, plates) to immobilize the spine, this immobilization will enhance the healing process. Spinal instrumentation acts as an internal splint.

Surgeons use this procedure when patients have spinal vertebrae injuries, protrusion and degeneration of the discs, curvature of the spine or a weak spine caused by injections or tumours.

Why is this surgery suitable for me?

Surgery is an option if:

  • painkillers, rest, exercises and injections don’t help
  • there is a likelihood of serious complications involving the nerves if left untreated
  • when the pain in the back, hips, buttocks and legs is having a profound effect on your quality of life

The aim of the procedure is to reduce the pain in the lower back and legs.

How is it performed?

Lumbar fusion can be carried out with an anterior (from the front) approach or a posterior (from the back) approach. Your surgeon will determine which approach is the best method for you. An anterior approach does carry a slightly higher risk of complication, but generally gives a better result and quicker healing time. Both procedures are performed under general anaesthetic and require a minimum one night stay in hospital.

Anterior approach

A 10-12cm incision is made into the abdomen. Organs and blood vessels are expertly moved aside by a vascular surgeon, revealing the front of the lumbar spine. The degenerate discs are carefully removed and replaced with a spacer. The spacer may be a fusion cage or a prosthetic disc replacement. If a cage is used, it is filled with synthetic bone material (bone putty) and then inserted into disc space. The cage holds the upper and lower vertebra tightly together, while the bone material aids to fuse it all together. Screws may also be fixed in place to keep it all secure and stable.

Posterior approach

A 10-12cm incision is made into the back. They surgeon must cut through layers of muscle to reach the spine. The degenerate discs are carefully removed and replaced with a spacer. The spacer may be a fusion cage or a prosthetic disc replacement. If a cage is used, it is filled with synthetic bone material (bone putty) and then inserted into disc space. The cage holds the upper and lower vertebra tightly together, while the bone material aids to fuse it all together. Screws may also be fixed in place to keep it all secure and stable.

What are the risks?

  • infection of your wound after surgery, which is not usually serious and can be treated with antibiotics (deeper spinal infection is more serious but very rare) (2-3%)
  • damage to nerves and blood vessels, which occurs in rare cases (1%)
  • paralysis, which means loss of use of the legs, loss of sensation and loss of control of bowels and bladder is low (1%)
  • implant failure, if the body rejects the implant, a further operation may be required. Alternatively if the implant moves and press on the nerves, the initial symptoms may return
  • failure of fusion, if the bones fail to fuse together, neck pain can recur and a further operation may be considered (15%)
  • rare complications associated with general anaesthetic, such as heart attack, blood clot in the lung or an allergic reaction
  • dural tear (tear in the tissue covering the spinal cord), which if damaged during surgery can easily be repaired with no significant side effects. If this does not heal itself, then a further operation may be required (6%)

Contact us

If you would like to know more about our lumbar fusion procedure then contact us today by phone on 020 3370 1030 or email spinespecialists@hje.org.uk

Spine Clinic

The Spine Clinic at St John & St Elizabeth Hospital is a centre for excellence in the diagnosis, intervention and aftercare of all spinal conditions.

A patient speaking to a receptionist

Patient information

Our Hospital is renowned for providing exemplary levels of care across more than 90 services. From orthopaedics, to urology, our private GP practice and Urgent Care Clinic, our services are led by some of London’s leading Consultants. For more information, and to find a service suitable for your care, find out more about the services that we offer.

Make an enquiry

If you have any questions relating to treatment options or pricing information, get in touch with us by filling out one of our contact boxes or giving us a call on 020 3370 1030.

Our Appointments Team have a dedicated and caring approach to finding you the earliest appointment possible with the best specialist.

If you are self-paying you don’t need a referral from your GP for a consultation. You can simply refer yourself* and book an appointment.

If you have health insurance (e.g. Bupa, Axa Health, Aviva), you will need to contact your insurer to get authorisation before any treatment, and in most cases you will also require a referral letter from your GP.

If you are not registered with a GP, we have an in-house private GP practice you can use. Alternatively, we can suggest the most appropriate course of action for you to take, given your location and individual circumstances.

*Please note – for investigations such as X-rays and MRIs, a referral will be required. However, we may be able to arrange this for you through our on-site private GP.

    Make an enquiry

    Latest articles

    The latest news, insights and views from St John and Elizabeth Hospital.

    Find out what we’re doing to keep you safe, read expert articles and interviews with our leading specialist Consultants, learn more about common conditions and get your questions answered.

    medical professional looking into microscope

    12th January 2022

    Under the microscope: The many benefits of private healthcare

    Whatever your situation, there might come a point when you consider going private…

    gallbladder attack

    04th December 2021

    Are you having a gallbladder attack? Find out more about the causes, symptoms and treatment

    A gallbladder attack can happen at a moment’s notice and cause aggressive pain….

    overactive bladder

    02nd December 2021

    Constantly need to pee? How to treat an overactive bladder

    If you regularly get the feeling that you’ve “got to go”, you’re not…

    partial knee replacement

    29th November 2021

    Pros and cons of partial knee replacement: Is it right for you?

    More than 10 million people in the UK have osteoarthritis or a similar…

    hearing loss

    19th November 2021

    Surprising facts about hearing loss you may not know

    Did you know that hearing loss is the second most common disability in the UK? It affects one in six UK adults, but shockingly, people with hearing loss wait an average of 10 years

    private healthcare

    02nd November 2021

    Private healthcare vs the NHS: Which should you choose?

    Whether you’re not feeling well and struggling to get a doctor’s appointment, been…

    nhs waiting list

    29th October 2021

    NHS waiting lists: How long is too long? (and what can you do about it?)

    The NHS is a beacon of hope for millions of people all over…

    spine - back awareness week

    21st October 2021

    Back Care Awareness Week 2021: Improving your back pain when working from home

    Every year, back pain charity BackCare (the National Back Pain Association) shines a light on one of the most prevalent complaints of modern times.

    woman with good skin - private dermatology care

    18th October 2021

    Reasons why you should see a private dermatologist in London

    Here’s a look at some common skin conditions that may require the attention of a private dermatologist in London or elsewhere to clear them up.

    looking after your vision

    14th October 2021

    Looking after your vision with check-ups at a London eye clinic

    It’s easy to overlook eye health until problems occur that may be difficult to treat. Regular check-ups at our London Eye Clinic will put your mind at rest.

    knees and elbows

    11th October 2021

    Elbow treatments: A look at different injuries and how they’re fixed

    Elbow fractures, breaks and other injuries and conditions require specialised elbow treatment plans so that you can get back to normal.

    Doctor with a stethoscope

    07th October 2021

    Benefits of a private health care check-up

    Detecting problems before they have a chance to become serious is one of the main reasons for having a health care check-up — but should you go public or private?