Lumbar fusion: when fusing is the right decision
Vertebral fusion with minimally invasive techniques in Valencia — only when instability demands it.
Lumbar fusion (arthrodesis) joins (“fuses”) two or more vertebrae to eliminate the painful movement between them. It is an effective surgery when the indication is correct — and a source of poor results when applied to problems that are not about instability. That is why this page starts with the most important thing: when yes and when no.
When it IS indicated
Unstable spondylolisthesis documented on dynamic X-rays, with pain or sciatica (more on vertebral slippage at spondylolisthesis); post-surgical instability or after wide decompressions; progressive deformity (advanced degenerative scoliosis) with trunk imbalance; fractures or injuries that compromise vertebral stability; severe degenerative disc disease at a specific level, with concordant disabling pain and after exhausting conservative care — the most demanding indication to confirm.
When NOT (or not first)
Nonspecific low back pain
Without demonstrated instability.
Simple herniation with sciatica
An endoscopic discectomy, far less aggressive, is usually enough.
Stable canal stenosis
Decompression without fusion is sufficient in most cases.
An image without symptoms
A finding alone never justifies a fusion.
How it is done today: minimally invasive
Current techniques (minimally invasive TLIF/PLIF, percutaneous approaches for the screws, high-precision radiological assistance) reduce muscle damage, bleeding and hospital stay compared with classic open surgery. The interbody implant (a “cage” between the vertebrae) restores disc height and promotes the definitive bone fusion.
Realistic recovery
Hospital: 2–4 nights usually. Walking: from the first day, progressively. Office work: typically 4–6 weeks. Complete bone fusion: 6–12 months, confirmed by X-ray follow-up. Impact sport: individual assessment from 6 months.
Frequently asked questions
Fusion of one or two lumbar levels is barely perceptible in daily life: the remaining levels and the hips compensate for most of the movement.
The overload of the discs neighboring the fusion, which over the years may degenerate. It is one of the reasons to fuse only what is essential.
They are tools for different problems: the prosthesis requires strict criteria (see disc arthroplasty); fusion is the versatile option when there is instability or deformity.
Have you been advised to have a fusion?
It is one of the spine surgeries where criteria vary the most. A second opinion with a review of your dynamic imaging gives you confidence before deciding.