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Lumbar Spinal Fusion in New Jersey | (ALIF, TLIF, XLIF)

Bedminster & Newton, NJ

 

At the New Jersey Spine Institute, all of our procedures are performed by a team of two Board Certified Orthopedic Spine Surgeons to maximize relief and minimize your recovery time.

 

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Lumbar Spinal Fusion is a Minimally Invasive procedure that is performed to relieve pressure on spinal nerve roots caused by a variety of Degenerative Disc Diseases. This procedure involves the removal of herniated spinal discs and/or bone spurs and uses an implant to fuse two of the spinal vertebrae together to increase stability in the spine.

During a Spinal Fusion surgery, magnification and proper illumination and specially designed surgical instruments are used to remove the herniated disc and/or bone spurs. Once removed, an implant is placed in the space formerly occupied by the disc. This implant is filled with the patients own bone material in an effort to help the bones fuse more naturally. Pedicle screws may be used to ensure the stability of the newly fused segments.

Depending upon the anatomy and area of injury, several different approaches are available. All of these procedures require only an incision of about 3-4 cm and are performed on an outpatient basis. Our Minimally Invasive Approach avoids unnecessary muscle dissection and damage to the surrounding areas and utilizes fluoroscopic guidance to ensure accuracy. With this Minimally Invasive Approach, patients are able to return to their active routines much faster than with traditional spine surgery.

Anterior Lumbar Inter-body Fusion (ALIF)

The incision for an ALIF procedure is made typically through the lower abdomen or side. This procedure is usually assisted by a vascular surgeon who provides exposure to the vertebral bodies in concert with the spinal surgeon.

Transforaminal Lumbar Inter-body Fusion (TLIF)

The incision for a TLIF procedure is made through the back of the spine using a muscle sparing approach. This approach allows for the procedure to be performed while maintaining the integrity and viability of the surrounding muscle and tissue.

Xtreme Lumbar Inter-body Fusion (XLIF)

The incisions for a XLIF procedure are made through two small incisions on the patient’s side at the level of the affected spinal disc(s). This approach allows for the procedure to be performed while maintaining the integrity and viability of the surrounding muscle and tissue.

At the New Jersey Spine Institute, all of our procedures are performed by a team of two Board Certified Orthopedic Spine Surgeons to maximize relief and minimize your recovery time.

Recovery After Surgery

Patients can typically return home the same day as their lumbar spinal fusion surgery.. Your surgeon may prescribe pain medication, a back brace and may recommend physical therapy to speed up recovery.

Though it generally takes the bone grafts and vertebrae a few months to fuse together completely, typically you should notice an improvement in preoperative symptoms almost immediately. However, there is pain associated with the incision and operative procedure that is different from your pre operative pain. Within the first four to six weeks, back pain may subside, and mobility may improve. Most people with jobs that don’t require physical labor can return to work at this point. For jobs that require light labor, it may take 3 to 6 months before you can return to work after lumbar spinal fusion surgery.

Potential Complications

Our surgeons practice minimally invasive lumbar fusion for everything from spinal stenosis to degenerative disc disease. Though the minimally invasive approach reduces risk and speeds up recovery times, there are still certain potential complications. These complications include:

Infection

Infection is always a possibility after a surgical procedure. New Jersey Spine Institute has preoperative protocols that significantly reduce the occurrence of post op infections. Dr. Dwyer and Dr. Vessa do everything in their power to reduce the chances of infection.

Ongoing symptoms

Our surgeons have an astonishing 100% fusion success rate for single-level cases and an equally impressive 92% success rate for two-level cases. Post op x- rays will be performed sequentially to evaluate your fusion. If you have had prior nerve damage from your spinal condition, documented by an EMG, symptoms may take longer to resolve and may require physical therapy.

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What To Expect During Your Consultation

Your surgeon will discuss your back problems with you and carefully assess your condition. Lumbar spinal fusion isn’t the right option for every patient— The key to success is an accurate diagnosis pinpointing your pain generator and the correct surgery to address your spinal condition.

The spinal fusion procedure is just one of many spinal surgery options, and spinal surgery may not even be necessary. The right procedure depends on which conditions are affecting your spine. Your surgeon will give you an honest overview of which options may help alleviate or cure your symptoms.

Frequently Asked Questions

Does a lumbar spinal fusion affect my mobility and daily activities?
You can expect to have limited mobility in the days and weeks after the lumbar spinal fusion surgery. If there’s no physical labor involved, most people can return to their regular jobs after 4-6 weeks. Once you’ve fully recovered, you may find the surgery has even improved your mobility.
What alternative treatments are available if I decide not to go through with the fusion?
There are several alternative treatments available if you do not go through with spinal fusion; these range from surgical to non-surgical options. The types of treatments available will depend on the condition being treated.
How much will the lumbar spinal fusion cost, and what is typically covered by insurance?
Lumbar spinal fusion costs vary depending on several factors but expect a minimum of $50,000. If it is medically necessary, insurance may cover the fusion.
How is pain managed after the surgery?
Your surgeon will prescribe pain medication to help manage pain for the first few months after the surgery. Icing, physical therapy, back braces, and other supplemental treatments may also be used to reduce pain and increase mobility.
Are there any lifestyle changes I need to make after the surgery?

Immediately after the surgery, you won’t be able to work for 4-6 weeks and should not do any heavy lifting for a number of months. Once you’ve completely recovered from the fusion, most people will be able to go back to their day-to-day lives.

We reviewed our out-patient experience, at our privately-owned surgical center, performing a one and two level Transforaminal Interbody Fusion (TLIF) over a seven year period of time.
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Analysis

This retrospective study analyzed the results of 50 consecutive patients.
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Length of Stay

We found an average length of stay of 17.37 hours at the facility. Time to ambulation was an incredible 3.75 hours with only three patients requiring an overnight stay at a local rehab center.
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Success Rate

The Board Certified Surgeons at the NJ Spine Institute were able to accomplish a fusion success rate of 100% for a single level and 92% for the two-level cases.
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Complications

Complications including wound, cardiac, pulmonary, neurologic, Urinary Tract Infection (UTI), CSF Leak, Deep Vein Thrombosis (DVT) and Pulmonary emboli (PE) were zero.
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Narcotic Use

Post-operative narcotic use was minimal and short-lived.
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Conclusion

We believe these results demonstrate an effective, reproducible, safe and cost effective alternative to an in-patient lumbar spinal fusion. To learn more, contact us today.

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Dr. James Dwyer
Dr. Paul Vessa

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