Posterior Lumbar Decompression and Fusion (PLDF)
Below are some of the most common questions we receive from patients who are considering proceeding with a Posterior Lumbar Decompression and Fusion. Please keep in mind that the recovery from surgery is quite subjective and is effected by various factors such as patient age, comorbid illnesses, degree of spinal cord or nerve impingement, the length of illness prior to surgery as well as degree of disability prior to surgery to name a few. The answers below are based on the average patient that we see.
What is Posterior Lumbar Decompression and Fusion?
Posterior Lumbar Decompression and Fusion (PLDF) is a surgical procedure that aims to relieve pain and pressure on the spinal cord and the nerves in the lower back. The lower back is made up of the lumbar vertebrae that is located right above the spine. These supports most of the weight of your upper body. This spinal fusion is performed to relieve the symptoms of this lower back pressure and pain.
How is Posterior lumbar decompression and fusion performed?
There are two major parts of this spinal fusion. The first being the bony portion of the fusion. This consists of a combination of bone from the bone bank and local bone from the area of the spinal decompression. In a majority of cases, Dr. Albert does not take a bone graft from the patient’s iliac crest (hip area), which means you will not have a separate incision. Bone growth is stimulated and then the grafts are put into place. This fuses the vertebrae and stops the painful movement in the area. The second component of the fusion is the instrumentation. The instrumentation may be rods and screws and/or a cage that is placed between the vertebrae.
Is PLDF Surgery painful?
Please keep in mind that pain is a very subjective experience and one’s reaction to surgery is affected by a variety of factors as mentioned above. It is not uncommon for patients to experience “reminder” pain after surgery. This is when a patient begins to experience the same symptoms as they had before surgery. While this is common in recovery from spine surgery we understand that this can be very concerning to our patients. We encourage you to call the office with any concerns you may have after surgery.
What to avoid Before Or After Surgery
We ask that you refrain from taking any non-steroidal anti-inflammatory medicines 10 days before your surgery and 10 weeks after surgery such as:
- Aspirin, Advil, & Aleve
- Herbal Supplements
- Vitamins E & K
- Fish oil
If you have another treating physician who recommends that you do not stop Aspirin prior to surgery please be sure to discuss this with our office. You should discontinue all exposure to nicotine, as well as nicotine-containing products, two weeks before and at least 6 weeks after your surgery.
The first visit to Dr. Alberts is around 3 weeks after surgery. However, if you have any questions or concerns prior to your first post-op visit, please call the office. After speaking with you, if we believe we should see you in the office we will schedule an earlier appointment. Outpatient Physical Therapy will be required. You may use any facility or therapist whom you feel comfortable working with.
Most patients do not have sutures that need to be removed after a Posterior Lumbar Decompression and Fusion Surgery. There are internal sutures that will dissolve with time. There may also be steri-strips (white pieces of tape) over the incision that will either fall off or we will remove them during your visit.
For the first 2-3 weeks, your activity will be limited to walking and any exercises you may have been taught by the home therapist. We encourage you to walk as much as you are comfortable. During this time you may go up and down stairs, with the use of a railing, and you may also sleep in a normal bed. You will be limited to lifting 5 pounds for the first 2-3 weeks. After three weeks, you will be able to resume low-impact cardiovascular activities and increase the amount of weight you are lifting. Within a reasonable amount of time after surgery, you will have very few restrictions on your activities. The average length of time out of work after a Posterior Lumbar Decompression and Fusion Surgery is between 4-6 weeks. Patients who perform labor intense jobs are more likely to be out of work closer to 6-8 weeks. Please be sure to discuss any specific questions with us in the office.
Frequently Asked Questions
- When will I be able to drive?
Most patients are able to begin driving, short distances, between 3-4 weeks after surgery. You may be a passenger in a car as soon as you feel up to it.
- How long will I be wearing the lumbar brace?
The average amount of time patients wears the brace after a PLDF is 3 weeks.
- Will I set off metal detectors?
No, the titanium instrumentation does not currently set off metal detectors.
- Will I be able to have I have an MRI after surgery?
Yes, the titanium instrumentation does not react to the magnet in the MRI machine however you should still notify the MRI facility of the presence of the instrumentation.