July 21, 2015

Lumbar Interbody Fusion and Facet Fixation

Our minimally invasive lumbar facet fusion stabilizes degenerative joints to reduce pain. While spinal fusion is a technique that has been used for years, our endoscopically assisted procedure is a safer, less invasive alternative to traditional open back surgery. It also allows the surgeon to select the optimum incision area for the patient. Here are the Spine Institute Northwest, our surgeons specialize in minimally invasive interbody fusion and facet fixation because it offers patients:

  • Less pain
  • Faster recovery
  • Higher rate of success



When the bones in your spine become worn, movement can lead to nerve root inflammation and pain in the neck, shoulder, arm, pelvis, hip, or thigh. Spinal fusion and facet fixation uses a cage to restore the space between your vertebrae and join the vertebrae together. This stabilizes the vertebrae and helps relieve nerve root pressure, allowing you to return to normal activities with less pain.

This procedure is often recommended for conditions such as segmental instability, degenerative disc disease (osteoarthritis of the spine), spondylolisthesis, spondylolysis, or for recurrent disc herniations despite multiple surgeries.


Our procedure uses a facet screw system designed to stabilize the spine. We use small incisions, neuromonitoring, and fluoroscopic guidance to safely and accurately insert a dilator in between the patient’s muscles to ensure minimal irritation to nerves and muscles. A retractor is then put in place to allow the surgeon to remove disc or bone material, then insert a PEEK spacer cage to stabilize and align the spine. The spacer is filled with bone graft, allowing the spine to fuse. Screws and small rods are inserted to keep the fusion site solid. The procedure avoids cutting and disrupting the muscles of the back, allowing for a less painful surgery than traditional open fusion surgery, and letting patients recover in weeks instead of months.


This type of surgery allows most patients to be in and out of our surgical center in one day. Before the surgery, we use x-rays, CT scans, MRI scans, or nuclear bone scans to identify joint problems and design a patient-specific surgical plan. For 6 to 24 months following the surgery, your screws and rods will stabilize your spine while your bones fuse together. During this time, you will need supervision with a physiotherapist to work on mobilizing the rest of your lower back without putting too much stress on the fusion site. PLEASE DISCUSS WITH YOUR SURGEON WHEN YOU CAN START PHYSICAL THERAPY AFTER YOUR OPERATION. DO NOT BEGIN OR RE-START ANY TYPE OF THERAPY BEFORE DISCUSSING IT WITH YOUR SURGEON.

During recovery, attempt to keep your lower back as vertical as possible, and minimize bending or twisting. Do attempt to lightly mobilize your lower back so it does not become stiff. A light lumbar support brace may be used for up to 3 weeks for additional pain relief, but we encourage you to avoid using it longer so you may strengthen and mobilize your back and core muscles. Walking is extremely helpful in recovery, and we encourage you to walk at least half a mile twice a day. Swimming and straight leg exercises are also excellent, once your wound has healed. Additionally, know that smoking interferes with healing, as it reduces the development of new blood vessels that are essential for developing bone.

It is important to know your back will never be as good as new and it is unusual to be totally cured of pain; it’s important to have realistic expectations and know that surgery simply aims to significantly improve your symptoms by addressing the cause. You may experience a feeling of “fullness” at the operation site, as your spine has been stiffened, but you should gradually be able to get back to your daily living activities.

Want to learn more? Call the Spine Institute Northwest at (425) 486-1000 today!