Open Lumbar Decompression / Fusion

An Open Lumbar Decompression / Fusion is a surgical procedure used to relieve nerve compression and stabilize the lower spine.
This traditional open approach involves a larger incision to directly access the spine, allowing Dr. Tristan Fried to treat complex or multi-level conditions that may not be suited for minimally invasive surgery.

• Decompression: Removes bone spurs, herniated disc material, or thickened ligaments to create more space for spinal nerves, relieving pain, numbness, and weakness.
   
• Fusion: Stabilizes the affected area by joining two or more vertebrae together using bone grafts and implants (screws, rods, cages), preventing painful movement.
   

While minimally invasive techniques are preferred whenever possible, an open lumbar decompression and fusion may be recommended for:

• Severe spinal deformities, such as scoliosis or kyphosis
   
• Advanced degenerative changes or instability affecting multiple levels
   
• Revisions or complex cases, such as prior failed surgeries
   
• Large tumors or traumatic injuries requiring extensive reconstruction
   
• Situations where visualization and access must be maximized for safety and precision
   

Key point: The open approach provides direct, wide access to the spine, making it ideal for complex reconstructions and advanced pathology.

 

• Lumbar spinal stenosis (severe narrowing of the spinal canal)
   
• Spondylolisthesis – vertebra slipping forward over another
   
• Degenerative disc disease with instability
   
• Fractures or trauma to the spine
   
• Spinal tumors requiring resection and stabilization
   
• Severe scoliosis or deformity
   
• Recurrent herniated discs after previous surgeries

• Incision: A midline incision is made in the lower back, allowing full visualization of the spine.
   
• Muscle retraction: Muscles are carefully moved aside to access the vertebrae and nerves.
   
• Decompression: Bone spurs, thickened ligaments, or herniated disc fragments are removed to relieve pressure on the spinal nerves.
   
• Fusion:
   
• A bone graft or interbody cage is placed between the vertebrae.
   
• Small screws and rods are inserted to hold the spine in proper alignment while the bones fuse.
   
• Closure: The muscles and skin are carefully closed in layers.
   

• Reliable and durable spinal stabilization
   
• Direct access and visibility for multi-level or complex pathology
   
• Can treat severe deformities and trauma
   
• Provides long-lasting pain relief by decompressing nerves and stabilizing the spine
   
• Widely studied with decades of successful outcomes

You may be a good candidate if you have:

• Persistent lower back and leg pain that hasn’t improved with conservative treatments
   
• Numbness, tingling, or weakness due to severe nerve compression
   
• Imaging that shows instability, deformity, or multi-level disease
   
• Complex conditions that cannot be safely treated with minimally invasive techniques
   
• Good overall health to tolerate a longer recovery process

• Hospital stay: Typically 1–2 days, depending on the complexity of the surgery.
   
• Initial mobility: Walking begins within 24 hours with assistance.
   
• Early recovery: Light activity is encouraged, but heavy lifting and bending are restricted.
   
• Physical therapy: Usually starts 6 weeks after surgery to restore strength and mobility.
   
• Return to light activity or desk work: Usually at 6–8 weeks, depending on healing progress.
   
• Full fusion timeline: Complete bone healing and stabilization take 6 months.
   
• Full recovery: Most patients return to normal activities by 6–12 months.
   

Recovery is slower than with minimally invasive techniques but provides lasting stability and symptom relief.
 

• Stop certain medications such as blood thinners, as directed by Dr. Fried.
   
• Avoid food or drink for a set period before surgery.
   
• Arrange for transportation and support at home during the early recovery period.
   
• Prepare a recovery area with essentials like a firm chair, grab bars, and easy-to-reach items.
   
• Quit smoking, as nicotine greatly slows bone healing and increases the risk of fusion failure.
   

Contact Dr. Fried’s office immediately if you experience:

• Fever, chills, or redness at the incision site
   
• Sudden, severe back or leg pain
   
• New or worsening weakness, numbness, or tingling
   
• Difficulty walking or maintaining balance
   
• Sudden loss of bladder or bowel control (medical emergency)