“Dear, The Golfing Doc; I heard Tiger Woods just had his lumbar fused. What is that surgery and can you still golf after you have it done? Thanks. Frank N. Seattle, WA”.
Well, Tiger Woods is back in the news again. And again, it’s all about his back and not his game. It seems like every year, the news is about when he will to return to the game or what new injury Tiger has.
This past April, Tiger Woods announced that he underwent spinal surgery again. I do not work with Tiger Woods, but based on the information provided by his agent on social media, he received a single-level lumbar spinal fusion. To be more specific, his surgery was described as an “anterior lumbar interbody fusion at the L5-S1” level of his spine. In addition, the damaged disc in between those two vertebrae were removed and the space between the two was lifted. Since this news became public, many readers have inquired about the nature of Tiger’s surgery, as well as the future of his golf game.
A lumbar fusion is when two vertebrae are fused together. This can be done at a single-level between two adjacent vertebrae or between your last lumbar vertebra (L5) and the top of your sacrum (S1). Since the lumbar region of your spine consists of five vertebrae, a multi-level fusion may be done, depending on the condition being treated. For example, I have patients who have had fusion from L3 all the way down to L5. It all depends on the problem.
The lumbar fusion procedure can be performed through a variety of techniques. For example, the fusion can occur at the front of the vertebrae, hence the name “anterior fusion”. Alternatively, it can be done at the back of the vertebrae, hence the name “posterior fusion”. Tiger’s L5-S1 procedure was a fusion at the front of the vertebrae.
In most cases, screws are used to hold the vertebrae together. These screws will extend from one vertebrae and right through to the other. In addition, a surgeon may also use bone grafts from the hips and transfer them to the surgical site to help encourage natural fusion between the bones. For patients who are having pain due to abnormal motion between these vertebrae, the fusion will stop any movement from occurring, as to eliminate pain or, at the very least, result in fewer problems.
There is normally space between each vertebra. When this space is reduced, or compromised, nerves can become pinched and compressed. In a fusion, the surgeon will recreate the normal space by inserting some sort of spacer such as an artificial disc. For patients who are having pain due to a compressed nerve, this space should relieve the compression and alleviate the pain.
So back to the question about the possibility of pursuing a golf career after a lumbar fusion. My answer is yes, golf is possible, based on my patients and experience. It is very rare that a patient receives a lumbar fusion and is not able to play golf. However, I do have to give the disclaimer that I have several patients who have had a lumbar fusion and their back pain did not go away. In some cases, their back problems worsened.
Before anyone considers this type of surgery, I will always recommend trying conservative treatment first. This includes anything from Chiropractic care, physical therapy, massage therapy, acupuncture, rehab exercises, and even steroid injections. If, after trying of these there is still a back-pain problem, then surgery may be an option.
I have attached a few basic pictures to help you visualize an anterior lumbar interbody fusion a little better. If you are experiencing acute or chronic back pain, or have ever been recommended for surgery, please consider contacting us for a consultation. You would be surprised how proper treatment and exercise can help alleviate your back pain and even prevent surgery.