What is Spinal Fusion Surgery?
Spinal fusion is a surgical procedure to weld two or more vertebrae (backbones) together to reduce movement and eliminate pain. The surgery creates an environment the encourages the body to grow new bone tissue through use of an implanted graft that acts as a scaffold for new bone.
What does it treat?
Spinal fusion can be a treatment option for a number of spine conditions, including:
- Herniated discs
- Spinal deformities such as scoliosis
- Spinal stenosis
- Vertebral fractures
- Weakness or instability of the spine
Who is a candidate?
Candidates for spinal fusion are people who experience back pain or radiculopathy with movement. Most people who have spinal fusion surgeries have attempted conservative management of their condition without relief.
How is it performed?
The goal of spinal fusion surgery is to create an environment that encourages two or more vertebrae to grow together. This is accomplished with a bone graft, which acts like a scaffold for the body to build new bone.
There are three types of bone grafts:
- Allograft, which comes from a donor (cadaver)
- Autograft, which comes from the patient’s own body, usually from the pelvis
- Synthetic, an artificial piece of tissue
The standard approach is to use an autograft, but each surgeon will decide which source of bone graft is best on a case-by-case basis.
The vertebrae to be fused can be accessed in one of two ways: anterior (from the front) or posterior (from the back). An anterior approach is often used when fusing cervical vertebrae (in the neck). In many cases a discectomy is performed at the same time, and the common name for this surgery is anterior cervical discectomy and fusion, or ACDF.
A posterior approach may be better suited for lumbar spinal fusion. A 2015 study published in Journal of Clinical Neuroscience examined data from more than 10,000 patients who underwent lumbar spinal fusion surgery. The study suggests that people who had a spinal fusion using a posterior approach had a lower rate of complications and less risk of reoperation in the first two years.
In either case–anterior or posterior–the surgery will be performed under general anesthesia. Surgeons will be guided by fluoroscopy, an imaging technique involving contrast dye and computed tomography (CT) to see the area of operation better.
Surgeons will insert and secure the bone graft over the vertebrae to be fused. If a decompression surgery such as a discectomy must be done, it will be performed at the same time. Then the incisions are closed.
Recovery
A short hospital stay of less than a week is usually necessary after a spinal fusion surgery. Spinal fusion recovery time can be longer than recovery time for other spine surgeries because it takes a matter of months for the new bone to grow and harden.
The spine needs to be immobilized for healing and bone growth to occur. Surgeons will secure the graft with plates, screws and rods during the surgery. The patient may need to wear a back brace to keep spinal movement to a minimum.
Physical therapy may be necessary after spinal fusion surgery. The goal of physical therapy is to return strength and range of motion to the muscles and joints surrounding the area, as well as to help the patient sit, stand and move with a partially fused spine.
If you are experiencing back pain, neck pain or radiating pain the arms and legs, request an appointment with Edison Spine Centers. We can diagnose the cause of you pain and help you decide if spinal fusion is right for you.