Spinal Fusion Surgery

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Definition of Spinal Fusion Surgery

Spinal fusion surgery is performed to permanently join two or more bones of the spine. This eliminates movement between them.

Spinal fusion surgery uses techniques that are designed to mimic the same process broken bones go through as they heal. Bone or material like a bone is placed in the space between two vertebrae. Instrumentation, which is metal screws, rods or plates, may also be used to keep the bones together as they heal into one solid piece of bone.

Because spinal fusion surgery makes parts of your spine immobile, it places strain and stress on the bones below and above the site that was fused. This may cause these areas to wear away or degenerate more quickly.

Spinal fusion surgery joins two or more vertebrae into one solid piece of bone. This creates more stability in the spine, it can help reduce pain or help correct a curvature or deformity.

Reason for spinal fusion surgery

Your physician might recommend spinal fusion surgery as treatment for one of the following problems:

  • Broken vertebrae: Many broken vertebrae heal on their own. But if a broken bone creates spinal instability, you may need spinal fusion surgery.
  • Deformities of the spine: Spinal curvatures like kyphosis and scoliosis are treated with spinal fusion surgery.
  • Spinal weakness or instability: Some cases of severe arthritis can cause too much movement in the spine. Surgery might be needed to add stability to the spine in these cases.
  • Spondylolisthesis: In this condition, one backbone slips forward, over the top of the one beneath it.
  • Herniated disk: When the damaged disc is removed, spinal fusion surgery may be needed to stabilize the spine.
  • Chronic low back pain: Sometimes surgery can help to relieve pain, but this use is not always recommended.

Spinal fusion surgery has been done for many years. Many different techniques and approaches can be used.

  • Anterior approach: The spine is accessed from the front of the body
  • Posterior approach: The spine is accessed from the back
  • Lateral approach: The spine is accessed from the side

Spinal fusion surgery can also be performed using minimally invasive techniques which require smaller incisions. The procedure your surgeon recommends will depend on your condition and where it is located.

Bone Grafting

Spinal fusion surgery uses some kind of bone graft. Typically, small sections of bone are used or bone-like material is placed in the space between the vertebrae that are being fused.

The bone graft promotes healing and helps the backbones grow together into one solid mass of bone following spinal fusion surgery.

It used to be that the only option was to use a bone taken from the patient’s own body, creating the need for another incision, more pain, and the risk of additional complications. One alternative that is now available for spinal fusion surgery is the use of an allograft from a bone bank. An allograft is the bone of a cadaver.

There are also several other artificial options available, such as demineralized bone matrices, bone morphogenetic proteins, and ceramics. Your surgeon will talk with you about what type of bone graft material will work best for your spinal fusion surgery.

Immobilization

After your spinal fusion surgery, a brace might be needed to provide stabilization while the fusion heals. In a process known as internal fixation,  instrumentation, such as screws, rods, and plates, are used to help keep the vertebrae and the bone graft in place. This adds stability and many patients are able to be mobile sooner after their operation.

Spinal fusion surgery risks

Spinal fusion surgery is generally thought of as a safe procedure. Like any operation, it does carry the risk of complications. Possible complications include:

  • Bleeding,
  • Delayed wound healing,
  • Infection,
  • Blood clots,
  • Damage to the nerves or blood vessels around or in the spine,
  • Pain at the donor site (where the bone graft was taken from).

Because it changes the mobility of your spine, spinal fusion surgery adds increased stress and strain to the vertebrae around the fusion site. This may cause damage from wear and tear on these vertebrae to happen earlier than it would have, had you not had spinal fusion surgery. This wear and tear damage can lead to chronic pain.

Following spinal fusion surgery, it is critical that you follow all your doctor’s instructions. Instructions relating to infection and blood clots are especially important. Blood clots and infection are most likely to happen within the few weeks after your spinal fusion surgery.

Signs and symptoms of a blood clot include:

  • Swelling in your foot, ankle or calf,
  • Tenderness or redness in your lower leg that extends just below or just above the knee,
  • Pain or tenderness in the calf of the leg.

Sometimes, a blood clot can break off and travel through the bloodstream to the lungs. If you develop a sudden cough, trouble breathing or chest pain, call 911 immediately.  Infection following spinal fusion surgery rarely occurs.

Signs and symptoms of infection include:

  • A fever above 100 F (taken by mouth),
  • Redness increased pain and swelling around your incision,
  • Increased drainage from your incision,
  • Increased pain,
  • Chills or shaking,
  • A foul odor from your incision.

If you develop any of these symptoms after spinal fusion surgery, call your doctor or go to the emergency room for medical care right away.

Care after spinal fusion surgery

Complete fusion of the bone may not be complete for several months following spinal fusion surgery. You will probably be feeling much better long before the fusion is complete. Even though you feel better, your spine needs to be treated with care. You will be taught the right ways to move, turn, stand, sit and walk.

Right after spinal fusion surgery, you will probably be restricted to only light exercise like walking. As you get stronger, you will probably be able to slowly increase the amount of activity and exercise you can perform.

Practicing healthy habits and following your doctor’s recommendations and instructions will help ensure a successful outcome from your spinal fusion surgery.

Spinal fusion surgery is usually used in cases of spinal instability, curvature deformities, and vertebral fractures. In studies, it has been shown that non-surgical treatment is usually just as effective as surgery for treating neck or back pain when the cause of pain is unclear.

The exact cause of back pain can be difficult to determine, even if bone spurs or a disc herniation is visible on spinal X-rays. This is because people who have these problems are often pain-free. Your pain may be not be caused by something that is visible.

Even when spinal fusion surgery provides relief from symptoms, it may lead to more back pain later due to degenerative changes in other sections of the spine.

  • Avoid smoking,
  • Avoid use of narcotics,
  • A back brace is worn as part of care,
  • Appropriate exercise (physiotherapy),
  • Get assistance for difficult tasks,
  • Don’t pick up heavy objects.

Patients have to look out to avoid infection around the wound site which can be noticed by:

  • Spike in temperature
  • Increased reddening at the incision sight
  • Pain in the area
  • Oozing pus

The doctor will also prescribe painkillers to help manage the pain during the healing process.

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