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Fusion

Spinal surgery is performed in order to permanently join together 2 or more bones (vertebrae) in the spine so there is no movement between them. 

The technique used in this intervention mimics the natural process during which bones heal. Spinal fusion means that a bone or a material that imitates the bone is placed between two vertebrae. In order to ensure that the vertebrae heal together as a unit, doctors use screws, rods, or metal plates to bond the bones.

Spinal fusion surgery modifies your spine’s movement as parts of it become immobilized. Consequently, the vertebrae located near the fused portion will bear more pressure and strain. Also, the degeneration rate of that part of the spine may increase.

Spinal fusion may be done if you have:

• spine injury or fractures
• spine weakness or instability due to a tumor or an infection
• spondylolisthesis, which implies that the vertebrae slip forward
• abnormal curvatures
• arthritis

The following series of steps are performed to complete a spinal fusion procedure:

• the doctor will make a surgical cut (incision) to view the spine
• other surgery, such as a discectomy, laminectomy, or foraminotomy, is almost always done first
• the surgeon will use grafts so that the bones can fuse together
• the vertebrae may also be fixed together with rods, screws, plates, or cages to keep the vertebrae from moving until the bone grafts are fully healed

Spinal fusion can be performed:

• The patient lies down and the surgeon gains access to the spine by separating the muscles and the tissue.
• On the patient’s side if he or she has back surgery. The doctor separates the soft tissue and blood vessels with the aid of retractors and starts operating.
• On the front part of the neck, by making a cut.

The vertebrae can be fused together in different ways:

• the surgeon may place bone graft strips on the spine’s back
• bone graft material can be inserted between the patient’s vertebrae

The surgeon may get the bone graft from different places:

• from different parts of the body; typically, the pelvic bone area (autograft)
• from a bone bank (allograft)
• a synthetic bone substitute can also be used

The primary reason for most back surgeries is to get relief from back pain.

Spine fusion surgery comes with many additional benefits, including:

• increased activity
• better physical fitness
• improved mood
• less need for pain medicines with fewer drug side effects
• ability to go back to work
• increased productivity at work

However, not everyone experiences a reduction in back pain after surgery.

Because most back pain improves with time, surgeons recommend trying non-surgical treatments such as physical therapy before considering back surgery.

Spinal fusion is generally a safe procedure, but as with any surgery, it poses some potential risks such as:

• excessive bleeding
• blood clots
• infection
• vessel or nerve injury in the spine area
• pain in the area where the bone graft was extracted
• poor wound healing

Your spine will work differently after the surgery: the stress of the fused vertebrae will be placed on the adjacent areas. This can lead to additional damage and chronic pain due to the wearing and tearing of the vertebral joints located above and below the fusion.