Back (spinal) fusion
What is back (spinal) fusion surgery?
Spinal fusion is a surgical procedure to permanently join two or more spinal vertebrae, ultimately eliminating motion between them.
Spinal fusion procedures are very similar to the normal healing process of fractures. During spinal fusion, the surgeon puts bone pieces or a bonelike artificial material within the space between two spinal vertebrae. Implants like metal plates, screws and rods may be used to fix the vertebrae together, so that they can unite into one solid unit.
Why is back (spinal) fusion surgery done?
Spinal fusion permanently connects two or more vertebrae in your spine in order to improve stability, correct any deformity or reduce arthritic pain. Doctors recommend spinal fusion to treat:
- Deformities of the spine. Spinal fusion can help correct various spinal deformities, such as a sideways curvature of the spine (scoliosis) or forward curvature (kyphosis).
- Spinal instability or weakness. Your spine may have abnormal or excessive motion between two vertebrae, it becomes unstable. Severe arthritis in the spine gives rise to this type of unstable spine. Spinal fusion can help restore spinal stability in such cases.
- Herniated disk. Spinal fusion may also be used to stabilize the spine after excision of a damaged (herniated) intervertebral disk.
Risks in back (spinal) fusion surgery
Spinal fusion is quite a safe procedure in the hands of experienced surgeons in India. But as with any surgical procedure, spinal fusion carries the potential risk of complications:
- Poor wound healing
- Blood clots
- Injury to arteries, veins or nerves in and around the spine
- Pain at the site from where the bone graft is taken
- Implant loosening and failure
During spinal fusion
Surgeons perform spinal fusion while you’re made unconscious by putting you under general anesthesia during the procedure. Surgeons use a variety of techniques for performing spinal fusion surgery. The technique your surgeon performs depends on the location of the vertebrae to be fused, the reason for the spinal back fusion, and in some cases, your general health and body shape.
Generally, the following procedure involves:
- Incision. To gain access to the vertebrae being fused, the surgeon makes a cut in either of three places: in your back or neck directly over your spine, on either side of spine, or in abdomen or throat so that your surgeon can access the spine from the front.
- Bone graft preparation. The bone grafts are bone chips that actually fuse two vertebrae together may be acquired from a bone bank or from your own body, usually from the pelvis. If your own bone is used, the surgeon makes an incision at your pelvic bone, removes a small chunk of it and then closes the incision.
- Fusion. To fuse the vertebrae permanently, the surgeon puts the bone graft material between the vertebrae. Metal plates, screws or rods are used to help fix the vertebrae together while the bones fuse.
In a few cases, some surgeons can use a synthetic substance instead of bone grafts. These synthetic substances promote bone growth and speed up the fusion of the vertebrae.
Back (spinal) fusion recovery
A hospital stay of only a few days is usually required following spinal fusion. You may suffer some pain and discomfort depending upon the location. The pain is controllable with medications.
Once you are back home, reach your doctor if you show signs of infection, such as:
Redness, tenderness or swelling
- Wound drainage
- Shaking chills
- Fever higher than 100.4 F (38 C)
It usually takes several months for the affected bones in the spine to heal and fuse together. Your doctor may recommend a brace for you to wear for a time to keep your spine aligned. Physical therapy will help teach you how to move, sit, stand and walk so to keep your spine properly aligned.
Results back (spinal) fusion surgery
Spinal fusion is usually an effective treatment for fractures, deformities or instability of the spine. But when the cause of pain is not clear, study results are more mixed. And in many cases, spinal fusion is no more effective than nonsurgical conservative methods of treatments for nonspecific back pain.
At times it can be difficult to pinpoint what exactly is causing your back pain, even if a herniated disk or bone spurs are seen on your scans. Many people are found to have X-ray evidence of back issues that actually never caused them any pain. So your pain may not be associated with findings revealed on your imaging scans.
Even though spinal fusion provides symptomatic relief, it does not avoid you from developing more back pain in the future. Most of the age related degenerative conditions in the spine are caused by arthritis, and surgery cannot cure your body of that disease.
Immobilizing or fusing a section of your spine causes additional stress and strain on the areas around the fused portion. This might increase the rate at which other areas of your spine degenerate — so you may need more spinal surgery in the future.