Spinal fusion

Spine is a dynamic structure and by virtue of its alternating vertebrae bones and intervertebral disc provides mobility and stability. But at times this mobility between vertebrae is the cause of pain as in facet joint arthritis or disc/disk degeneration. Spondylolisthesis is another condition where pain is due to excessive mobility or instability caused by break in bony continuity between two vertebrae.

Whenever mobility is cause of spinal fusion is the preferred treatment. Mobility can be due to various reason like arthritis, infection, injury or degeneration of spinal elements. Spinal fusion is a process of eliminating this motion with bone grafting or fixation with implants or both.

Spinal-Fusion

This causes loss of normal mobility between vertebrae but most spinal fusions involve small segment of spine. Whatever loss of flexibility occurs is well compensated by increased mobility in neighbouring joints.

The principle behind spinal fusion is with the elimination of movement between the affected vertebra, the reason for pain is also eliminated.

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FAQs

Is a spinal fusion major surgery?

Yes, spinal fusion is a major surgery.

What are the different types of spinal fusion?

Spinal fusion is categorised based on if spine is fused from front(anterior) or back(posterior) or both. It is also named according to which part of spine is fused.

ACDF-Anterior cervical discectomy and fusion is done on neck part of the spine or the cervical spine
ALIF – Anterior lumbar interbody fusion is dine through the front on lumbar or lower back spine
LLIF – Lateral lumbar interbody fusion is done through side on the lower back spine
PLIF – Posterior lumbar interbody fusion is done from back at the lumbar level
TLIF – Transforaminal lumbar interbody fusion is fusion of the lumbar spine through the foramen for nerves

What is the success rate of spinal fusion surgery?

More than 80% of the patients report significant relief in pain after spinal fusion surgery. More than 90% patients feel satisfied after transforaminal lumbar interbody fusion (TLIF) of spine.

What is the recovery time for spinal fusion surgery?

After spine fixation surgery with or without bone grafting, it takes at least 4-6 months for the bones to fuse together. Pain relief is within few days and patient can resume his/her routine activities in about 2 weeks’ time.

When can one return to work after spine fusion surgery?

A person doing desk job can return to office within a month of spine surgery. Someone doing manual labour work should avoid doing heavy work for 2-3 months.

Which is better disc replacement or fusion?

Fusion is attempt to eliminate motion at the diseased part. Some pain may remain in case of incomplete fusion. Disc replacement simulates the natural movement between the vertebrae. Disc replacement is better at eliminating pain and preserving movement.

What is life like after spinal fusion?

Life gets better after pain elimination by spinal fusion.

Can you walk after spinal fusion surgery?

One can walk few days after spinal fusion, initially few steps a day. Patient easily recovers to be able to do home activities in less than 2 weeks’ time.

What are the dangers of spinal fusion?

Apart from general risks of infection and bleeding, spinal fusion surgery may in rare case damage nerves.

Can you bend after spinal fusion surgery?

Once the fusion is confirmed on x-ray one can return to active lifestyle and can bend, lift or twist. This usually takes 6 months to one year after spine fusion.

Is there an alternative to spinal fusion?

IDET or Intradiscal electrothermal coagulation (or annuloplasty) can be attempted as an alternative measure to spinal fusion.

What happens if a spinal fusion does not fuse?

There is always possibility of delay in formation of bone between the fused vertebrae. Till the time this happens implants in the form of screws hold bones in place to facilitate fusion.

What is one-level fusion?

When one disc space is obliterated with fixing two adjacent vertebrae is one-level spinal fusion. Similarly, when two disc space is fused is called two-level spinal fusion. Multiple levels can be fused depending on the involvement of spine.

Can spinal fusion hardware/implant be removed?

Implant is designed to be left in place for lifetime in spinal fusion. It is usually not removed unless it causes some discomfort to the patient. Besides removal of implant is another major surgery and has its own associated risks.