What is Spinal Fusion Surgery?
Spinal fusion is a surgical procedure that involves placing pieces of bone in between two vertebrae. This is done to fuse the two segments together to eliminate movement between them, and relieves the patient of pain and other symptoms of degenerative disc disease, as well as other conditions like deformity, instability, or a spinal break that can cause similar symptoms. The bone fragments are kept in place by a mechanism consisting of rods, screws, and cylinders.
It takes several months for the segments to fuse together, but when they do, the spine becomes stable and immobile. This helps in greatly reducing or eliminating chronic back pain, and pain in extremities like the legs or arms. When the bones fuse together, it cannot be undone. This is why it is recommended to try traditional non-surgical methods first before deciding on proceeding with this type of surgery.
Ideal Candidates for Spinal Fusion
This procedure is very helpful in treating symptoms of degenerative disc disease and other conditions that produce the same symptoms; however, not all patients suffering from these conditions can be considered candidates for surgery. In order to determine whether or not a patient is a good candidate, surgeons have to consider several factors. The first and most important factor is the patient’s medical history. A patient must be in good overall health in order to withstand this procedure.
The surgeon will also have to determine the cause of the pain, and see if other less invasive methods would work before recommending surgery. Another determining factor are the results of physical and diagnostics exams. Different spinal conditions may present with the same symptoms, but this does not mean they can be treated the same way. Patients who are looking to undergo this procedure must first go through a series of tests in order to determine if this particular surgery is the right course of action.
How the Procedure is Done
Spinal fusion is done under general anesthesia and lasts approximately 4 hours or more, depending on the extent of the damage within the spine and whether other procedures may be needed to ensure that the nerves in the spine are protected. The surgeon can either access the spine from the abdomen or through the patient’s back, depending on the location of the affected vertebrae.
For fusion of the cervical vertebrae, an incision is made in the front of the neck. For lumbar and thoracic vertebrae, the patient lays face down on the operating table, and an incision is made down the middle of the patient’s back. Using a retractor, surgeons must work their way through layers of muscles, tissue, organs, and veins in order to expose the vertebrae. The surgeons identify the segments that need fusion by utilizing a fluoroscopy and x-ray images
At this point, herniated disc fragments, bone spurs, and tissue may be removed to decompress the spinal nerves before inserting the bone grafts in the space between the two affected vertebrae. The bone fragments are usually harvested from the patient’s pelvic bone, lamina, or tail bone. While the harvesting can happen during surgery, surgeons may opt to harvest the bone fragments ahead of time if the patient is weaker, to prevent keeping the patient on the operating table for too long. Once the bone fragments are in place, they are held together by screws, rods, and cylinders to help keep them in place until the bone segments fuse.
This procedure is considered a major surgery, and the effects are permanent. In order to help you make the best informed decision, our excellent surgeons are willing to speak with you about spinal fusion surgery, and help you decide whether it’s right for you.