Spine Fusion | Spine Surgery
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    Spinal fusion was formerly used primarily for conditions such as scoliosis and other spinal deformities. Today, it has become increasingly popular for treating low back pain. Spinal fusion has been used as a treatment for what's called discogenic pain — pain originating in the area of a particular disk and without involving leg pain (sciatica). If the cause of your back pain seems to be motion between segments of your vertebrae, spinal fusion may be a way to prevent motion and stop the pain. Spinal fusion involves permanently connecting or "welding" two or more vertebrae together.

    BRIEF ABOUT THE PROCEDURE

    Spinal fusion surgery is done under general anesthesia. The procedure may take from 2 to 12 hours, Spine Fusiondepending on how extensive the surgery is and the technique used. Surgery may involve a large incision, or may be done using newer techniques with smaller incisions.

    Small pieces of extra bone are used to fill the space between two vertebrae to fuse the spine. This bone if harvested from the patients own body is usually taken from a pelvic bone. The disc is first removed if the front of the spine needs to be fused. Bone graft substitutes, such as genetically engineered proteins, are being developed as alternatives to using bones from your body or a bone bank. The surgeon may also use wires, rods, screws, metal cages or plates to stabilise the spine as desired. As with any surgery, spinal fusion carries risks, including pain at the donor site for the bone, infection and nerve injury.

    There are different types of spinal fusion.

    Anterior inter-body spinal fusion is performed via an incision in a patient's abdomen. The vertebral bodies are approached from the front and a femoral ring (cadaver bone), or cylindrical cage, is placed between the two vertebral bodies. The femoral ring or cage instrumentation is filled with bone graft usually obtained from the patient's hip. If fusion is successful, motion between the vertebrae will stop and any pain caused by abnormal motion between those vertebrae will no longer exist.

    Posterior spinal fusion, sometimes referred to as a post-erolateral spinal fusion, is performed from an incision made in the back. The procedure entails roughening the surfaces of the transverse processes and inserting bone graft between the transverse processes. The bone is usually obtained from a patient's hip. If fusion is successful, motion between the fused segments will stop and any pain caused by abnormal motion between those vertebrae will no longer exist.

    A spine fusion is a surgery performed to link together individual segments, or vertebrae, within the spine. The spinal column, or backbone, is made up of individual bones called vertebrae. These bones are stacked together. Between each of the vertebrae is a soft cushion called a disc. The disc spaces allow each vertebrae to bend slightly; this motion allows us to bend forward and arch backwards.

    Spinal instrumentation may be recommended as part of the process to perform spine fusion. The type chosen will depend on the age, the number of levels and the underlying problem.

    SOME ASSOCIATED RISKS

    Risksspine fusion

    There are several concerns with spine fusion surgery, among the concerns of surgery are:

    • The segments do not fuse.One of the most difficult parts of spine fusion surgery is the difficulty to get the new bone to grow. There are ways to stimulate bone growth in spine fusion surgery. The possibilities to stimulate bone growth include using extra bone from the pelvis (autograft) to stimulate new bone growth, using bone chips from a donor (allograft), or using a manufactured bone substitute
    • The vertebrae and discs next to the spine fusion develop problems. This problem tends to develop years after the surgery. This occur when the segments next to the fusion have more forces applied and leads to 'adjacent level' degeneration
    • Other risks of spine fusion include blood loss and infection. The potential for one of these complications depends on the extent of the surgery being performed

    You should discuss these possible problems with your doctor.

    The other complication which concerns many people is the possibility of damage to the spinal cord or the nerves which exit the cord. Again, these risks will vary depending on the type of surgery being performed. While the majority of patients will improve following spine fusion surgery, there are potential risks.

    TIPS ON RECOVERY

    Hospital stay for several days is needed after surgery. There would be considerable pain and discomfort after surgery, the same may be controlled with oral and intravenous medications. It takes from several weeks to several months to heal from this surgery, depending on your age, condition and what level of activity you plan to return to. The type of healing that needs to occur after spinal fusion is comparable to recovery from a broken bone. The earliest that X-rays might reveal bone healing after spinal fusion is about six weeks.

    Spinal fusion removes some spinal flexibility. This can be beneficial if movement and instability between spinal segments is what causes your pain. 
    However to maintain the fused spine in proper alignment the patient would be adviced on sitting, walking and standing postures.  Rehabilitation program may start as early as about four weeks after spinal fusion surgery.

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