For individuals with chronic and severe back pain, spinal fusion surgery may be a viable treatment option. The procedure uses medical hardware and bone graft technology to connect two adjacent vertebrae. Over time, these vertebrae grow together and can no longer move relative to each other; in effect, a new bone structure consisting of both vertebrae is formed in the spinal column. Spinal fusion can be used to treat an extensive range of disorders and injuries that can cause back pain, including:
• Spinal stenosis
• Degenerative disc disease
• Herniated discs
• Spondylosis or spondylolisthesis
• Injuries and fractures
• Congenital or acquired deformities of the spine
• Age-related deterioration of joints and discs
Additionally, spinal fusion may be required after surgical procedures used to treat infections, tumors of the spinal column or other related conditions. These surgeries are intended to reduce the pain of patients and can provide increased mobility in many cases.
Spinal Fusion Techniques
The underlying principles of spinal fusion surgery are consistent throughout most procedures.
• A bone graft is acquired from the patient or from another source and is placed between the two vertebrae to be fused. This bone graft provides a direct link between the adjacent vertebrae that allows the two to grow together naturally.
• Metal pins and connectors connect the two vertebrae manually and keep them immobile in relation to each other. This helps to encourage the growth of the bone graft and prevents the connection from being broken while the bone growth process continues.
In most cases, the bone graft is taken from the patient's pelvic bone area, but donor grafts may be used if this is not feasible. Surgeons typically use one of two approaches to the spinal fusion surgery.
• Interbody fusion positions the bone graft material between the two vertebrae as a replacement for the disc normally found there. The disc is removed during the procedure, and pins are used to hold the two vertebrae together during the fusion process.
• Posterolateral fusion methods join the transverse processes located at the back of each vertebra; bone grafts are placed between these protrusions, leaving the disc intact and connecting only the bones of the pedicles with metal pins or wires.
Both traditional open-spine surgeries and minimally invasive surgical techniques are used to achieve spinal fusion. In most cases, minimally invasive procedures offer reduced recovery times due to the smaller incision and decreased tissue damage. However, the overall recovery period can last as long as two years regardless of which type of surgery is chosen.
What to Expect After Surgery
Patients typically must wear a back brace for an extended period after spinal fusion surgery. Orthopedic surgeons and physicians generally recommend a number of precautionary measures during the recovery period. Patients should avoid smoking, heavy lifting, strenuous exercise and other high-impact activities. Instead, gentle stretching and less intensive fitness training can provide significant benefits and increase flexibility during the healing process.
Spinal fusion surgery can provide relief for individuals suffering from chronic lower or upper back pain. However, this surgery is not right for everyone. Patients who are considering spinal fusion as a solution for their back pain problems should consult their physician or orthopedic surgeon to discuss options for achieving real relief from their symptoms.
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