Spinal fusion is generally performed in three different ways. If the painful vertebrae are located in the neck, surgeons most prefer taking an anterior approach (from the front). If the painful vertebrae are located in the upper or lower back, surgeons may perform spinal fusion by taking an anterior approach, which involves an abdominal incision, a posterior approach (from the back), or a lateral approach (from the side). The type of surgical procedure depends upon the nature and location of the pain or disorder.
Different materials are used to permanently graft, or fuse, vertebrae together. A bone graft is used to help stimulate bone healing, as it increases bone production and helps the vertebrae heal together into a solid bone. Depending upon each patient’s health and medical condition, a surgeon will use one or more of the following materials when grafting vertebrae:
- Patient’s own natural bone may be placed between affected vertebrae or placed on the back part of the spine. The natural bone is usually taken from the hip or pelvic bone. Called autograft, this procedure is currently the gold standard in spinal fusion.
- Bone from a bone bank may be placed between affected vertebrae or placed on the back part of the spine. Called allograft, this procedure involves the use of natural bone materials from an unidentified donor.
- Synthetic bone substitute may also be placed between affected vertebrae or placed on the back part of the spine.
- Additional materials, such as cages, plates, rods and screws, may be used to help support vertebrae and to keep them from moving until the bone is fully healed.
Benefits of Spinal Fusion Surgery
When non-surgical treatment for chronic neck and back pain are no longer effective, spinal fusion is effective in lessening pain symptoms. As a result, patients may benefit from:
- Increased ability to participate in physical activity, resulting in improved physical health.
- Improved quality of life and mood.
- Reduced need for prescription medication, which reduces drug side effects experienced.
- Increased productivity at home and at work.
Risks of Spinal Fusion Surgery
As is the case with all types of surgeries, spinal fusion involves risks. Complications from surgery may include anesthesia problems, blood clotting, infection, nerve injury, device issues, etc. Always consult with a physician before committing to any type of surgical procedure to learn about specific surgical risks.
What to Expect Before Spinal Fusion Surgery
You may be required to undergo a medical examination and pre-surgical tests to determine the nature of your neck or back pain, and to determine if you are a viable candidate for spinal fusion. Tests may include blood and urine tests, heart checks, X-rays and diagnostic images of the affected area.
Diagnostic testing may include magnetic resonance imaging (MRI), computerized tomography (CT), and/or discography, a procedure in which dye is injected into the disc and further X-rays or CT scans are taken.
The surgeon will also review any medications that you are currently taking, and will outline what medications you should continue to take until the procedure. You will also be instructed to not eat or drink anything for a certain number of hours leading up to the procedure. You may also meet with an anesthesiologist to discuss your options.
What to Expect During Spinal Fusion Surgery
At the time of surgery, the surgeon will make an incision, taking either an anterior approach through the abdomen, a posterior approach in the back or a lateral approach through the side. The surgeon will surgically insert the chosen bone graft material(s) between affected vertebrae, and may incorporate additional materials (such as cages, plates, rods and screws) to hold vertebrae together. The incision will be closed, and you will be relocated to a recovery suite where you will be closely monitored by an experienced team of health care professionals.
What to Expect After Spinal Fusion Surgery
Following spinal fusion surgery, you will remain in the hospital for a few of days for continued close monitoring and pain management. In addition, a postoperative rehabilitation program may be recommended by your surgeon. You may also be advised to wear a brace for added support during the first few months after surgery.
The recovery period for spinal fusion is longer than other surgeries. This is due to the fact that the process of healing bone takes several months. However, your comfort level following surgery will continually improve as this time passes.
It is important to note that spinal fusion is designed to lessen pain symptoms, but may not eliminate pain completely. Maintaining a healthy lifestyle and following your doctor’s instructions will greatly increase your chances for a successful outcome.