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Spinal fusion surgery is a procedure in which bone graft material is placed between adjacent vertebrae. This promotes bone growth that fuses the two structures together. At Modern Spine in Houston, TX, our doctors will attempt to make the procedure as painless as possible, and utilize minimally invasive spine surgery techniques whenever it is suitable for the patient.
What is Spinal Fusion Surgery?
The purpose of spinal fusion surgery and fusing the two the two vertebrae together is to stop them from moving against each other. Bone grafts, or bone graft substitutes are placed between the affected vertebral bone, acting as a binding medium, and assisting in maintaining normal disc height. While the body is healing, the vertebral bone and bone graft will grow together overtime, to join the vertebrae and stabilize the spine.
Why Do I Need This Procedure?
Spinal fusion surgery may become necessary due to a variety of reasons. It is typically used to treat one of the following conditions:
- One or more fractured (broken) vertebrae
- Spondylolisthesis (slippage of one vertebral bone over another)
- Abnormal curvatures of the spine, such as scoliosis or kyphosis
- Protruding or degenerated discs (the cartilaginous “cushions” between vertebrae)
- Instability of the spine (abnormal or excessive motion between two or more vertebrae)
Spinal fusion surgery is typically an option that will be considered after conservative treatment has been attempted and not produced the desired results. A number of factors will be taken into account when determining if the surgery is a suitable option, including: your age, health condition, lifestyle, and anticipated level of activity following the surgery. The surgeons of Modern Spine will thoroughly discuss this treatment option with you if it is something you are considering.
How Is Spinal Fusion Performed?
There are a variety of approaches to spinal fusion surgery, but the commonality between all of them is the placement of bone graft material between the vertebrae. Depending on the individual needs of each patient, the graft material may be bone or a synthetic bone substitute. If bone will be used, it will either be taken from the patient (autograft) or from a bone bank (allograft).
The spine may be approached and the graft positioned either from the back (Posterior Lumbar Interbody Fusion [PLIF]), the front (Anterior Lumbar Interbody Fusion [ALIF]) or the side (Tranforaminal Lumbar Interbody Fusion [TLIF]). It also may be determined by your surgeon to utilize more than one approach. The surgeons of Modern Spine will discuss the best approach for your individual needs and condition.
Finally, an “internal cast” made up of instrumentation such as screws, plates or cages may be used to support the vertebral structure during the healing process.
Spinal Fusion: Traditional vs. Modern Approach
Spinal fusion surgery has been traditionally performed as an open procedure that involves making an incision, tripping bands of muscle and retracting muscle and tissue for a clear view of the spine and easy access to the vertebrae for implantation.
Autograft has been considered “the gold standard” in graft material. This procedure requires bone to be removed from an area of the patient’s body, typically the pelvis or iliac crest, which can be very painful. Alternatively, Allograft does not require this extra procedure, but healing often is not as predictable as with the patient’s own bone. BMP, a genetically produced protein, prompts the patient’s own bone cells to make more bone.
Modern spinal fusion can employ less invasive surgical techniques, such as muscle dilation, making the highly invasive posterior fusion approach unnecessary in many cases. Modern Spine utilizes minimally invasive spinal surgery whenever possible.
In minimally invasive treatment, muscle dilation is achieved by using a series of sequential dilators, or tubes to separate the fibers of the back muscles and create a small tunnel. This enables the surgeon to view the spine through an incision less than an inch long and leaving the muscle virtually intact. Advances in instrumentation allow rods and screws to be inserted via tiny incisions in the skin.
How Long Will It Take Me To Recover?
The recovery period after spinal fusion surgery varies, depending on the procedure and the ability of each patient’s body to heal, and firmly fuse the vertebrae together. It is typically recommended for the patient to stay in the hospital for several days after the surgery, however, the amount of time may be longer for more extensive surgeries. This may also include time in a rehabilitation unit. Your surgeon will prescribe pain medication as needed, and may recommend a brace and follow-up physical therapy.
The length of time you will be off work will depend on a number of factors, includuing: your particular fusion procedure and the physician’s approach to your spine, the size of your incision, and whether or not you experienced any significant tissue damage or complications. Amount of time off will also depend on the nature of the work that you plan on returning to. Typically, you can expect to be on medical leave for 3 to 6 weeks.
Work closely with your spinal surgeon to determine the appropriate recovery protocol for you, and follow his or her instructions to optimize the healing process.
Are There Any Potential Risks Or Complications?
All treatment and outcome results are specific to the individual patient, and so the results may vary from patient to patient. Some of the potential complications associated with spinal surgery include:
- Nerve damage
- Blood clots
- Blood loss
- Bowel and bladder problems
- Complications associated with anesthesia
A potential risk inherent to spinal fusion surgery is failure of the vertebral bone and graft to properly fuse. If this condition occurs, additional surgery may be required.
Please consult your physician for a complete list of indications, warnings, precautions, adverse effects, clinical results and other important medical information that pertains to a spinal fusion procedure.
The materials on this website are to provide general educational information only. Information you read on this website cannot replace the relationship that you have with your health care professional. We do not practice medicine or provide medical services or advice as a part of this website. You should always talk to your health care professional for diagnosis and treatment. Contact Modern Spine for additional information or to have any questions answered