What is spinal fusion?

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.
A spine fusion is a surgery that is done to link together two or more vertebrae. When there is a problem with the vertebrae (often a problem with the disc space), your doctor may recommend a spine fusion to eliminate the motion that occurs within that portion of the spine. By linking together the vertebrae, your doctor is trying to eliminate the source of your back problem. Spinal fusion may be recommended for:

· Abnormal curvature of the spine (scoliosis or kyphosis)

· Injury to the spinal vertebrae

· Protrusion of the cushioning disk between vertebrae (slipped disk, herniated nucleus pulposus)

· Weak or unstable spine caused by infections or tumors

Spinal fusion preparation

Before you and your doctor agree to surgery as an option, your doctor will want to make sure that youve given nonsurgical treatments a reasonable trial. Also, your doctor may conduct a study called a diskogram, which is a special X-ray examination that involves the use of a dye. The dye, injected into a disk, serves to make it appear better on an X-ray. The injection of dye also may produce a pain similar to your ongoing back pain, which helps your doctor pinpoint that disk as the source of your pain.

Spinal fusion-the surgery

Spinal fusion surgery requires general anesthesia. The procedure may take from two to 12 hours, depending on how extensive the surgery is and the technique your surgeon uses. Surgery may involve a large incision, or may be done using newer techniques with smaller incisions.

To fuse the spine, your doctor needs small pieces of extra bone to fill the space between two vertebrae. This bone may come from your own body (autogenous bone), usually from a pelvic bone. Or, it may come from another person (allograft bone) by way of a bone bank. If the front of your spine is fused, the disk is removed first. Bone graft substitutes, such as genetically engineered proteins, are being developed as alternatives to using bones from your body or a bone bank. Sometimes, doctors also use wires, rods, screws, metal cages or plates. As with any surgery, spinal fusion carries risks, including pain at the donor site for the bone, infection and nerve injury.

Spinal fusion recovery

Expect to be in the hospital for several days after surgery. Youll also likely experience considerable pain and discomfort after surgery, but your doctor will control pain 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, the fused spine needs to be kept in proper alignment. Youll be taught how to move, sit, stand and walk in a manner that keeps your spine properly aligned. You may be able to start a physical rehabilitation program as early as about four weeks after spinal fusion surgery.

Set realistic expectations

Beyond the immediate potential risks of spinal fusion surgery, the areas of your spine adjacent to the fusion will bear more stress. This makes those areas more likely to experience future wear and tear. Also, like any treatment for back pain, dont expect spinal fusion to eliminate your pain — just to improve it. For example, if your level of pain on a scale of 0 to 10 was a 7 before surgery, your doctor might regard a reduction to a pain level of 3 or 4 to be a successful result.

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