Spinal fusion

Definition

Spinal fusion is surgery to permanently join together two or more bones in the spine so there is no movement between them. These bones are called vertebrae.

Alternative Names

Vertebral interbody fusion; Posterior spinal fusion; Arthrodesis; Anterior spinal fusion; Spine surgery - spinal fusion

Description

You will be asleep and feel no pain (general anesthesia).

The doctor will make a surgical cut (incision) to view the spine. This may be done:

Other surgery, such as a diskectomy, laminectomy, or a foraminotomy, is almost always done first.

The surgeon will use a graft (such as bone) to hold (or fuse) the bones together permanently. There are several ways of fusing vertebrae together:

The surgeon may get the graft from different places:

The vertebrae may also fixed together with rods, screws, plates, or cages. They are used to keep the vertebrae from moving until the bone grafts are fully healed.

Surgery can take 3 to 4 hours.

Why the Procedure Is Performed

Spinal fusion is most often done along with other surgical procedures of the spine. It may be done:

Spinal fusion may be done if you have:

You and your doctor can decide when you need to have surgery.

Risks

Risks of any surgery are:

Risks of spine surgery are:

Before the Procedure

Tell your doctor or nurse what medicines you are taking. These include medicines, herbs, and supplements you bought without a prescription.

During the days before the surgery:

On the day of the surgery:

After the Procedure

You will stay in the hospital for 3 to 4 days after surgery.

You will receive pain medicines in the hospital. You may take pain medicine by mouth or have a shot or an intravenous line(IV). You may have a pump that allows you to control how much pain medicine you get.

You will be taught how to move properly and how to sit, stand, and walk. You will be told to use a "log-rolling" technique when getting out of bed. This means that you move your entire body at once, without twisting your spine.

You may not be able to eat for 2 to 3 days. You will be given nutrients through an IV. When you leave the hospital, you may need to wear a back brace or cast.

Your healthcare team will tell you how to take care of yourself at home after spine surgery. Follow instructions on how to take care of your back at home.

Outlook (Prognosis)

If you had chronic back pain before surgery, you will likely still have some pain afterward. Spinal fusion is unlikely to take away all your pain and other symptoms.

It is hard for a surgeon to predict which patients will improve and how much relief surgery will provide, even when using MRI scans or other tests.

Losing weight and getting exercise increases your chances of feeling better.

Future spine problems are possible after spine surgery. After spinal fusion, the area that was fused together can no longer move. Therefore, the spinal column above and below the fusion are more likely to be stressed when the spine moves, and may have problems later on.

References

Daubs MD, Norvell DC, McGuire R, et al. Fusion versus nonoperative care for chronic low back pain: do psychological factors affect outcomes? Spine. 2011;36:S96-109.

Weinstein JN, Tosteson TD, Lurie JD, et al. Surgical versus nonoperative treatment for lumbar spinal stenosis four-year results of the Spine Patient Outcomes Research Trial. Spine. 2010;35(14):1329-38.

Wood GW III. Arthrodesis of the spine In: Canale ST, Beaty JH, eds. Campbell’s Operative Orthopaedics. Philadelphia, Pa: Elsevier Mosby; 2012:chap 39.