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Spinal Fusion Methods

A spinal fusion corrects problems with vertebrae in the back by fusing bone together and eliminating motion (see Reference 1). The procedure has many risks to be balanced with potential benefits and must be thoroughly discussed with an orthopedic surgeon.

  1. Indications

    • Orthopedic surgeons can perform spinal fusions on patients with conditions such as back pain, spinal stenosis, spondylolisthesis, scoliosis and bone fractures who do not respond to more conservative methods (see Reference 2).

    Methods

    • Surgical incisions can take place from the front (anterior) or the back (posterior) of the patient. The disc is usually removed first (diskectomy), along with bone spurs on the spine (laminectomy) and widening of the spinal column (foraminotomy) to relieve pressure on spinal nerves (see Reference 3).

      In one form of spinal fusion, the surgeon takes extra pieces of bone from the patient's pelvic bone or a bone bank and places them between the vertebrae. Bone graft substitutes are still being developed and are not widely used. Another form of fusion involves packing bone fragments into titanium or carbon fiber interbody cages attached to the vertebrae. The surgeon can then insert pedicle screws to provide additional strength to the area (see references 2 and 5).

      The procedure takes about three hours but can last as long as 12 hours. Patients grow new bone and develop the fusion of the vertebrae by the third month after surgery (see Reference 4).

    Risks

    • Problems can be severe and include blood clots, infection, heart attack, stroke and damage to the spinal nerve. Additionally, pain is not always relieved by a spinal fusion (see Reference 4).

    Post-Surgery

    • According to the North American Spine Society (see Reference 3), the pain from a spinal fusion is often greater than with other spinal surgeries. Patients usually stay in the hospital for a few days to better manage pain and reduce associated surgical risks. Sometimes, surgeons require patients to wear a stiff back brace for several weeks after the fusion. As healing occurs, the patient must learn new movement techniques, such as "log-rolling" out of bed, to avoid injury (see Reference 2).

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