Spinal fusion is surgery to permanently join together two or more bones (vertebrae) in the spine so there is no movement between them.
Spinal fusion is a surgical procedure that helps to relieve pain in the vertebrae (small bones of the back). Vertebrae pain can be associated with a variety of conditions, including degenerative disk disease, spinal stenosis, scoliosis, fracture, infection, and tumor.
Spinal fusion is typically undertaken when a precise source of pain (i.e., specific vertebrae) can be identified using imaging tests such as x-rays, CT scans or MRIs.
During spinal fusion, small pieces of bone called bone grafts are placed between painful vertebrae, and the vertebrae are essentially “welded” or fused together. The inserted bone grafts increase bone production and the vertebrae subsequently heal together into a single solid bone.
Bone grafts can be acquired from a variety of sources. Historically, autografts (bone grafts acquired from the patient’s hip) was the only option for spinal fusion. However, acquiring autografts lengthens the surgery, and can also increase pain after the procedure. Today, a variety of alternative bone graft options (both natural and artificial) have been developed.
Depending on the nature and location of pain, a variety of techniques and approaches may be used to fuse the spine.
Some spinal surgeries require an anterior approach, which means that the procedure is performed through an incision in the lower abdomen. Other spinal fusions are performed from the side, which is called a lateral approach. Posterior surgeries, performed from the back, may also be required.
After surgery, the fusion process takes time, usually several months. To help the process, vertebrae need to be held together, and patients may need to wear a brace. In many cases, plates, screws, and rods – what is referred to as internal fixation – will also be used to keep the spine from moving.
During this initial recovery period, activity level will naturally be limited. Patients are taught how to move properly, reposition, sit, stand and walk. However, slowly over time, activity levels are able to be increased, and patients’ lives can return to normal.
Spinal fusion eliminates motion between vertebrae, and also prevents the stretching of tissues and nerves that surround vertebrae. By preventing motion and movement, pain can be alleviated.
Fusion surgery may also take away some flexibility, but typically the procedure does not limit motion drastically because most surgeries involve only small segments of the spine.
Because there are so many things to consider when spinal fusion is recommended, it is best to discuss the procedure with a spine care specialist at the Florida Spine Institute before making a decision.
References
Spinal fusion. American Academy of Orthopaedic Surgeons (2010). Available at: http://orthoinfo.aaos.org/topic.cfm?topic=a00348. Last accessed December 26, 2014.
