What Is a Spinal Fusion?

Vertebrae in the back are fused together during a spinal fusion.

During a spinal fusion, two or more vertebrae in the back are fused together. This surgical procedure helps treat various types of spine and back problems. It may be performed on the cervical vertebrae (upper back) or the lumbar vertebrae (considered the lower back). The procedure decreases range of motion, but reduces pain.

Indications

Spinal-fusion surgery may be recommended to treat various types of problems with the vertebrae, after less invasive treatments have failed to work effectively. Conditions that can cause pain in the vertebrae include a herniated disk or injury to the vertebrae from an accident. Spinal-fusion surgery may be used to treat scoliosis, a medical condition that causes a curvature in the spine. In patients who develop tumors in the back, the spine may weaken and a spinal fusion may be used to strengthen and stabilize the spine.

Procedure

The surgery is usually performed under general anesthesia. Incisions are made over the back to allow the surgeon to view the spine. In a bone graft, bone will be used to fuse the vertebrae together. It may be placed in between the vertebrae or over the spine. Bone can be used from the patient and is primarily taken from the patient's pelvic bone. Donor bone acquired from a bone bank may be used instead. Screws and metal plates may also be used to help keep the vertebrae fused. The procedure may take several hours depending on the extent of the fusion.

Risk

As with other types of surgery, risks may include a blood clot or an excess loss of blood. Complications from general anesthesia are also a possibility, although not common. An infection can occur around the incision site or in the vertebrae itself. Another risk is nerve damage in the spine, which can cause complications such as bladder and bowel problems. Problems with the part of the spine directly above or below the fusion may also occur, according to the University of Maryland Medical Center.

Recovery

Spinal-fusion recovery depends on the overall health of the patient and condition being treated. According to the Mayo Clinic, pain is common after surgery and patients are likely to remain in the hospital for several days. Patients may need to wear a back brace while they recover. Since the procedure decreases some flexibility, patients will need to learn how to keep the spine in correct alignment while walking and sitting. A physical therapy and rehabilitation program will usually be recommended about a month after a spinal fusion.

Considerations

Although pain will likely be reduced, it may not be completely eliminated after a spinal fusion. Keeping fit and maintaining a healthy weight helps lingering pain. Because areas of the spine above or below the fusion may be placed under added stress after surgery, those areas may begin to cause pain. According to the Mayo Clinic, in about 20 percent of patients, an additional spinal fusion may be needed eventually on other vertebrae in the back.

References

• American Association of Orthopedic Surgeons
• University Of Maryland Medical Center
• Mayo Clinic