What is Spinal Fusion Surgery?

Spinal fusion is a surgical technique in which one or more of the vertebrae of the spine are joined together (fused) to stop them from moving against each other. This is done by placing bone grafts or bone graft substitutes between the affected vertebral bone. The graft material acts as a binding medium and also helps to maintain normal disc height – as the body heals, the vertebral bone and bone graft eventually grow together to join the vertebrae and stabilize the spine.

What is Lumbar Spinal Fusion?

The goal of the lumbar fusion is to have the two vertebrae fuse (grow solidly together) so that there is no longer any motion between them. Removing the intervertebral disc or bone spurs can reduce some of the pressure on the nerves, helping to reduce pain. Additionally, by fusing the two vertebrae together this will stop the formation of bone spurs at that location, further reducing pain and potential nerve injury.

There are many different specific techniques to try to fuse the vertebrae together. Spinal fusion surgery can be performed either through an incision in the back, the abdomen, or a combination of both. In many cases metal screws and rods are placed from the back into the bones to hold them steady while the fusion occurs. During an interbody spinal fusion surgery, the surgeon removes the intervertebral disc and places either a piece of bone or a metal or plastic cage in its place. The decision on what type of fusion is best for each patient is based on their specific complaints and the cause of symptoms. Spinal fusion can be very effective in the properly selected patient.

Why Do I Need Spinal Fusion Surgery?

There are a number of reasons your surgeon may recommend spinal fusion. This procedure is frequently used to treat

  • One or more fractured (broken) vertebrae
  • Spondylolisthesis (slippage of one vertebral bone over another)
  • Abnormal curvatures of the spine, such as scoliosis or kyphosis
  • Protruding or degenerated discs (the cartilaginous “cushions” between vertebrae)
  • Instability of the spine (abnormal or excessive motion between two or more vertebrae)

Spinal fusion surgery is typically recommended only after conservative treatment methods fail. Your surgeon will take a number of factors into consideration before making this recommendation, including the condition to be treated, your age, health and lifestyle and your anticipated level of activity following surgery. If you are considering spinal fusion, please discuss this treatment option thoroughly with your spinal care provider.

How Is Spinal Fusion Performed?

There are a variety of surgical approaches and procedures, but all involve the placement of bone graft material between vertebrae. The graft material may be bone – either taken from the patient (autograft) or from a bone bank (allograft) – or a synthetic bone substitute called bone morphogenetic protein (BMP).

The spine may be approached and the graft positioned either from:

  • The back (Posterior Lumbar Interbody Fusion [PLIF])- This procedure is done from the back and includes removing the disc between the two vertebrae and inserting bone into the space created between the two vertebral bodies.
  • The front (Anterior Lumbar Interbody Fusion [ALIF])- This procedure is done from the front and includes removing the disc between the vertebrae and inserting bone into the space created between the two vertebral bodies.
  • Anterior/Posterior spinal fusion- this procedure is done from the front and back.
  • The side (Tranforaminal Lumbar Interbody Fusion [TLIF])

Your surgeon also may decide that more than one approach is necessary. Please discuss your fusion approach options thoroughly with your surgeon,and rely on his or her judgment about which is most appropriate for your particular condition.

Instrumentation, such as screws, plates and cages, may be used to create an “internal cast” to support the vertebral structure during the healing process.

How Long Will It Take Me To Recover?

The recovery period for spinal fusion will vary depending on the procedure and your body’s ability to heal and firmly fuse the vertebrae together.

Patients typically stay in the hospital for several days, longer if necessary for more extensive surgery. This may also include time in a rehabilitation unit. Your surgeon will prescribe pain medication as needed, and may recommend a brace and follow-up physical therapy.

The length of time you will be off work will depend on a number of factors: your particular fusion procedure and the physician’s approach to your spine, the size of your incision, and whether or not you experienced any significant tissue damage or complications.

Work closely with your spinal surgeon to determine the appropriate recovery protocol for you, and follow his or her instructions to optimize the healing process.

Are There Any Potential Risks Or Complications?

All treatment and outcome results are specific to the individual patient. Results may vary.

Please consult your physician for a complete list of indications, warnings, precautions, adverse effects, clinical results and other important medical information that pertains to a spinal fusion procedure.