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Spinal Fusion and What's Involved

Spinal fusion is surgery to fuse spine bones (vertebrae) that cause you to have back problems. Fusing means two bones are permanently placed together so there is no longer movement between them. Spinal fusion is usually done along with other surgical procedures of the spine.

Spinal fusion may be recommended for:

  • Treatment for spinal stenosis
  • After diskectomy in the neck
  • Injury or fractures to the bones in the spine
  • Weak or unstable spine caused by infections or tumors
  • Spondylolisthesis, a condition in which one vertebrae slips forward on top of another - Abnormal curvatures, such as those from scoliosis or kyphosis

In order to decide whether or not spinal fusion is the right option for you, it is important to understand the procedure. First, you will be asleep under general anesthesia. Your surgeon has several choices about where to make the first incision.

The surgeon may make an incision on your back or neck over the spine. Muscles and tissue are separated to expose the spine.

The surgeon may make a cut through one side of your belly (for surgery on your lower back). The surgeon will use tools called retractors to gently separate, hold the soft tissues and blood vessels apart, and have room to work.

The surgeon may make the cut on the front of the neck, toward the side.

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

  • Strips of bone graft material may be placed over the back part of the spine.
  • Bone graft material may be placed between the vertebrae
  • Special cages may be placed between the vertebrae. These cages are packed with bone graft material.

The surgeon may get the graft from another part of your body (usually around your pelvic bone). This is called an autograft. Your surgeon will make a small cut over your hip and remove some bone from the back of the rim of the pelvis. In some cases, the bone may come from an allograft, a bone bank. Finally, the surgeon may decide to use a synthetic bone substitute, but this is not common yet.

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

Spine surgery will often provide full or partial relief of symptoms. Although future spine problems are possible for all patients 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 is more likely to be stressed when the spine moves, and have problems later. Also, if you needed more than one kind of back surgery (such as laminectomy and spinal fusion), you may have more of a chance of future problems.

As with any surgery there are certain risks involved. It is important to talk with your doctor about what treatment plan is right for you.