Definition
A spinal fusion is a surgery to weld together two vertebrae. Vertebrae are the bones that make up the spine.
Reasons for Procedure
To treat persistent pain and disability caused by:
- Spinal stenosis (narrowing of the canal that the spinal cord runs through)
- Spinal injury
- Spondylolisthesis (vertebra is out of line with the others)
- Scoliosis (abnormal curve in the spine)
- Weak or unstable spine, usually due to infection or tumors
- Herniated disk
Spinal fusion may be done if the treatments below do not relieve pain and disability:
- Rest
- Pain medicines
- Muscle relaxants
- Physical therapy
- Injection of drugs to relieve pain and swelling
- Massage
- Bracing
- Behavior change therapy
Imaging tests must also show a problem that can be fixed with this procedure.
Possible Complications
Complications are rare, but no procedure is completely risk-free. If you are planning to have a spinal fusion, your doctor will review a list of possible complications. These may include:
- Bleeding
- Infection
- Incomplete fusion of the bones
- Blood clots
- Hematoma (build-up of blood in the wound)
- Nerve damage causing pain, numbness, tingling, or paralysis
- Impaired bowel and/or bladder function
- Reaction to anesthesia
Factors that may increase the risk of complications include:
What to Expect
Prior to Procedure
Your doctor may do the following:
- Physical exam, especially of the back and neck
- X-ray—a test that uses radiation to take a picture of structures inside the body, especially bones
- MRI—a test that uses magnetic waves to make pictures of the spinal nerves and disks between vertebrae
- Myelogram—a type of x-ray that uses dye inserted near the spinal cord to show if there is pressure on the cord or the nerves
- Possibly a CT scan—a type of x-ray that uses a computer to make pictures of the bones of the spine
Before your surgery:
-
Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:
- Aspirin or other anti-inflammatory drugs
- Blood thinners, such as clopidogrel (Plavix) or warfarin (Coumadin)
- Arrange for a ride home and for help at home.
- Eat a light meal the night before. Avoid eating or drinking anything after midnight.
Anesthesia
General or spinal anesthesia may be used. With general anesthesia, you will be asleep. Spinal anesthesia will numb an area of your body, but you will be awake.
A metal cage filled with bone graft is placed between lumbar vertebrae.
Copyright © Nucleus Medical Media, Inc.
Description of Procedure
Your doctor will make an incision in your back or neck. The muscles will be spread to access the spine. Your doctor may fuse the bones with either:
- Grafts made from pieces of bone or bony material (the pieces of bone may be taken from the pelvis [hip])
- A small metal cage filled with bone graft material (the cage may be placed between the spinal bones)
Your doctor will implant screws and plates or rods to hold the bones in place while they fuse together. The incision will be closed with stitches or staples.
How Long Will It Take?
4-6 hours (sometimes longer)
How Much Will It Hurt?
Anesthesia will prevent pain during surgery. You will receive medicine after surgery to help manage pain.
Average Hospital Stay
3-4 days (sometimes less, sometimes more, depending on age, overall health, and extent of surgery)