Spine Fusion Surgery

Spinal fusion is a procedure that promotes the fusing, or growing together, of two or more vertebrae in the spine.

A spinal fusion surgery is designed to stop the motion at a painful vertebral segment, which in turn should decrease pain generated from the joint. All lumbar spinal fusion surgery involves adding bone graft to an area of the spine to set up a biological response that causes the bone graft to grow between the two vertebral elements and thereby stop the motion at that segment.conditions that may be treated by a spinal fusion surgery include :

 Degenerative disc disease
 Isthmic, degenerative or postlaminectomy spondylolisthesis.A weak or unstable
spine (caused by infections or tumors), fractures, scoliosis or deformity

A spine fusion surgery involves using bone graft to cause two vertebral bodies to grow together into one long bone. Bone graft can be taken from the patient's hip (autograft bone) during the spine fusion surgery, or harvested from cadaver bone (allograft bone). Synthetic bone graft substitutes are also in development, and one type—bone morphogenic proteins (which helps the body create bone)—is currently being used for certain fusion procedures.

Types of Spinal Fusion :

There are two main types of lumbar spinal fusion, which may be used in conjunction with each other:

1. Posterolateral fusion places the bone graft between the transverse processes in the back of the spine. These vertebrae are then fixed in place with screws and/or wire through the pedicles of each vertebrae attaching to a metal rod on each side of the vertebrae.


2. Interbody fusion places the bone graft between the vertebra in the area usually occupied by the intervertebral disc. In preparation for the spinal fusion, the disc is removed entirely. A device may be placed between the vertebra to maintain spine alignment and disc height. The intervertebral device may be made from either plastic or titanium. The fusion then occurs between the endplates of the vertebrae. Using both types of fusion is known as 360-degree fusion. Fusion rates are higher with interbody fusion. Two types of interbody fusion are : 1. Anterior lumbar interbody fusion (ALIF)- an anterior abdominal incision is used to reach the lumbar spine. 2. Posterior lumbar interbody fusion (PLIF) - a posterior incision is used to reach the lumbar spine.

These complications are most likely to occur during the first few weeks after surgery.

1. Swelling in the calf, ankle or foot
2. Tenderness or redness, which may extend above or below the knee
3. Pain in the calf

Infection following spine surgery occurs

1. Redness, tenderness, and swelling around the wound edges
2. Drainage from the wound
3. Pain or tenderness
4. Shaking chills
5. Elevated temperature, usually above 100°F if taken with an oral thermometer

Modern Lumbar Spine Fusion Surgery:

A new type of spinal fusion surgery using genetically engineered protein to create new bone eliminates the need for painful bone graft harvesting and significantly improves patients' recovery time, according to spine surgeons at the University of Maryland Medical Center Surgeons traditionally use bone graft taken from a patient's hip and devices, such as metal cages, to build a bridge between the vertebrae, immobilizing a segment of the spine. The surgery is usually performed after physical therapy.

By using a genetically engineered protein as a bone-graft substitute, the surgery takes less time, is less painful and causes less blood loss.

Spinal fusions give up flexibility in their lower backs in order to reduce their pain and improve the overall quality of their lives. "By fusing the vertebrae, you are essentially putting a segment of the spine to rest permanently. So you are exchanging some motion for pain relief.

Spinal fusions can be performed by accessing the spine from the front or back of the body, either through an "open" incision or laproscopically through several small incisions, Artificial discs are an alternative treatment to spinal fusion surgery for operative disc disease. These complications are most likely to occur during the first few weeks after surgerynew technique to stabilize the lumbar spine called axial lumbar interbody fusion, or AxiaLIF. The procedure requires only a tiny incision in the back and can have patients up and walking without pain within hours of leaving the operating theater.

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