What is Spinal Fusion?

Chronic back pain can have a variety of sources. When that back pain becomes debilitating or cannot be resolved by other treatment means spinal fusion surgery might be seen as a final measure to help stabilize the spine and restore a functional quality of life for the patient.

Spinal fusion surgery is sometimes used to correct problems and deformations in the small bones in the vertebrae of the spine. As the name implies it’s essentially a bonding or welding process that effectively fuses together two or more vertebrae together to stabilize the spine.

It’s important to note that this type of spinal surgery is typically only recommended only when the physician can clearly identify the source of your pain and after other treatment attempts have failed to produce sufficient results.

What Conditions Are Treated By Spinal Fusion

Spinal fusion is not the ideal treatment strategy for all types of back pain. Though it is commonly used to treat some of the following conditions.

Degenerative Disk Disease

This is when the vertebral disks in between the bones of the spine have suffered excess wear and tear, causing the vertebral bones to rub together painfully.

Spondylolisthesis

Which is a spinal condition causing strong lower back pain, and occurs when one of the vertebrae slips out of place onto the vertebra below it.

Spinal Stenosis

This is a gradual narrowing of the spinal canal that houses the spinal cord. It can also cause nerve inflammation and discomfort as the spine gradually destabilizes.

Scoliosis

This is a curvature of the spine that causes the vertebrae to contact each other in key locations at an unhealthy angle.

Fractured Vertebra

Often associated with a severe injury such as a car accident, severe sports injury or a hard fall, a fractured vertebrae may not be able to heal properly without the stabilization of a spinal fusion.

Herniated disk

Similar to degenerative disk disease, the discs between the vertebrae of the back and neck can gradually thin with age. This can cause one or more to frequently “Slip” or “Bulge” causing pain and numbness. A spinal fusion can help stabilize the affected area to prevent it from herniating again in the future.

Tumors

Both benign and cancerous tumors can place excess pressure on the spine or even cause deformations in the once healthy bone structure. Even after the offending tissues have been removed, a spinal fusion might be able to stabilize the compromised area to prevent further complications.

What Does A Spinal Fusion Do?

Spinal fusion surgery is designed to prevent motion between the problematic vertebrae. This also serves to prevent stretching and pressure on the surrounding nerves as well as the associated muscles and connective tissues.

Some spinal fusion procedures are included in or performed as part of another spinal surgery like a Laminectomy. This serves to remove compromised bone material and other compromised tissues that apply pressure to the spine or the surrounding nerves. and diseased tissues that are putting pressure on spinal nerves.

It’s important to note that a spinal fusion procedure will reduce some of your spinal flexibility. Just how much flexibility is lost will depend on the number of vertebrae that are being fused as well as other health factors. Your physician might also recommend losing a significant amount of weight to help improve your overall range of motion.

How Is A Spinal Fusion Performed?

There are three different approaches that your physician might take to affect a spinal fusion. The size and location of the area being fused will be prime factors, as will any other health complications.

In an “Anterior Approach” the surgeon might opt to approach the spine from the front, and is more common in lumbar fusions and cervical neck fusions.

With a “Posterior Approach” an incision is made from the back, and is more common for thoracic vertebral fusions.

Some spinal fusions will use a “Lateral Approach,” which is more common when only two vertebrae need to be fused together, with no other surgical techniques being performed.

Does A Spinal Fusion Require Bone Grafting?

Bone grafting is a critical component of a spinal fusion, and typically involves attaching small pieces of bone material into the space between the vertebrae that are being fused. This helps stimulate bone healing as well as increasing bone production. The net effect in the long run is to fuse the treated vertebrae together into one solid piece of bone.

Autografting is often used to source the bone material from a section of the pelvis known as the “Iliac Crest.” This is more common for smaller spinal fusions that don’t call for any other alterations to the surgical field. If other alterations need to be made a “Local Autograft” might be used to source healthy bone tissue from nearby bone material.

In some cases a “Synthetic Bone Graft” might be used without harvesting any local bone tissues. This is a special graft material made from calcium and phosphates.

Your physician will help you understand which type of bone graft is right for you.

Pain Management After Spinal Fusion

Recovering from spinal fusion surgery can take several weeks, if not months. Your physician will likely prescribe you with pain medications to help you manage discomfort. This might include opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), or even injections of local anesthetic. Your physician might use a combination of pain relief techniques to avoid the use of opioids and reduce the risk of opioid dependence.

Rehabilitation After Spinal Fusion Surgery

It can take several months for the altered bone tissues to knit and heal. While this happens, you will need to keep your spine properly aligned. To help maintain this, a physical therapist will teach you how to do things like move properly, reposition your body, sit with proper posture, stand, and even walk.

As the bone tissues heal and your discomfort lessens, your activity level will be able to gradually increase. Formal physical therapy tends to start within 6 to 12 weeks after spinal fusion surgery.

With diligent physical therapy and performing the at-home exercises your physical therapist gives you, most people see a full recovery within 6 to 12 months after a spinal fusion surgery.