Spinal fusion is surgery to permanently connect two or more vertebrae in your spine, eliminating motion between them.
Spinal fusion involves placing extra bone (bone graft) to fill the space between two spinal vertebrae. The bone graft material used in spinal fusion may be in a preformed shape, or it may be contained within a plastic, carbon fiber or metal cage. Your surgeon may use plates, screws or rods to hold the vertebrae and graft in place to promote healing after spinal fusion. Once the bone graft heals, the vertebrae are permanently connected.
Your doctor may recommend spinal fusion if you have a broken vertebra, a spinal deformity, spinal weakness, spinal instability or chronic low back pain.
Why it's done
Spinal fusion permanently connects two or more vertebrae in your spine to improve stability, correct a deformity or reduce pain. Your doctor may recommend spinal fusion to treat the following spine problems:
Spinal fusion is generally a safe procedure. But as with any surgery, spinal fusion carries the potential risk of complications.
Potential complications include:
Beyond the immediate risks of the procedure, spinal fusion surgery changes how your spine works by shifting stress from the fused vertebrae to adjacent areas of your spine. This added stress may accelerate the process of wear and tear in the vertebral joints on either side of the fusion, causing further damage and possibly chronic pain.
How you prepare
Preparation before surgery may involve trimming hair over the surgical site and cleaning the area with a special soap or antiseptic. Your doctor will give you specific instructions. Tell your doctor about any medications you are taking. You may be asked not to take some medications before the surgery.
What you can expect
During spinal fusion
The surgical team monitors your heart rate, blood pressure and blood oxygen throughout the procedure with a blood pressure cuff on your arm and heart-monitor leads attached to your chest. After you're unconscious, your surgeon will begin the procedure.
Surgeons have developed a variety of techniques for performing spinal fusion surgery. The technique your surgeon uses depends on the location of the vertebrae to be fused and the reason for spinal fusion. Generally, the procedure involves the following:
In selected cases, some surgeons use a minimally invasive technique to perform spinal fusion through several smaller incisions, rather than open surgery performed through one larger incision. Minimally invasive back surgery is complex and requires great skill. It's not available at all hospitals.
After spinal fusion
Once the bone graft placed during spinal fusion surgery fully heals, the bone is unlikely to break down. Because of this, spinal fusion is typically an effective, long-term treatment for broken vertebrae, spinal deformities, spinal instability and spondylolisthesis.
Spinal fusion usually doesn't eliminate all back pain. If you had chronic back pain prior to spinal fusion, it's likely you will continue to have some pain, but less than before. Your pain may be further reduced by staying in good physical condition and exercising regularly.
Because spinal fusion surgery immobilizes parts of your spine, it changes the way your spine can move. This places additional stress and strain on the areas around the fused portion and may increase the rate at which those areas of your spine degenerate.
A fused spine doesn't protect against developing other problem areas in your spine. If you have a strong family history of back pain, if you're obese or if you're in poor physical condition, you may be at increased risk of additional spinal problems. Unfortunately, those problems could require treatment in the future. For a few individuals, that may include more spine surgery.
Last Updated: 2010-05-14
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