Spinal fusion, also known as spondylodesis, is an invasive surgical procedure that joins two or more vertebrae together. This procedure can last for several hours and is done using different fusion methods. With one spinal fusion method metal implants are placed and secured to the vertebrae as a means to hold them together while new bone grows between them. With the other method, bone is taken directly from the abdomen (or in some cases bone is obtained from a blood bank) and the bone is used to make a bridge between vertebrae as the bone graft stimulates new bone growth.
Spinal fusion is done mostly in the lumbar (lower back) region of the spine but can also be used to treat cervical (upper back) and thoracic (middle back) problems. The purpose of spinal fusion is to eliminate pain in the back that may be caused by abnormal vertebrae motion. Most people find that since the thoracic area of the spine experiences limited motion it is the area that is less likely treated using this method.
Spinal fusion may be done as a lone procedure or it is done in combination with or after decompression procedures as a means to treat painful symptoms as well as herniated disc, spinal injuries, deformities, infections, and tumors.
There are several types of spinal fusion surgery options. These options include posterolateral gutter fusion which is a type of lumbar spinal fusion that is done through the back and places bone graft between the transverse processes in the back of the spine. After which, the vertebrae is set in place with wire and screws through the pedicles (the segment between the transverse process and the vertebral body) of each vertebrae attaching to a metal rod of the vertebrae’s sides.
With posterior lumbar interbody fusion the disc is accessed from a posterior incision. This procedure places bone graft between the vertebrae where the intervertebral disc is located. The disc is removed entirely and a device is placed between the vertebra to help maintain alignment and spine height. Fusion occurs between the endplates of the vertebrae.
There is also anterior lumbar interbody fusion which is done from the front of the body and involves removing the disc between two vertebrae and inserting space between the vertebrae.
Spinal fusion surgery is designed to stabilize and treat the spine including cases of deformity, degenerative bone, spinal stenosis, disc changes and spinal fractures. Though spinal fusion may often be necessary to stabilize the spine there is no solid research that supports the effectiveness of this procedure for a variety of spinal conditions. There is, in fact, research that supports that spinal fusion shows no distinguishable benefit over intense rehabilitation.
Some of the risk associated with spinal fusion include failure of fusing process, pain at the graft site, nerve injury, blood cloys, graft rejection and infection.
Spinal fusion is an absolute last result for treating back pain. This surgical method of treatment is very invasive so please be sure to exhaust all other treatment possibilities and consult with a specialist before considering this option.
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