Spinal Fusion Surgery

Dr. Philip Henkin

October 10, 2022

Spinal Fusion Surgery - Philip Henkin

If you are experiencing pain in your spine, your doctor may recommend spinal fusion surgery. This procedure can be performed in many different areas of the spine. It’s essential to understand how your spine functions and spinal fusion works so you can make an informed decision about your treatment. You can have spinal fusion in one or more of your spine regions, including your cervical spine.

Cervical fusion

Cervical fusion is a standard surgical procedure to stabilize the spine after spinal fusion. It uses a metal plate or screws to hold vertebrae rigidly in place while the fusion takes effect. This procedure eliminates the need for casts or braces, which can hinder movement and healing.

The surgical site is cleaned using sterile water containing antibiotics. The deep fascial layer and subcutaneous layer are closed with strong sutures. Sometimes, the skin is closed with sutures or staples. A sterile bandage is placed over the wound. The surgery takes anywhere from two to four hours.

Lateral fusion

Lateral fusion of the spine is a procedure that can help people with slipped discs or spinal stenosis. The process restores spinal stability by removing the damaged disc and placing bone graft material between adjacent vertebrae. The bone graft serves as a bridge between the vertebrae and encourages fusion. The surgery is usually performed using an x-ray machine known as a fluoroscope.

Unlike other methods of interbody fusion, lateral fusion is less invasive. During the procedure, the surgeon accesses the spine through the side muscle known as the psoas. The psoas muscle, which extends along the length of the lower back, is responsible for flexion and stability.

Autografts

When performing spinal fusion, the surgeon will choose between autografts from the spine or a donor site. Autografts are harvested from the bone in the pelvis or spine and usually require less time during surgery than allografts. However, autografts are not without their limitations. For example, they may not be as osteogenic as allograft bone, which can lead to lower bone inductance and increased infection rates.

In some cases, bone shavings, bone dust from laminectomy, or bone dust from posterior osteophytes can be used as autografts in spinal fusion. These are derived from animal tissues and contain viable osteoblasts. They are also used in minimally invasive surgeries.

Pseudoarthrosis

Pseudoarthrosis is a severe complication of spinal fusion surgery. This condition often occurs a few months or years after the spinal fusion operation. It appears when there is a lucency in the cage, and solid bone grows from the vertebral endplates. Pseudoarthrosis may be associated with bone density achieved during the surgery.

Surgical exploration is the only method to confirm a diagnosis of pseudoarthrosis, but this is not practical for all patients. Pseudoarthrosis is most often found at the caudal level, which accounts for over 80% of cases. In addition, it can also be caused by a higher level of contact stress at the graft-body interface during the spinal fusion.

Recovery from spinal fusion

Recovery from spinal fusion surgery is a long and challenging process. The recovery time depends on several factors, including your age and physical health, the type of spinal fusion surgery, and the amount of physical activity you are expected to return to. For most people, the recovery time ranges from two to four weeks, though it may be longer for some. Most people can return to work or light physical activity after four to six weeks. However, recovery may take up to six months for patients who have undergone complicated spinal fusion surgery.

Physical activity can speed up recovery after the surgery. While it’s essential to avoid bending and twisting, patients can gradually ramp up their activity levels. This will help the fusing bones become more muscular and stimulate healing. Patients can also use body pillows and canes to aid with daily activities.