A Patient’s Guide to Spinal Fusion

 In back surgery

A spinal fusion is a surgical procedure that is performed on a person’s spine, which permanently joins two or more vertebrae to each other. By infusing the two or more vertebrae to each other, a board-certified orthopedic spine surgeon ensures that the vertebrae heal into a single, solid bone. There are many conditions for which spinal fusions are often performed. They are commonly performed to treat the following conditions:

  • Degenerative disc disease
  • Deformities of the spine, like scoliosis and kyphosis
  • Spondylolisthesis
  • Spinal instability
  • Fractured vertebrae
  • Damaged and herniated discs
  • Infections in the spine
  • Tumors

Is Spinal Fusion a Major Surgery?

Although spinal fusion often involves major surgery, in many instances, it can be performed using minimally invasive techniques in a same-day surgical setting. It is performed best by reputable orthopedic surgeons or neurosurgeons under general anesthesia, who have specialized fellowship training in spinal surgery and are also board-certified. Successful spinal fusion surgery relieves pain and allows patients to regain a higher level of function. There are a variety of surgical techniques that can be utilized and are dependent on several factors, which include: each patient’s unique condition, the location of the vertebrae to be fused, and a patient’s general health and body shape. In most cases, spinal fusion surgery involves the following steps:

  • Incision and exposure – Your surgeon will choose from several different approaches. Your doctor may make an incision directly overlying the spine on your back. Another approach is from the front through your abdomen or the front of your neck near your throat. Alternatively, a skin incision can be made on the side of the body, and the spine can be approached through the flank or the chest wall/rib cage. Once exposed, the vertebrae would be prepared for the upcoming fusion.
  • Bone graft selection and preparation – Bone grafts are used in all spinal fusion surgeries and allow the bones to heal to each other. Before surgery, the surgeon determines which type of bone graft material is best for each patient. There are three main options, and these include the following: the patient’s own bone (autograft), cadaver bone from another person, who has been sterilized (allograft), and synthetic materials which promote bones to fuse (osteopromotive synthetic materials). When using a patient’s bone for the graft (autograft), the surgeon can harvest a small portion of the patient’s pelvic bone through a separate incision. However, to avoid the pain that is associated with this procedure, many times surgeons choose to use allograft and synthetic materials instead.
  • Fusion –The spine surgeon will then place the bone graft material between the vertebrae where a fusion is desired. This will create an environment that is necessary for the vertebrae to fuse. In most cases, the surgeon will also use metal plates, screws, and rods to stabilize the spine, which increases the success rate and the incidence of achieving a solid fusion.

What is the Recovery Time for Spinal Fusion Surgery?

The time to recovery after spinal fusion surgery depends upon many factors, which include: the condition for which the fusion is being performed, the preoperative health of the patient, the number and location of vertebrae to be fused, the surgical technique utilized, the extent of surgery performed, and the presence of any post-operative complications.

Patients in poorer health preoperatively and those undergoing more extensive surgery can take longer to recover from fusion surgery. In addition, surgeons can utilize several techniques to perform spinal fusions, which can affect recovery times. With less invasive techniques and less extensive surgery, many patients can be discharged to their homes the same day as their surgery. With more extensive and complicated fusion surgery, patients typically spend two to five days recovering in the hospital after which they are discharged to their homes. However, some of these patients may benefit from additional rehabilitative care, and admission to an acute or subacute rehabilitative facility can be explored.

Post-operative pain will be managed with medications that may include opioid pain medications, skeletal muscle relaxants, nerve pain medications, and over-the-counter medications like Tylenol and non-steroidal anti-inflammatory pain medication (NSAIDs). As the pain improves, the use of these medications will be weaned and will be discontinued.

Post-operatively, patients will be advised to follow their surgeon’s instructions and to maintain healthy lifestyles. Normally, it takes several months for the spine to fully heal after fusion surgery. Immediately after surgery, your doctor may recommend wearing a brace to keep the spine stabilized, which can also provide some comfort. Once back home, patients must also monitor for any signs of infection such as swelling, wound drainage, fever, and/or chills. If any of these symptoms occur following surgery, you should contact your spine surgeon immediately.

Once the spine has healed adequately, your doctor may prescribe physical therapy. During physical therapy, patients regain strength and range of motion and are taught how to move and exercise properly, sit, stand, reposition, and walk to help prevent future injuries. It may take several months for the bones to fuse and completely heal; however, during this time, symptoms will steadily improve.

How Painful is a Spinal Fusion?

It is normal for patients to experience pain and discomfort after their fusion procedure. This pain improves with time and is also controlled with medications, which can include opioids, non-steroidal anti-inflammatory drugs (NSAIDs), Tylenol, skeletal muscle relaxants, and nerve pain medications. Typically, patients experience the most severe discomfort within the first few weeks after surgery, which improves steadily; however, with more complicated procedures, some patients may experience higher levels of pain for longer periods (sometimes up to 3 to 4 months after their procedure).

What is the Success Rate of Spinal Fusion Surgery?

For appropriately chosen candidates, spinal fusion surgery is an effective treatment and is very successful. Success rates vary for patients with different medical conditions, for different fusion procedures, fusions in different locations in the spine. Success rates for certain fusion procedures have been reported to be as high as 95% and for others as low as 50%.

It is difficult to report the exact rate of success or failure of spinal fusion surgery because certain factors will affect surgical outcomes. However, one of the most common reasons for a poor surgical outcome is the failure to address the actual source of a patient’s pain. For this reason, it is extremely important to undergo evaluation with a board-certified spine surgeon before surgical intervention to learn about your condition and the surgical treatment options that are most appropriate for you. This will give you the best opportunity at achieving a successful outcome with surgical intervention.

Treating Back Pain with Spinal Fusion Surgery at NJSS

With convenient locations in both Summit and Montclair, New Jersey Spine Specialists is here to help with its board-certified and fellowship-trained doctors. To see if spinal fusion surgery is the best treatment option for you, call our renowned spine specialists at (908) 608-9619 to make an appointment for a comprehensive consultation.

* WebMD: https://www.webmd.com/back-pain/spinal-fusion-facts
* Health Line: https://www.healthline.com/health/spinal-fusion

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