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Spinal Fusion Surgery
Relevant information about Spinal Fusion Surgery.
Spinal Fusion is a spinal column surgical procedure that uses bone grafts to fuse two or more vertebrae. The main goals of this operation are to correct as much as it is possible spinal column deformities, the most usual of these being Scoliosis and to relieve the pain symptoms caused by the abnormal position of the spinal bones. Sometimes, devices called Instrumentations are placed inside the patient’s back after a Spinal Fusion.
Scoliosis is a condition that happens when the spinal column curves sideways and takes the shape of an “S”, which is a double curve, or a long “C”, which is a single curve. A scoliotic spine can be also rotated or twisted, causing one side of the chest to become higher than the other or changes in the shape of the breastbone. Due to all the possible combinations of curvatures Scoliosis can be very different from individual to individual. It is believed that the causes of Scoliosis are multiple. These can include wrong sitting postures during adolescence growth, underlying spinal column anomalies and genetic factors. In addition to Scoliosis there is another problem that may require a Spinal Fusion, but as a previous step to another operation. A herniated disc, also called prolapsed disc, may happen when due to a big pressure, a spinal column disc bulges out from between two vertebrae, thus compressing the spinal canal. When the herniated disc is in the lumbar or thoracic region, this will cause sharp and continuing back pain, a weakening of the muscles in the leg, and some loss of sensation in the leg and foot. In addition, it may also be difficult to raise the leg when it is held in a straight position. If the herniated disc is in the cervical region it will cause neck pain, stiffness, and numbness and weakness in the arms or hands.
The Spinal Fusion procedure is usually complemented with Instrumentation, which is an operation in which a device that stabilizes the spinal column and helps it to recover its normal shape is inserted into the patient’s body. The fusion can be posterior or anterior. A posterior fusion consists on operating the spinal column on from behind, doing an incision in the back. It is the most common approach used and sometimes it does not require Instrumentation. An anterior fusion consists on operating the spinal column on from the front or side. It is usually done in special instances of Scoliosis, and requires Instrumentation. In addition to these two approaches, there is third option that combines posterior and anterior fusion. However both operations cannot be performed simultaneously. The Spinal Fusion procedure begins with the patient being put in a position that is suitable for posterior or anterior Spinal Fusion. Then, an incision is made in the zone that has to be treated. The muscles and nerves are put aside, in order to allow reaching the spinal column. Once the spinal column has been reached, flaps are sliced in the vertebrae of the problem zone. Next, the bony outgrowths that allow the spinal column to twist and bend are removed. Bone grafts are then put vertically across the exposed surface of the cut vertebrae. All the bone grafts used must also touch adjoining vertebrae. After this is done, the flaps are folded back to their original position, covering the bone grafts. It is expected that the grafts will grow into the bone and fuse the vertebrae together. Finally, the muscles and nerves are put back in place and the skin is stitched together.
During the post surgery patients usually have to wear a full body cast. Also they may have to lie in bed for at least three months after the procedure. This time can be extended until six months. Additional precautions may be taken, depending on each patient’s particular case and if any type of instrumentation has been done.
There are two complications that must be considered. First of all, if the fusion fails to heal, a pseudoarthrosis may be developed. This happens when a false joint develops on the treated site causing pain symptoms. The other complication is disc degeneration. This happens when the stress generated by the fusion in the lower back is too big and damages the lower spinal column discs. This can cause pain symptoms and instability.
The operation allows the patient to recover the spinal column normal stability and strength. It also eliminates the pain caused by the scoliotic curves or similar diseases.
The fused part of the Spinal Column will never recover its previous mobility.
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