Spinal fusion

Overview

Spinal fusion is surgery to connect two or more bones in any part of the spine. Connecting them prevents movement between them. Preventing movement helps to prevent pain.

During spinal fusion, a surgeon places bone or a bonelike material in the space between two spinal bones. Metal plates, screws or rods might hold the bones together. They then can fuse and heal as one bone.

Why it's done

Spinal fusion connects two or more bones in the spine to make it more stable, correct a problem or reduce pain. Spinal fusion can be used to:

• Reshape the spine. Spinal fusion can help correct problems with the way the spine is formed. An example is when the spine curves sideways, also known as scoliosis.
• Spinal weakness or instability. Too much motion between two spinal bones can make the spine unstable. This is a common side effect of severe arthritis in the spine. Spinal fusion can make the spine more stable.
• Damaged disk. Spinal fusion might be used to stabilize the spine after a damaged disk is removed.

Risks

Spinal fusion is generally safe. But as with any surgery, spinal fusion carries some risks.

Possible complications include:

• Infection.
• Poor wound healing.
• Bleeding.
• Blood clots.
• Injury to blood vessels or nerves in and around the spine.
• Pain at the bone graft site.
• Return of symptoms.

How you prepare

Getting ready for the surgery might include trimming hair over the surgical site and cleaning the area with a special soap. Tell your health care provider about medicines you take. You may be asked to stop taking some medicines for a time before the surgery.

What you can expect

During spinal fusion

Surgeons perform spinal fusion while the person having the procedure is unconscious, known as general anesthesia. There are several ways to do spinal fusion surgery. The technique the surgeon uses depends on where the bones to be fused are on the spine, the reason for the spinal fusion, and possibly, general health and body shape.

Generally, the procedure involves the following:

• Getting to the spine. To get to the bones being fused, the surgeon cuts in one of three places. From the back, these cuts are in the neck or back directly over the spine or on either side of the spine. To get to the spine from the front, the surgeon cuts into the stomach area or throat.
• Getting the bone graft ready. Bone grafts come from a bone bank or from the body of the person having the surgery, usually from the pelvis. Sometimes surgeons use human-made material instead of bone grafts. To use the person's bone, the surgeon cuts near the pelvic bone, removes a small part of it and then closes the cut.
• Fusion. To fuse the spinal bones, the surgeon places the bone graft material between the bones. The surgeon might use metal plates, screws or rods to help hold the bones together while the bone graft heals.

After spinal fusion

A hospital stay of two to three days is usually required following spinal fusion. Depending on the location and extent of your surgery, you may experience some pain and discomfort but the pain can usually be controlled well with medications.

After you go home, contact your doctor if you exhibit signs of infection, such as:

• Redness, tenderness or swelling
• Wound drainage
• Shaking chills
• Fever higher than 100.4 F (38 C)

It may take several months for the affected bones in your spine to heal and fuse together. Your doctor may recommend that you wear a brace for a time to keep your spine aligned correctly. Physical therapy can teach you how to move, sit, stand and walk in a manner that keeps your spine properly aligned.

Results

Spinal fusion typically works for fixing broken bones, reshaping the spine or making the spine more stable. But study results are mixed when the cause of the back or neck pain is unclear. Spinal fusion often works no better than nonsurgical treatments for back pain with a cause that's not clear.

Even when spinal fusion relieves symptoms, it doesn't prevent future back pain. Arthritis causes much of back pain. Surgery doesn't cure arthritis.

Having a spine that doesn't move in places puts more strain on the areas around the fused part. As a result, those areas of the spine might break down faster. Then the spine might need more surgery in the future.