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Jul 22, 2019

When Is Spinal Fusion Used?

shutterstock_405564487.jpgWe’ve all heard of the dreaded spinal fusion surgery. For most of us, that brings up images of major back surgery, going under the knife for hours, and waking up with rods and pins in our backs. But, spinal fusion has come a long way in the last few years and now it is being used in a number of new ways that are far less invasive than before. Here’s the latest on spinal fusion surgeries and when they’re used.  However, in order to understand how spine fusion surgery works, we need to review some basic simple anatomy and define the vertebral motion segment.

What Is A Vertebral Motion Segment?

A vertebral motion segment consists of; 1. any two adacent vertebrae, 2. the three joints that connect these two vertebrae together, that is, the disk in the front and the two facet joints in the back, and 3. the ligaments that support and stabilize this unit.  It is the three joints, the disk and the facet joints, between each two adjacent vertebrae that allow mobility across the vertebral segment.  As these joints go through wear-and-tear and start to degenerate, a vertebral motion segment will start to lose its mobility.

What Is Spinal Fusion?

Spinal fusion is the process of fusing a single vertebral motion segment, or multiple vertebral motion segments, to form a single bone structure.

How Is Spinal Fusion Done? 

Spinal fusion can be done through an anterior (from the front) approach, a lateral (from the side) approach, a posterior (from the back) approach, or a combination of the above.  The approach will depend on the specific pathology/condition, the accessibility of the motion segment(s) being addressed, and the surgeon preferrance and skills. 

In some cases, decompression of the spinal cord and/or the nerves, by means of a laminectomy, facetectomy and/or discectomy, is indicated.  

Implants, including screws and rods, are used to stabilize the motion segment(s) so that a solid fusion can be achieved across the motion segment(s).  In cases where a complete discectomy is performed, an interbody cage, or spacer, is placed inside the empty disk space as well.  Once the motion segment(s) is/are stabilized, it will typically take up to a few months before achieving a complete solid fuison.

When Is Spinal Fusion Indicated? 

It must be noted that most cases of neck or back pain can be managed and addressed through conservative non-surgical options first, such as, physical therapy, chiropratic therapy, massage therapy, and pain management interventions.  Spine surgery, in most instances, should be considered a last resort.  This is very true when it comes to spinal fusion surgery.  However, there are certain circumstances and conditions when spinal fusion surgery is clearly indicated, for example, in correcting a spinal deformity, such as scoliosis, in fixing a fracture of the spine, and in addressing spinal instability.  A spine surgeon might also discuss the need for a spinal fusion surgery if they anticipated the need to remove a significant amount of the stabilizing structures of the motion segment(s), thus, creating instability, in order to address a specific pathology, such as removal of a tumor or treating an infection.

How Has Spinal Fusion Surgery Advanced? 

In the past, spinal fusion surgery was more invasive and required extensive planning, operative time, hospital stay and recovery time.  However, recent advances in material used for implants, in material used to aid and augment fusion, or biologics, in minimally invasive techniques and approaches, in navigation and image guidance, and in robotic spine surgery have revolutionized the field of spinal fusion surgery.  These advances have significantly increased the safety of and improved the outcome of spinal fusion surgery while remarkably reducing the risks and the length of time required for surgery, for hospitalization and for reccovery.

If you’ve been living with chronic and severe neck or back pain, and you’re looking for permanent treatment options, contact Dr. Abdulhamid and Royal Spine today. We specialize in avoiding major spinal surgeries like spinal fusion by offering modern technologies and utilizing minimally invasive approaches.  We only use spinal fusion as a last resort, and we will work with you to determine whether or not it is the right option for you. We've helped hundreds of patients just like you regain their qualty of life without resorting to spinal fusion surgery.



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