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Spinal fusion

Vertebral interbody fusion; Posterior spinal fusion; Arthrodesis; Anterior spinal fusion; Spine surgery - spinal fusion; Low back pain - fusion; Herniated disk - fusion; Spinal stenosis - fusion; Laminectomy - fusion; Cervical spinal fusion; Lumbar spinal fusion

Spinal fusion is surgery to permanently join together two or more bones in the spine so there is no movement between them. These bones are called vertebrae.

Images

Scoliosis

Presentation

Spinal fusion - series - Normal anatomy

Description

You'll be given general anesthesia, which puts you into a deep sleep so you do not feel pain during surgery.

The surgeon will make a surgical cut (incision) to view the spine. Other surgery, such as a diskectomy, laminectomy, or a foraminotomy, is almost always done first. Spinal fusion may be done:

The surgeon will use a graft (such as bone) to hold (or fuse) the bones together permanently. There are several ways of fusing vertebrae together:

The surgeon may get the bone graft from different places:

The vertebrae may also be fixed together with rods, screws, plates, or cages. They are used to keep the vertebrae from moving until the bone grafts are fully healed.

Surgery can take 3 to 4 hours.

Why the Procedure Is Performed

Spinal fusion is most often done along with other surgical procedures of the spine. It may be done:

Spinal fusion may be done if you have:

You and your surgeon can decide when you need to have surgery.

Risks

Risks for anesthesia and surgery in general include:

Risks for this surgery include:

Before the Procedure

Tell your doctor what medicines you are taking. These include medicines, herbs, and supplements you bought without a prescription.

During the days before the surgery:

On the day of the surgery:

After the Procedure

You may stay in the hospital for up to 3 to 4 days after surgery.

You will receive pain medicines in the hospital. You may take pain medicine by mouth or have a shot or an intravenous line (IV). You may have a pump that allows you to control how much pain medicine you get.

You will be taught how to move properly and how to sit, stand, and walk. You will be told to use a "log-rolling" technique when getting out of bed. This means that you move your entire body at once, without twisting your spine.

You may not be able to eat regular food for 2 to 3 days. You will be given nutrients through an IV and will also eat softer food. When you leave the hospital, you may need to wear a back brace or cast.

Your surgeon will tell you how to take care of yourself at home after spine surgery. Follow instructions on how to take care of your back at home.

Outlook (Prognosis)

Surgery does not always improve pain and in some cases, can make it worse. However, in some people surgery can be effective for severe pain that does not get better with other treatments.

If you had chronic back pain before surgery, you will likely still have some pain afterward. Spinal fusion is unlikely to take away all your pain and other symptoms.

It is hard to predict which people will improve and how much relief surgery will provide, even when using MRI scans or other tests.

Losing weight and getting exercise increase your chances of feeling better.

Future spine problems are possible after spine surgery. After spinal fusion, the area that was fused together can no longer move. Therefore, the spinal column above and below the fusion are more likely to be stressed when the spine moves, and may cause problems later on.

Related Information

Scoliosis
Kyphosis
Bone graft
Anterior
Herniated disk
Osteoarthritis
Spinal stenosis
Sciatica
Taking care of your back at home
Neck pain
Diskectomy
Laminectomy
Foraminotomy
Low back pain - acute
Low back pain - chronic
Bathroom safety for adults
Surgical wound care - open
Preventing falls
Spine surgery - discharge
Preventing falls - what to ask your doctor

References

Bennett EE, Hwang L, Hoh DJ, Ghogawala Z, Schlenk R. Indications for spine fusion for axial pain. In: Steinmetz MP, Benzel EC, eds. Benzel's Spine Surgery: Techniques, Complication Avoidance, and Management. 4th ed. Philadelphia, PA: Elsevier; 2017:chap 58.

Liu G, Wong HK. Laminectomy and fusion. In: Shen FH, Samartzis D, Fessler RG, eds. Textbook of the Cervical Spine. Philadelphia, PA: Elsevier; 2015:chap 34.

Wang JC, Dailey AT, Mummaneni PV, et al. Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 8: lumbar fusion for disc herniation and radiculopathy. J Neurosurg Spine. 2014;21(1):48-53. PMID: 24980585 www.ncbi.nlm.nih.gov/pubmed/24980585.

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Review Date: 7/7/2019  

Reviewed By: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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