Overview
If the cause of your back pain seems to be motion between segments of your vertebrae, spinal fusion may be a way to prevent motion and stop the pain. Spinal fusion involves permanently connecting — or "welding" — two or more vertebrae together.
Spinal fusion was formerly used primarily for conditions such as scoliosis and other Spinal Fusion Decompression. Today, although most people with chronic low back pain don't need to undergo spinal fusion, it has become increasingly popular for treating low back pain. The number of spinal fusions for all causes in the United States has more than doubled since 1993. Spinal fusion has been used as a treatment for what's called discogenic pain — pain originating in the area of a particular disk and without involving leg pain (sciatica).
Evaluating Your Suitability
Before you and your doctor agree to surgery as an option, your doctor will want to make sure that you've given nonsurgical treatments a reasonable trial. Also, your doctor may conduct a study called a diskogram, which is a special X-ray examination that involves the use of a dye. The dye, injected into a disk, serves to make it appear better on an X-ray. The injection of dye may also produce a pain similar to your ongoing back pain, which helps your doctor pinpoint that disk as the source of your pain.
Spinal Fusion :
Spinal fusion permanently connects two or more bones in your spine to improve stability, correct a deformity or treat pain. In this case, bones, rods and screws are used to fuse vertebrae.
Spinal fusion surgery requires general anesthesia. The procedure may take from two to 12 hours, depending on how extensive the surgery is and the technique your surgeon uses. Surgery may involve a large incision, or may be done using newer techniques with smaller incisions.
To fuse the spine, your doctor needs small pieces of extra bone to fill the space between two vertebrae. This bone may come from your own body (autogenous bone), usually from a pelvic bone. Or, it may come from another person (allograft bone) by way of a bone bank. If the front of your spine is fused, the disk is removed first. Bone graft substitutes, such as genetically engineered proteins, are being developed as alternatives to using bones from your body or a bone bank. Sometimes, doctors also use wires, rods, screws, metal cages or plates. As with any surgery, spinal fusion carries risks, including pain at the donor site for the bone, infection and nerve injury.
The Aftermonth Of Surgery :
Expect to be in the hospital for several days after surgery. You'll also likely experience considerable pain and discomfort after surgery, but your doctor will control pain with oral and intravenous medications. It takes from several weeks to several months to heal from this surgery, depending on your age, condition and what level of activity you plan to return to. The type of healing that needs to occur after spinal fusion is comparable to recovery from a broken bone. The earliest that X-rays might reveal bone healing after spinal fusion is about six weeks.
Spinal fusion removes some spinal flexibility. This can be beneficial if movement and instability between spinal segments is what causes your pain. However, the fused spine needs to be kept in proper alignment. You'll be taught how to move, sit, stand and walk in a manner that keeps your spine properly aligned. You may be able to start a physical rehabilitation program as early as about four weeks after spinal fusion surgery.
Set Realistic Expectations :
Beyond the immediate potential risks of spinal fusion surgery, the areas of your spine adjacent to the fusion will bear more stress. This makes those areas more likely to experience future wear and tear. That may mean you'll need to undergo surgery again. About 20 percent of people who have spinal fusion surgery need another operation within 11 years.
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