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Spinal fusion - Overview

Alternative Names

Vertebral interbody fusion; Posterior spinal fusion; Arthrodesis; Anterior spinal fusion; Spine surgery - spinal fusion

Definition of Spinal fusion:

Spinal fusion is surgery to fuse spine bones (vertebrae) that cause you to have back problems.

Fusing means two bones are permanently placed together so there is no longer movement between them. Spinal fusion is usually done along with other surgical procedures of the spine.

Description:

You will be asleep and feel no pain (general anesthesia).

Your surgeon has several choices about where to make the incision (cut).

The surgeon may make an incision on your back or neck over the spine. You will be lying facedown on a special table. Muscles and tissue are separated to expose the spine.
The surgeon may make a cut through one side of your belly (for surgery on your lower back). The surgeon will use tools called retractors to gently separate, hold the soft tissues and blood vessels apart, and have room to work.
The surgeon may make the cut on the front of the neck, toward the side.

Other surgery, such as a diskectomy, laminectomy, or a foraminotomy, is almost always done first.

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

Strips of bone graft material may be placed over the back part of the spine.
Bone graft material may be placed between the vertebrae
Special cages may be placed between the vertebrae. These cages are packed with bone graft material.

The surgeon may get the graft from different places:

From another part of your body (usually around your pelvic bone). This is called an autograft. Your surgeon will make a small cut over your hip and remove some bone from the back of the rim of the pelvis.
From a bone bank, called allograft.
A synthetic bone substitute can also be used, but this is not common yet.

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

Surgery can take 3 to 4 hours.

Scoliosis

Spinal fusion - series

Reviewed last on: 3/4/2009
C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Dept of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Weinstein JN, Tosteson TD, Lurie JD, et al. Surgical versus nonsurgical therapy for lumbar spinal stenosis. N Engl J Med. 2008;358:794-810.

Katz JN, Harris MB. Clinical practice. Lumbar spinal stenosis. N EnglJMed. 2008;358(8):818-825.

Chou R, Qaseem A, et al. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med. 2007;147(7):478-491.

Hedequist DJ. Surgical treatment of congenital scoliosis. Orthop Clin North Am. 2007;38(4):497-509.

Curlee PM. Other disorders of the spine. In: Canale ST, Beatty JH, eds. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 41.

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