Wednesday, December 13, 2017
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Spinal Fusion

Lumbar Spinal Fusion

One of the main goals of any surgical procedure on the skeletal system is to stop the pain caused by joints that have worn out over time-degenerative joints. One of the most reliable ways to reduce pain from degeneration is to fuse the joint together. A fusion is an operation where two bones, usually separated by a joint, are allowed to grow together into one bone. The medical term for this type of fusion procedure is arthrodesis.

Spinal fusion has been used for many years to treat painful conditions in the lumbar spine. Over the past decade, there have been dramatic improvements in the way that spinal fusion operations are performed. One major improvement has been the development of fixation devices as well as minimally invasive techniques, both of which Dr. Aryan has been on the forefront of.

A spinal fusion is simply the uniting of two bony segments, whether a fracture or a vertebral joint. The reason for instrumentation with rods and screws is to act as and 'internal cast' to stabilize the vertebra until the fusion, or bony re-growth, can occur.

Why is it done?

Historically spinal fusions have been used to correct degenerative spondylolisthesis. However, there are many indications for a spinal fusion and it is not the only procedure preformed to treat those various conditions.

Only when all other conservative treatments have failed will Dr. Aryan suggest fusion surgery. Several back conditions may require a spinal fusion, including

The Operation

  • Incision - The patient is positioned on the operating table in a prone position. The incision is made over the anatomic position of the spinous process.

  • Bone is Removed - When indicated, soft tissue and bony decompression are performed to relieve neurological compression.

  • Screw Placement - For a degenerative spondylolisthesis case, a blunt probe is inserted through the pedicle and into the vertebral body. Once the pedicle canals are prepared and the screw length determined, screws are sequentially inserted.

      

View animation of pedicle screw placement

  • Bone Graft - The facet joint capsules are removed and cancellous bone graft is placed into each facet joint. The transverse processes, sacral alae, and the lateral walls of the facet joints are decorticated with high-speed burs and curettes.

  • Compression -Once the construct has been assembled, segmental distraction and compression may be carved out.


 

Complications

Like all surgical procedures, operations on the spine may have complications. Because the surgeon is operating around the spinal cord and nerves, back operations are always considered extremely delicate and potentially dangerous. You should take time to review the risks associated with spine surgery with your doctor. Make sure you are comfortable with both the risks and the benefits of the procedure planned for your treatment.

Rehabilitation

A minimum of three months is needed for the bones to fuse together and become solid. Yet the bone graft will continue to mature for one to two years. Your doctor may have you wear a rigid brace for up to three months to keep your spine still and make sure the bones fuse. You may not require a rigid brace after fusion with instrumentation.

Most patients are able to return home when their medical condition is stabilized, usually within one week after fusion surgery. Limit your activities to avoid doing too much too soon. Avoid bending, lifting, twisting, and driving for at least six weeks.

Physical Therapy

Your doctor may have you attend physical therapy beginning a minimum of six weeks after surgery. A well-rounded rehabilitation program assists in calming pain and inflammation, improving your mobility and strength, and helping you do your daily activities with greater ease and ability. Therapy sessions may be scheduled up to three times each week for eight to 12 weeks.

Surgery for Spinal Disorders - Lumbar

Surgery for Spinal Disorders

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