Spinal Fusion

About the Procedure

Spinal fusion is a major form of surgery by which two adjacent vertebrae in the spinal column are fused together as one. The primary reasons one might undergo this surgery are because they suffer from a congenital spine disorder (such as scoliosis); they have sustained damage to their spine which has destabilized it; or because one of their spinal discs have begun to decay or herniate. Spinal fusion surgery is also used to treat a variety of other spinal conditions if they have not responded to more conservative, non-surgical forms of treatment.

The first step in the process is procuring a piece of bone matter, called a bone graft, to bridge the gap between the vertebrae. Ideally, this would be taken from the patient’s own hip bone. A small incision would be made by the hip joint and the surgeon would remove a sliver of bone before closing the incision back up. If the patient lacks sufficient bone matter to supply an autologous graft, one can be obtained from a bone bank or a third party donor.

The next step is for the surgeon to gain access to the spinal column. This is most commonly done by making an incision either directly over the spinal chord or to the immediate left or right of it. Once the surgical site has been reached, the bone graft is placed between the two vertebrae whose friction is causing the pain. A series of metal wires and titanium screws are also used to ensure that the vertebrae and the bone graft are pressed tightly together. Once that is done, the incisions are sealed and the surgery is complete.

From beginning to end, the process can take anywhere from 3 to 5 hours to complete and is always performed under general anesthesia.

The surgery, in this case, is only the beginning of the overall treatment. The presence of the bone graft in close proximity to the two vertebrae stimulates natural bone growth between the three elements. Over a period of time of between 6-12 months, enough new bone grows between them to make them fuse into one continuous mass.

What to Know Before the Procedure

While spinal fusion surgery is safe, it is considered somewhat controversial. This is due to the fact there are no conclusive studies proving that the results it affords are significantly greater than more conservative treatments such as physical therapy. Like all surgeries, the possibility of complications exists, and since the surgery is dealing with the spine, such complications can be life altering. Given these facts, it is in a patient's best interest to thoroughly explore non-surgical treatments before deciding to have spinal fusion surgery. Discuss other treatment methods with your doctor first.

Be sure to discuss any prescription medications you are on with your doctor, as they may have an impact on the effectiveness of the treatment.

What to Know After the Procedure

After the surgery, the patient remains at the hospital under close monitoring for 3 to 5 days. Pain killers may be prescribed to manage the discomfort at the incision site.

The recovery and fusion process is vital to the success of this procedure. The average patient is unable to return to normal daily activities, or even the least physically demanding of jobs, any earlier than 4 weeks; possibly as long as 7. At around the same time frame, the patient will begin a physical therapy regimen to teach them how to do daily activities while keeping their back in proper alignment to allow the fusion process to take place. It is common for the doctor to prescribe a back brace to assist with maintaining proper posture as well. While in some patients fusion occurs as early as 6 months, most patients will require close to a year before the fusing process is complete.

If you Need to Travel Outside of your Local Hospital

Without health insurance coverage, spinal fusion is extremely costly domestically. While international travel after the procedure can be challenging, particularly if it compromises your ambulatory ability, the cost difference can be quite substantial, saving the patient as much as $40,000 USD over having it done domestically. It is important to keep in mind that the procedure is extensive and very delicate. Picking a surgeon with a strong track record and high level of experience in spinal surgery is vital. Weigh these options very carefully when deciding where to have this procedure done.