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Spinal Fusion
What is it? Overview Usage Side Effects and Warnings
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Spinal Fusion Overview

Written by FoundHealth.

Definition

A spinal fusion is a surgery to weld together two vertebrae. Vertebrae are the bones that make up the spine.

What to Expect

Prior to Procedure

Your doctor may do the following:

  • Physical exam, especially of the back and neck
  • X-rays —a test that uses radiation to take a picture of structures inside the body, especially bones
  • MRI scan—a test that uses magnetic waves to make pictures of the spinal nerves and disks between vertebrae
  • Myelogram —a type of x-ray that uses dye inserted near the spinal cord to show if there is pressure on the cord or the nerves
  • Possibly a CT scan —a type of x-ray that uses a computer to make pictures of the bones of the spine

Leading up to your surgery:

  • Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:
  • Aspirin or other anti-inflammatory drugs
  • Blood thinners, such as clopidogrel (Plavix) or warfarin (Coumadin)
  • Arrange for a ride home and for help at home.
  • Eat a light meal the night before. Avoid eating or drinking anything after midnight.

Anesthesia

General or spinal anesthesia may be used. With general anesthesia, you will be asleep. Spinal anesthesia will numb an area of your body, but you will be awake.

Description of Procedure

The doctor will make an incision in your back or neck. The muscles will be spread to access the spine. The doctor may fuse the bones with either:

  • Grafts made from pieces of bone or bony material (The pieces of bone may be taken from pelvis [hip].)
  • A small metal cage filled with bone graft material (The cage may be placed between the spinal bones.)

The doctor will implant screws and plates or rods to hold the bones in place while they fuse together. The incision will be closed with stitches or staples.

Lumbar Fusion
Lumbar Fusion
© 2009 Nucleus Medical Media, Inc.

How Long Will It Take?

4-6 hours (sometimes longer)

How Much Will It Hurt?

Anesthesia will prevent pain during surgery. You will receive medicine after surgery to help manage pain.

Average Hospital Stay

3-4 days (sometimes longer depending on age, overall health, and extent of surgery)

Post-procedure Care

At the Hospital

You may receive the following care at the hospital:

  • Pain medicine
  • Back brace or cast
  • Lessons on how to properly move, sit, stand, and walk
  • Lessons on how to turn in bed without twisting the spine
  • Physical therapy
  • Special socks or boots to help prevent blood clots
  • Move and exercise your legs while in bed—You will also be encouraged to get up and walk around several times a day.

At Home

When you return home, do the following to help ensure a smooth recovery:

  • Be sure to follow your doctor's instructions .
  • Keep the incision area clean and dry.
  • Exercise your legs while in bed. This is to improve circulation and decrease the risk of blood clots.
  • Do not lift anything heavy.
  • The bones and grafts fuse together over several months. During this time, your activity will be restricted.
  • Only take medicine recommended by your doctor. Ask your doctor before taking any over-the-counter medicine.
  • Have the stitches or staples removed in two weeks.
  • Your doctor may tell you to permanently avoid heavy lifting and strenuous activities that involve lifting and twisting.

Rehabilitation

Rehabilitation may be done in a hospital or at an outpatient clinic. The program will likely include:

  • Exercises to strengthen your back
  • Low-impact aerobic exercises, such as walking or swimming

Time off from work ranges from 4-6 weeks to 4-6 months. It will depend on age, overall health, and the physical demands of your job.

Complete healing of the bones may take up to a year after surgery. You will likely notice less flexibility of your spine where the bones are fused. Following your rehabilitation program will speed your recovery and reduce discomfort.

Healed Lumbar Fusion
Healed Lumbar Fusion
© 2009 Nucleus Medical Media, Inc.

References

RESOURCES:

American Academy of Orthopaedic Surgeons
http://www.aaos.org/

American Association of Neurological Surgeons
http://www.neurosurgerytoday.org/

CANADIAN RESOURCES:

Canadian Orthopaedic Association
http://www.coa-aco.org/

The University of British Columbia Department of Orthopaedics
http://www.orthosurgery.ubc.ca/

References:

AAOS clinical guideline on low back pain/sciatica (acute) (phases I and II). American Academy of Orthopaedic Surgeons (AAOS) website. Available at: http://www.guidelines.gov/summary/summary.aspx?doc_id=5369&nbr=003672&string=spinal+AND+fusion . Accessed September 9, 2005.

Deyo RA, Nachemson S, Mirza SK. Spinal-fusion surgery—the case for restraint. N Engl J Med. 2004;350(7):722-726.

Lindström, D, Omid Sadr A, Wladis A, et al. Effects of a perioperative smoking cessation intervention on postoperative complications: a randomized trial. Ann Surg. 2008;248:739-745.

Lipson SJ. Spinal-fusion surgery—advances and concerns. N Engl J Med. 2004;350(7):643-644.

North American Spine Society. Phase III clinical guidelines for multidisciplinary spine care specialists. Spinal stenosis version 1.0. National Guideline Clearinghouse website. Available at: http://www.guidelines.gov/summary/summary.aspx?doc_id=3609&nbr=002835&string=spinal+AND+fusion . Accessed September 7, 2005.

Spinal fusion. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/fact/thrreport.cfm?ThreadID=156&topcategory=Spine . Updated September 2007. Accessed June 25, 2008.

Spinal fusion surgery. North American Spine Society website. Available at: http://www.spine.org/articles/spinalfusion.cfm . Accessed August 30, 2005.

 
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