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Spinal fusion


Alternative names

Harrington rod insertion; Posterior spinal fusion; Arthrodesis; Luque rod insertion; Anterior spinal fusion

Definition

Spinal fusion involves surgical treatment of abnormalities in the spine bones (vertebrae), such as abnormal curvatures ( scoliosis or kyphosis ) or injuries (fractures). The surgery stabilizes the back by fusing certain vertebrae together with bone grafts or metal rods.

The most common spinal area involved is the lower (lumbar) spine, but upper (cervical) spine fusion can also be performed. This surgery can also be used to treat arthritis or infection.

Description

While the patient is under general anesthesia (unconscious and pain-free), an incision is made over the area of the spine that will be treated.

The lower spinal vertebrae are often repaired through an incision directly over the spine -- this is called the posterior lumbar approach. The upper spinal vertebrae are often repaired through an incision in the front or side of the neck ( anterior cervical spine). The middle spinal vertebrae are sometimes repaired through an incision made in the chest and abdomen (anterior thoracic spine).

Any area of the spine can be repaired from the front side or the back, depending on the disease and surgeon's preferences.

The abnormal or injured vertebrae are repaired and stabilized with bone grafts , metal rods, or both.

Indications

Spinal fusion may be recommended for the following:
  • Abnormal curvature of the spine
    • Scoliosis
    • Kyphosis
  • Injury to the spinal vertebrae
  • Protrusion of the cushioning disc between vertebrae (slipped disk, herniated nucleus pulposus )
  • Weak or unstable spine caused by infections or tumors

Risks

Risks for any anesthesia include the following:
  • Reactions to medications
  • Problems breathing
Risks for any surgery include the following:
  • Bleeding
  • Infection
Additional risks include the following:
  • Urinary difficulties (including urinary retention)
  • Temporary decreased or absent intestinal function ( paralytic ileus )

Expectations after surgery

This surgery is usually very successful, especially with the many techniques and instruments now in use.

Convalescence

The patient will be hospitalized for several days after surgery. The repaired spine should be kept in proper position to maintain alignment.

The patient will be taught how to move properly, how to reposition, sit, stand and walk. While in bed, the patient will need to turn using a "log-rolling" technique, meaning that the entire body is moved as a unit, not twisting the spine.

There is usually considerable pain for the first few days after surgery, and pain medication will be given regularly, perhaps by a patient-controlled analgesia (PCA). The patient will probably have a urinary catheter.

Because of the risk of temporary decreased or absent intestinal function ( paralytic ileus ) after spinal surgery, the patient may not be able to eat for 2 to 3 days and will be fed intravenously.

The patient may be discharged with a back brace or cast.

Update Date: 11/13/2002

Thomas N. Joseph, M.D., Department of Orthopedic Surgery, NYU/Hospital for Joint Diseases, New York, NY. Review provided by VeriMed Healthcare Network.

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Last updated: Tue, 06 Jan 2009 00:20:03 GMT
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