What Is Spinal Fusion?

• Know when to arrive at the surgery center. You’ll need someone to drive you and take you home.
• Get a list of the medicines you can or can’t take in the days before surgery. Some drugs, like aspirin or other anti-inflammatory drugs, may be unsafe. Never stop taking any medicines without your doctor’s OK.
• Find out if you can eat or drink anything before your procedure.
• Get your home ready. You’ll need raised toilet seats, shower chairs, slip-on shoes, reachers, and other aids.

What you can expect

During spinal fusion

Surgeons perform spinal fusion while you’re under general anesthesia so you’re unconscious during the procedure. Surgeons have developed a variety of techniques for performing spinal fusion surgery. The technique your surgeon uses depends on the location of the vertebrae to be fused, the reason for the spinal fusion, and in some instances, your general health and body shape.

Generally, the procedure involves the following:

• Incision. To gain access to the vertebrae being fused, the surgeon makes an incision in one of three locations: in your neck or back directly over your spine, on either side of your spine, or in your abdomen or throat so that your surgeon can access the spine from the front.
• Bone graft preparation. The bone grafts that actually fuse two vertebrae together may come from a bone bank or from your own body, usually from your pelvis. If your own bone is used, the surgeon makes an incision above your pelvic bone, removes a small portion of it and then closes the incision.
• Fusion. To fuse the vertebrae together permanently, the surgeon places the bone graft material between the vertebrae. Metal plates, screws or rods may be used to help hold the vertebrae together while the bone graft heals.

In selected cases, some surgeons use a synthetic substance instead of bone grafts. These synthetic substances help promote bone growth and speed the fusion of the vertebrae.

After spinal fusion

A hospital stay of two to three days is usually required following spinal fusion. Depending on the location and extent of your surgery, you may experience some pain and discomfort but the pain can usually be controlled well with medications.

After you go home, contact your doctor if you exhibit signs of infection, such as:

• Redness, tenderness or swelling
• Wound drainage
• Shaking chills
• Fever higher than 100.4 F (38 C)

It may take several months for the affected bones in your spine to heal and fuse together. Your doctor may recommend that you wear a brace for a time to keep your spine aligned correctly. Physical therapy can teach you how to move, sit, stand and walk in a manner that keeps your spine properly aligned.

Results

Spinal fusion is typically an effective treatment for fractures, deformities or instability in the spine. But study results are more mixed when the cause of the back or neck pain is unclear. In many cases, spinal fusion is no more effective than nonsurgical treatments for nonspecific back pain.

It can be difficult to be certain about what exactly is causing your back pain, even if a herniated disk or bone spurs show up on your X-rays. Many people have X-ray evidence of back issues that have never caused them any pain. So your pain might not be associated with whatever problem has been revealed on your imaging scans.

Even when spinal fusion provides symptom relief, it does not prevent you from developing more back pain in the future. Most of the degenerative conditions in the spine are caused by arthritis, and surgery will not cure your body of that disease.

Immobilizing a section of your spine places additional stress and strain on the areas around the fused portion. This may increase the rate at which those areas of your spine degenerate — so you may need additional spinal surgery in the future.