What is a Spinal Fusion?

Spinal fusion, sometimes referred to as lumbar or posterior spinal fusion, is a surgery to join two or more spinal bones (vertebrae) so that they eventually grow into one solid bone. The goal of spinal fusion is to stop abnormal movement and thus eliminate pain in your back and legs.

Why do I need it?

The surgery is usually done to correct instability of the spine. Arthritis, injuries, or simple wear and tear can cause some of the bones in your spine to slip or shift out of place. This abnormal bone movement can cause back pain. It can also pinch nerves, causing pain, numbness, or weakness in your legs. The leg pain is called sciatica or radiculopathy.

Spinal fusion surgery is usually done after non-surgical treatment options have failed. These can include:

  • Medications
  • Physical therapy
  • Traction
  • Spinal injections
  • Watching and waiting. If your symptoms are caused by an unstable spine, lumbar spinal fusion is probably your only effective treatment option. If you feel your symptoms are not severe enough to have surgery, tell your doctor. He or she will respect your decision.

What are the Risks and/or Side Effects?

Spinal fusion risks include:

  • Blood loss. With any surgery there is always the potential for life-threatening blood loss, but with current techniques this is rare.
  • Damage to the nerve sac, with leak of spinal fluid (2 to 5 in 100 cases). If the nerve sac is unintentionally opened during surgery, it will be repaired. This should not have any effect on your long-term outcome, but you may have to spend a day or two flat in bed to allow the repair to strengthen. Rarely, further treatment may be necessary.
  • Infection (1 or 2 in 100 cases). Even with antibiotics and careful sterile technique, there is still a small risk of developing a wound infection.
  • Damage to spinal nerves (fewer than 1 in 1000 cases). This could cause ongoing pain, numbness, or weakness in your legs.
  • Failure of fusion. If the fusion fails, you may need to have more surgery.
  • Failure to relieve symptoms. Your surgeon will do everything possible to give you the best results. Even so, surgery may not relieve all your symptoms.

What are the Benefits?

Spinal fusion may eliminate pain by stopping abnormal and painful movement between diseased vertebrae.

How is it Done or Administered?

Preparing for surgery

Take these steps to help your surgery and recovery go better:

  • Stop smoking. If you smoke, try to stop prior to surgery. Non-smokers have fewer complications related to surgery. More importantly, smoking slows bone healing, and could cause your fusion surgery to fail.
  • Stop certain medications. Stop taking aspirin two weeks before surgery. Stop taking anti-inflammatory medications such as ibuprofen (Advil, Motrin) and naproxen (Aleve) 1 week before surgery. If you take blood thinners, ask your doctor when to stop taking them. You can continue to take most of your other regular medications. Tell your doctor everything you’re taking so your doctor can help you know what to stop.
  • Ask for time off work. Ask your doctor how long you may need to be off work, and make arrangements with your employer.
  • Ask for someone to drive you home. Arrange for someone to drive you home from the hospital and to help you at home for the first few days.

Precautions to take before surgery

  • Do not eat or drink anything after midnight the night before the surgery.
  • Take your regular medications (as directed by your surgeon) as normal, with a few sips of water.
  • You will be admitted to the hospital on the day of the surgery.
  • Bring a list of all your current medications with you to the hospital. This includes over-the-counter medications and vitamins.
  • You may need to fill out some paperwork, including a consent form for the surgery.

The surgical procedure

  1. An anesthesiologist will put you to sleep so you will not feel or remember the surgery. You will also be given antibiotics to help prevent infection.
  2. You will be placed on your stomach so the surgery can be done from your back, at or near your spine.
  3. After making an incision (cut) in your skin and spine, the surgeon will implant fixation devices to hold the vertebrae in the correct position. These devices (called “hardware”) include spacers in the disc space between the bones, and a system of metal (titanium) screws and rods on the back of the bones.
  4. If spinal nerves are pinched by disc material, overgrown joints, or bone spurs, the surgeon will remove that material to ensure that the nerves have plenty of space.
  5. The surgeon will then pack bone chips between and around the abnormal vertebrae so that over time they will fuse (grow together) into one solid piece of bone.
  6. The incision will be closed with stitches or staples.

What Should I Expect During Recovery?

  • You will wake up from surgery in a recovery area of the hospital. Within about 30 minutes, you will be taken to your hospital room.
  • You will feel new pain in the area where the surgery was done. The first few days after surgery can be quite painful. You’ll be given medication for it, and the pain will gradually go away.
  • Most patients are up and walking the day of the surgery. Nurses and physical therapists will be there to assist you. By the time you are released from the hospital, you should be able to get around on your own, go up and down stairs, and take care of your own personal needs.
  • Expect to stay in the hospital between two and six days. Some patients need to stay longer. You will be allowed to go home as soon as you’re doing well medically and your surgeon approves.

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This medical information is provided by Intermountain Healthcare. It has not been developed to replace medical advice provided by your health care provider.