Spinal fusion

Spinal fusion is surgery to connect two or more bones in any part of the spine. Connecting the bones prevents movement between them. Preventing movement helps prevent pain.

During spinal fusion, a surgeon places bone or a bonelike material in the space between two spinal bones. Metal plates, screws or rods might hold the bones together. The bones then can fuse and heal as one bone.

Spinal fusion connects two or more bones in the spine to make it more stable, correct a problem or reduce pain. Spinal fusion may help relieve symptoms caused by:

• The shape of the spine. Spinal fusion can help correct problems with the way the spine is formed. An example is when the spine curves sideways, also known as scoliosis.
• Spinal weakness or instability. Too much motion between two spinal bones can make the spine unstable. This is a common side effect of severe arthritis in the spine. Spinal fusion can make the spine more stable.
• Damaged disk. Spinal fusion might be used to stabilize the spine after a damaged disk is removed.

Spinal fusion is generally safe. But as with any surgery, spinal fusion carries some risks.

Possible complications include:

• Infection.
• Poor wound healing.
• Bleeding.
• Blood clots.
• Injury to blood vessels or nerves in and around the spine.
• Pain at the bone graft site.
• Return of symptoms.

Getting ready for the surgery might include trimming hair over the surgical site and cleaning the area with a special soap. Tell your healthcare team about medicines you take. You may be asked to stop taking some medicines for a time before the surgery.

During spinal fusion

Surgeons perform spinal fusion while the person having the procedure is in a deep sleeplike state, known as general anesthesia. There are several ways to do spinal fusion surgery. The technique the surgeon uses depends on where the bones to be fused are on the spine, the reason for the spinal fusion, and possibly, general health and body shape.

Generally, the procedure involves the following:

• Getting to the spine. To get to the bones being fused, the surgeon cuts in one of three places. From the back, these cuts are in the neck or back directly over the spine or on either side of the spine. To get to the spine from the front, the surgeon cuts into the stomach area or throat.
• Getting the bone graft ready. Bone grafts come from a bone bank or from the body of the person having the surgery, usually from the pelvis. Sometimes surgeons use human-made material instead of bone grafts. To use the person's bone, the surgeon cuts near the pelvic bone, removes a small part of it and then closes the cut.
• Fusion. To fuse the spinal bones, the surgeon places the bone graft material between the bones. The surgeon might use metal plates, screws or rods to help hold the bones together while the bone graft heals.

After spinal fusion

A hospital stay of 2 to 3 days is usually required following spinal fusion. Depending on the location and extent of your surgery, you may experience some pain and discomfort. Medicines usually can control pain.

At home after surgery, contact your healthcare team if there are signs of infection. Watch for:

• A change in color around the wound. This might be a shade of red, purple or brown depending on your skin color.
• Tenderness or swelling in the wound area.
• Fluid coming from the wound.
• Chills that cause shaking.
• Fever higher than 100.4 degrees Fahrenheit (38 degrees Celsius).

It can take several months for the bones in the spine to heal and fuse. A healthcare professional might suggest wearing a brace for a time to keep the spine straight. Physical therapy can teach how to move, sit, stand and walk in a way that keeps the spine in line.

Spinal fusion typically works for fixing broken bones, reshaping the spine or making the spine more stable. But study results are mixed when the cause of the back or neck pain is not clear. Spinal fusion often works no better than nonsurgical treatments for back pain with a cause that's not clear.

Even when spinal fusion relieves symptoms, it doesn't prevent future back pain. Arthritis causes much of back pain. Surgery doesn't cure arthritis.

Having a spine that doesn't move in places puts more strain on the areas around the fused part. As a result, those areas of the spine might break down faster. Then the spine might need more surgery in the future.