A normal spine is made up of hard bones (vertebrae) with soft cushioning (discs) between them. If you’re having back or neck pain and have tried other treatments, you and your doctor may want to be consider spinal fusion. Your surgeon will fuse together two of more vertebrae with the goal of stabilizing the spine and thus minimizing pain. While spinal fusion limits the movement of those bones, it can sometimes increase your mobility as your pain is alleviated.
There are many potential reasons to consider spinal fusion, among them are fractured vertebrae, spinal curves, diseased discs, arthritis, and spondylolisthesis or vertebral slippage. There are two types of spinal fusion surgery depending on the location of your pain. Cervical Fusion is performed on the neck, Thoracic Fusion is performed on the chest and Lumbar Fusion is performed on the lower back.
The fusion procedure is as follows:
- The disc may be removed from between the vertebrae to be fused.
- Bone graft may be packed into the space or along the side of the spine, eventually growing into one solid unit with the surrounding bone. If additional support is needed, metal supports may be used to steady the spine as it fuses.
- The incision is closed with sutures or staples.
Your hospital stay after spinal fusion will be from one day up to a week depending on the type of fusion, followed by recovery at home which can take from 3 months up to a year. Post-operative regimen includes pain medication as directed, strengthening exercises, physical therapy, and possibly a brace as recommended by your doctor.
The spinal canal runs through our vertebrae, and between the vertebrae are the intervertebral discs. As we age, our discs become less spongy and less fluid-filled, resulting in less disc height and bulging discs. The bones and ligaments of the spinal facet joints can thicken and enlarge due to arthritis, pushing into the spinal canal. All of these changes cause a narrowing of the lumbar spinal canal, or spinal stenosis.
Spinal stenosis may occur rapidly or very slowly over time, resulting in compression of spinal nerves and nerve roots, with the most common symptoms being pain and/or numbness in the back and/or legs, or leg cramping. Non-surgical treatment options include anti-inflammatory medication, physical therapy, and cortisone injections. If the patient does not respond to conservative options, the most common surgical treatment for stenosis is a lumbar laminectomy.
A laminectomy involves surgery from either the back of the neck (cervical) or the lower back (lumbar) to remove the bone and ligaments pressing on the spinal cord. . Laminectomy patients typically remain in the hospital for a few days then return home with gradually increasing mobility, returning to normal activities within 3-6 months. Post-operative rehabilitation is recommended such as physical therapy.