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spinal fusion

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Brain and spinal cord

Spinal fusion is a surgical procedure that involves the joining, or fusion, of two or more vertebrae, the bones that make up the spine. The purpose is to correct abnormal movement between vertebrae to prevent potential damage to the spinal cord.

Who is a candidate for the procedure? 
Spinal fusions are performed on people who have unstable vertebrae, which may be caused by:
  • a congenital abnormality present at birth
  • a progressive spinal disorder, such as spondylolisthesis

Someone who has recurrent slipped discs may also need a spinal fusion to prevent future herniations of the disc. Spinal fusions are also performed on unstable spinal fractures to prevent harm to the spinal cord or nerve roots.

How is the procedure performed? 
With the person lying face down on a table in the operating room, an incision is made in the affected area of the spine. The bones to be fused are then roughened to create a raw surface on which a bone graft can grow. The bone graft, which usually consists of bone chips taken from the person's pelvis, is placed on the roughened surface. Metal plates or rods are used in most fusions to immediately stop motion in the spine. In some cases, the surgeon performs the fusion through an incision in the chest or abdomen.

What happens right after the procedure? 
After surgery, the person is often required to wear a type of brace or corset. This is usually worn for 3 to 6 months or until x-ray reveals that the fusion is complete. Activity is restricted, especially any activity involving lifting or vigorous motion. Discomfort gradually decreases as healing occurs. Once the fusion is complete, normal activity can take place. Weight loss, where appropriate, is recommended to decrease the strain on the spine. An individual who smokes is strongly encouraged to stop smoking. Smoking decreases the likelihood of a successful fusion, because decreased oxygen and chemicals in the bloodstream prevent proper healing.

What happens later at home? 
There is no special care required other than watching for signs of infection. The brace or corset should be worn as directed. Exercise restrictions given by the surgeon should also be followed. Any new or worsening symptoms should be reported to the doctor.

What are the potential complications after the procedure? 
Infection is the main concern. Antibiotics are usually given during and after surgery. Loosening of the metal plate or rod may require further surgery for removal or repositioning. Injury to the spinal cord or nerves may also occur. If the fusion was performed by entering the chest or abdomen, there is a possibility that injury to structures in those areas may have occurred. Finally, the bones may fail to fuse together, requiring further surgery or treatment.

Author: James Warson, MD
Reviewer: eknowhow Medical Review Panel
Editor: Dr John Hearne

Last Updated: 19/10/2004
Potential conflict of interest information for reviewers available on request

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