Vertebral fusion is a type of spinal surgery intended to treat a range of spinal problems. The vertebral fusion procedure generally involves using bone grafts to surgically fuse vertebrae together. Movement in that area of the spine is usually reduced, but the pain associated with the problem is also often greatly reduced or eliminated. While vertebral fusion can relieve the symptoms of a number of spinal conditions, it can also carry significant risks. People who have had this surgery remain at risk for future spinal problems.
Most physicians do not recommend a spinal fusion procedure until other treatments have failed to relieve the symptoms of spinal dysfunction. Spinal conditions that can necessitate a vertebral fusion can include scoliosis, spondylolisthesis, and degenerative disk disease. Injuries to the spine and spinal tumors can create instabilities in the vertebral column that can require a fusion procedure. Spinal fusion procedures are often performed as a follow-up procedure to diskectomy.
Surgeons typically use bone grafts to fuse spinal vertbrae together. These grafts may come from the patient's own body. Autografts are usually taken from the pelvis.
Bone grafts may also be taken from donors. More recently, synthetic bone grafts have come into use. These grafts are usually placed over or between the affected vertebrae, and the bones themselves are usually fastened together during the healing process.
The incisions used to perform this surgery may be made on the front or the back of the body. At least one technique requires surgeons to make incisions in both sides of the body and to perform the surgery from both front and back angles. Many surgeons prefer this technique, since it's generally easiest to access the spinal column and work around the delicate spinal nerves with access from dual incisions. The surgery itself generally lasts for about four hours, and most patients must remain hospitalized for at least two to three days.
Patients are normally kept immobilized by a spinal brace or cast while still in the hospital. It is considered crucial that the spine be kept immobilized during the healing process. Hospitalized patients are typically counseled in how to move without mobilizing the spine. Spinal braces may be required for up to three months after the vertebral fusion procedure is performed, and activity is generally restricted for at least six weeks after the procedure.
The vertebral fusion procedure is generally considered major surgery, and carries the same risks as any major surgery, including heart attack, stroke, infection, blood loss, and clots. Risks specific to this surgery can include nerve damage in the spine, leading to a range of problems including loss of muscle strength, pain, and incontinence. This surgery can significantly reduce the range of motion in the newly fused bones, which can put pressure on the parts of the spine adjacent to the fused area. Future spinal conditions and injuries may be more likely to develop in these adjacent vertebrae in the future.
