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Spinal Surgery
 

Spinal fusion, also known as spondylodesis or spondylosyndesis, is a surgical technique used to combine two or more vertebrae. Supplementary bone tissue (either autograft or allograft) is used in conjunction with the body"s natural osteoblastic processes. This procedure is used primarily to eliminate the pain caused by abnormal motion of the vertebrae by immobilizing the vertebrae themselves.

Spinal fusion is done most commonly in the lumbar region of the spine, but it is also used to treat cervical and thoracic problems.

Conditions where spinal fusion may be considered:

There are two main types of lumbar spinal fusion, which may be used in conjunction with each other:

Posterolateral fusion places the bone graft between the transverse processes in the back of the spine. These vertebrae are then fixed in place with screws and/or wire through the pedicles of each vertebra attaching to a metal rod on each side of the vertebrae.

Interbody fusion places the bone graft between the vertebra in the area usually occupied by the intervertebral disc. In preparation for the spinal fusion, the disc is removed entirely. A device may be placed between the vertebra to maintain spine alignment and disc height. The intervertebral device may be made from either plastic or titanium. The fusion then occurs between the endplates of the vertebrae. Using both types of fusion is known as 360-degree fusion. Fusion rates are higher with interbody fusion. Three types of interbody fusion are:

  • Anterior lumbar interbody fusion (ALIF)- the disc is accessed from an anterior abdominal incision
  • Posterior lumbar interbody fusion (PLIF) - the disc is accessed from a posterior incision
  • Transforaminal lumbar interbody fusion (TLIF) - the disc is accessed from a posterior incision on one side of the spine

In most cases, the fusion is augmented by a process called fixation, meaning the placement of metallic screws (pedicle screws often made from titanium), rods or plates, or cages to stabilize the vertebra to facilitate bone fusion. The fusion process typically takes 6–12 months after surgery. During this time external bracing (orthotics) may be required. External factors such as smoking, osteoporosis, certain medications, and heavy activity can prolong or even prevent the fusion process. If fusion does not occur, patients may require reoperation.

The information contained above is for educational purposes only.  If you have
any questions relating to this or to any other orthopedic conditions, please consult
a board-certified orthopedic surgeon.

 
     
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