Spinal fusion involves “welding” of vertebrae that may be misaligned or causing trouble by putting pressure on nerves, essentially turning two troublesome spinal bones into one single, combined bone.
Spinal fusion may be used to relieve back pain in the following conditions:
- Bone tumors
- Degenerative disc disease
- Spinal stenosis
Spinal fusion surgery is an option when the source of pain results in abnormal motion, often related to instability from severe arthritis, stress fracture or trauma.
Where Does the Bone Used in Spinal Fusion Come From?
Spinal fusion surgery involves a form of “bone grafting,” where part of a bone from elsewhere in the body is used to promote the growth of new bone. A small piece or pieces of bone will be placed between the two vertebrae that are to be fused, which aids in promoting bone production and stimulates bone healing.
In the past, bone from the patient’s own body (often the hip) was used to perform bone grafting for spinal fusion therapy. This procedure requires more incisions, can increase the amount of pain experienced and potential for complications.
Recent advances in techniques allow using bone from a cadaver bone bank, called an allograft. Synthetic or artificial bone substitutes have also been developed:
- Demineralized bone matrices are a material taken from donated bone, but the calcium contents are removed until they create a gel-like material which can be combined with other proteins to promote bone growth. They contain natural bone morphogenic proteins to enhance healing of the fusion.
- Bone morphogenetic proteins are proteins that stimulate the body’s stem cells to “morph” or change into bone-producing cells to enhance and promote fusion success rates.
Artificial calcium or phosphate mineral materials may be used which are similar in shape and consistency to bone taken from your own body. Before your spinal fusion surgery, your doctor will discuss with you what the best choice is for your back surgery.
After Spinal Fusion Surgery
Rehabilitation can take time, and can often take months before the spinal fusion is complete. During this process, immobilization in a brace is commonly prescribed for comfort and protection as the fusion incorporates. In most spinal fusion surgeries, rods, screws and plates may be used in a process called “internal fixation,” which provides increased stabilization and higher fusion rates.
While in the hospital, you will be taught by your physical therapist how to get in and out of bed, use your brace, climb stairs and other daily activities. You may need a walker initially for safety.