What You Can Expect with Spinal Fusion Surgery
Spinal fusion surgery “welds” vertebrae in the spine by fusing them together. The procedure aims to heal damaged areas by joining them into one solid bone to stabilize movement and pain in the affected area. While spinal fusion reduces pain, it may not eliminate it all together and it does open the risk of degeneration in other areas of the back in some patients.
Depending on the complexity, a spinal fusion surgery takes a few hours or more. The surgery involves bone grafting and materials such as metal rods, plates and screws to stabilize the vertebrae. Lumbar spinal fusion surgeries have a success rate of between 65 to 90 percent or higher depending on the health of the patient. Most people having spinal fusion surgery heal quickly and are back in full activity within about 90 days.
What are the Risks of Spinal Fusion Surgery?
As with any surgery, there are risks to be aware of that could introduce complications. These include infection, bleeding, pain at the site of the surgery, nerve damage, poor wound healing, and blood clots. The presence of any of these symptoms can also raise the risk of re-operation.
What Conditions Does Spinal Fusion Surgery Treat?
Depending on the nature of your back condition, spinal fusion may be a surgical solution. According to the American Academy of Orthopaedic Surgeons, these are the most common back-related conditions relieved by lumbar spinal fusion.
- Degenerative disc disease
- Spinal stenosis
Patients go under general anesthesia. Spinal surgeons then begin working on the damaged area. The steps to a standard lumbar spinal fusion surgery include:
- Incision: To secure passage through the fused vertebrae, your surgeon typically creates an incision at your abdomen, which is known as anterior approach spine surgery, and is thought to be muscle sparing.
- Disc preparation: Interbodies that fuse two vertebrae together may actually come from a bone bank from the patient’s own body, commonly from the patient’s pelvis or doctors can opt to use fully synthetic (plastic or metal) parts. If the patient’s bone is applied, the surgeon makes an incision above the pelvic bone, extracts a small portion of it, and then closes the incision up. In selected situations, some specialists employ a synthetic substance instead of bone grafts. These synthetic substances are thought to further promote bone growth and expedite the fusion of the patient’s vertebrae.
- Fusion: To permanently fuse the vertebrae together, your spine surgeon places the chosen interbody material between the vertebrae. Metal plates, screws, or rods may also be used to further hold the vertebrae together while the bone graft locks into place.
Caption: Illustration showing hardware (metal) is used to fuse the patient's spine from the back of the neck.
Expect to feel some pain after your surgery. This is natural and the attending nurses and your doctor will help you to reduce and manage post-op pain as you recover at the hospital over the course of one to two days.
Once discharged and home from surgery, recovery begins. While recovery tends to go smoothly, keep an eye on the aforementioned complications that can stifle your recovery. Your doctor may recommend a back brace for a short time as a way to manage spinal alignment. In addition, physical therapy will teach you how to bend, sit, rise, and walk in a safe fashion to prevent re-injury.
Your doctor will prescribe medications for short-term pain relief after surgery. Many are over-the-counter, non-steroidal anti-inflammatory drugs (NSAIDs), but you may also get a prescription for opioids. These are regulated by your doctor and serve to keep severe pain at bay.
Be aware that while opioids relieve pain they can be addictive. If prescribed, use only as directed by your doctor.
In time, the bones will fuse allowing for stability in the affected areas of the spine. It could take several months for the bones to solidly fuse. Most patients find their comfort level improves much faster throughout recovery. Keeping the fused spine properly aligned is key to a successful outcome. Once you regain strength and confidence, you should be able to gradually enjoy returning to your previous activities. Be sure to follow your doctor’s orders and maintain a healthy lifestyle, which includes being smoke-free, in order to have the best outcome.