According to NBC News, almost 600,000 Americans undergo back surgery every year. One common procedure when it comes to back surgery is spinal fusion.
Spinal fusion is performed on the vertebrae in the spine. During this procedure, surgeons connect two or more vertebrae together as one.
Experts often compare this process to welding because it literally fuses the vertebrae together. This keeps the vertebrae from moving, which often reduces or eliminates back pain.
So just what is the core concept behind this medical procedure?
The Spinal Fusion Process
In spinal fusion surgery, surgeons try to simulate the healing process of broken bones. As a result, the body heals as it would naturally. The end goal of surgery is to allow the vertebrae to heal as if they were one working part.
“Spinal fusion involves techniques designed to mimic the normal healing process of broken bones,” according to the Mayo Clinic. “During spinal fusion, your surgeon places bone or a bonelike material within the space between two spinal vertebrae. Metal plates, screws and rods may be used to hold the vertebrae together, so they can heal into one solid unit.”
Doctors often recommend spinal fusion surgery when pain associated with movement is thought to be the root of the problem. For example, this may occur in the case of an arthritic spine. Because surgery keeps affected areas of the spine from moving, this may eliminate pain.
In this process, surgery also reroutes the movement of the spine in general. Consequently, the areas above and below the fused vertebrae take on the stress of these changes. Experts say that this stress can speed up degeneration of these parts of the spine.
Risks of Spinal Fusion
Though spinal fusion is considered a safe procedure, it does come with risks. The Mayo Clinic says that some of these risks include infection, poor wound healing, bleeding, blood clots, injury to the blood vessels or nerves in and around the spine, and pain in the site where the bone graft is taken if grafting occurs.
There are a number of reasons why doctors may recommend spinal fusion surgery. According to Know Your Back, the most common of these are to correct a deformity in the spine, to alleviate pain due to motion, to treat a fractured vertebra, to treat instability and for cervical disc herniations.
One of the drawbacks of this surgery is the pain following the procedure. According to Know Your Back, “the immediate discomfort following spinal fusion is generally greater than with other types of spinal surgeries.” This can be frustrating for patients.
However, a number of pain medications and pain management options can be used to manage this discomfort. To combat pain, patients may be given prescription painkillers. In some cases, patients are even given a self-controlled pump to release medications for several days following surgery. By using this device, patients can choose when pain medication is administered by way of pressing a button.
It can take more time to recover from spinal fusion surgery than from other spinal surgeries. Though the average hospital stay is just three to four days, experts say that longer stays are not uncommon. This means the expected time spent in the hospital may change once doctors gauge the response to surgery. Of course, this varies depending on the health of the patient.
Some patients may be sent to a rehabilitation facility upon discharge from the hospital. This allows medical professionals to monitor progress in a controlled setting.
Other Surgical Concerns
Another drawback of spinal fusion surgery is that routine activities may not resume as quickly as they would be upon having other types of surgery. The surgeon must clear patients for activity. And to do this, he or she will want to see that the fused bones are healing properly. This time frame in which it takes to heal can be different based on the patient. Medical experts equate this to the differing amount of time that it takes for individuals to heal after experiencing a bone fracture. Usually, this healing cannot be seen for six or more weeks after the procedure itself.
Major healing then will usually be seen about three to four months after the procedure has taken place. This is when doctors will begin to remove activity restrictions while at the same time continuing to observe the patient’s progress. Therefore, restrictions are contingent on this progress. Bones may keep healing for up to a full year once surgery has taken place. Some patients also may be told to wear a brace to improve comfort or add necessary support to the spine.
Many patients will be placed in rehabilitation therapy to incorporate strengthening exercises and cardiovascular routines into their lives. The amount of rehabilitation suggested depends on the patient’s age, health, normal activity level and the type of procedure performed in terms of how many vertebrae have been fused.
That said, some say that back surgery can lead to more pain. According to NBC News, a study published in Spine analyzed the cases of 1,450 patients suffering from disc herniation, disc degeneration or radiculopathy. Fifty percent of those reviewed had spinal fusion surgery, and the other half received no surgical treatment. Two years after surgery, more than three-quarters of the patients who received surgical treatment had not returned to work. However, more than two-thirds of patients who did not receive surgery had returned to work. Patients who had had surgery reported a 41 percent increase in the use of painkillers to treat symptoms. Study author Dr. Trang Nguyen of the University of Cincinnati College of Medicine reported that this shows that, in many cases, spinal fusion surgeries are not successful in eliminating pain.
At the end of the day, the choice as to whether or not to have spinal fusion surgery is yours. Positive outcomes related to this surgery have been reported for years. It is not a new procedure and has been performed by medical professionals for a very long time. Discuss your options with your doctor to determine the pros and cons associated with this or any other surgery to reach an informed decision.