There are seven vertebrae separated by intervertebral discs in the cervical spine. Typically, the preparation for spinal fusion is like other surgical procedures. It requires preoperative laboratory testing. These include anticoagulants blood thinners , such as warfarin , and nonsteroidal anti-inflammatory drugs NSAIDs , including aspirin and ibuprofen. On the day of surgery, use only a sip of water to take any medications your physician has recommended.
Spinal fusion is performed in the surgical department of a hospital. This allows your surgeon and anesthesia provider to monitor your heartbeat and blood pressure during surgery. The whole procedure may take several hours. Your surgeon will prepare the bone graft that will be used to fuse the two vertebrae.
If your own bone is being used, your surgeon will make a cut above the pelvic bone and remove a small section of it. The bone graft may also be a synthetic bone or an allograft, which is a bone from a bone bank. Depending on where the bone will be fused, your surgeon will make an incision for placement of the bone. The bone graft will be placed between the affected vertebrae to join them. Sometimes, the graft material is inserted between the vertebrae in special cages.
Some techniques place the graft over the back part of the spine. Once the bone graft is in place, your surgeon may use plates, screws, and rods to keep the spine from moving. This is called internal fixation. The added stability provided by the plates, screws, and rods helps the spine to heal faster and with a higher rate of success.
This generally lasts three to four days. Initially, your doctor will want to observe you for reactions to the anesthesia and surgery. You may need to learn new techniques to walk, sit, and stand safely.
You also may not be able to resume a normal diet of solid food for a few days. After you leave the hospital you may need to wear a brace to keep your spine in proper alignment. You might not be able to resume your normal activities until your body has fused the bone into place. Fusing may take up to six weeks or longer. Your doctor may recommend physical rehabilitation to help you strengthen your back and learn ways to move safely.
Full recovery from spinal fusion will take three to six months. While the fusion is growing together and strengthening, these movements should continue to be avoided to prevent stress at the fused segments:.
If a back brace was previously prescribed to help immobilize the back, it may be advised to continue wearing it up to 3 months after surgery.
See When to Consider a Back Brace. As pain gradually alleviates and the energy level rises, it is good to gradually increase activity levels.
As long as it has been cleared by the surgeon, the patient can start doing more of the following:. By 4 to 6 weeks after lumbar fusion surgery , most patients are cleared to return to school or work that does not involve physical labor. About 6 weeks to 3 months after surgery, an outpatient physical therapy program may be started. Techniques are tailored to the individual, with more and more activities added as strength builds. Physical therapy helps patients stay aware of how they walk, sit, stand, and lie down to help prevent back pain from recurring.
Your doctor may recommend spinal fusion to treat:. Spinal fusion is generally a safe procedure. But as with any surgery, spinal fusion carries the potential risk of complications. Preparation before surgery may involve trimming hair over the surgical site and cleaning the area with a special soap or antiseptic. Additionally, the surgical team may order monitoring of any unhealthy bacteria in your nose by taking a swab sample.
Tell your doctor about any medications you are taking. You may be asked to stop taking some medications before the surgery. When spinal fusion is performed from the back of the neck posterior cervical fusion , rods and screws are used to hold the vertebrae together. In some cases, surgery on your neck cervical vertebrae occurs from the front anterior side of your neck.
In the example shown, a damaged disk is removed, a bone graft is inserted, and the vertebrae are fastened together with a plate and screws. Depending on whether your surgeon approaches your spine from the front anterior spinal fusion or from the back posterior spinal fusion , the vertebrae will be fastened together either with a metal plate or with rods and screws.
Surgeons perform spinal fusion while you're under general anesthesia so you're unconscious during the procedure. Surgeons have developed a variety of techniques for performing spinal fusion surgery. The technique your surgeon uses depends on the location of the vertebrae to be fused, the reason for the spinal fusion, and in some instances, your general health and body shape.
In selected cases, some surgeons use a synthetic substance instead of bone grafts. These synthetic substances help promote bone growth and speed the fusion of the vertebrae. A hospital stay of two to three days is usually required following spinal fusion.
Depending on the location and extent of your surgery, you may experience some pain and discomfort but the pain can usually be controlled well with medications. It may take several months for the affected bones in your spine to heal and fuse together. Your doctor may recommend that you wear a brace for a time to keep your spine aligned correctly.
Physical therapy can teach you how to move, sit, stand and walk in a manner that keeps your spine properly aligned. Spinal fusion is typically an effective treatment for fractures, deformities or instability in the spine. But study results are more mixed when the cause of the back or neck pain is unclear.
In many cases, spinal fusion is no more effective than nonsurgical treatments for nonspecific back pain. It can be difficult to be certain about what exactly is causing your back pain, even if a herniated disk or bone spurs show up on your X-rays.
Many people have X-ray evidence of back issues that have never caused them any pain. So your pain might not be associated with whatever problem has been revealed on your imaging scans. Even when spinal fusion provides symptom relief, it does not prevent you from developing more back pain in the future.
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