What is a Back Fusion

Back fusion, also referred to as spinal fusion, is the joining together of one or more vertebrae in order to stabilize the spine. It is often used in conjunction with other open back surgery procedures, and is sometimes used to treat deformities of the spine. Spinal fusion is a major surgery; fortunately, modern procedures have reduced the need for spinal fusion in most cases.

Uses

Open back surgery is often used to release pressure on the nerves (spinal decompression). When excess or misplaced tissue begins to press on the spinal cord or nerve roots, pain and neurological symptoms can result. Nerves can become compressed as a result of injury, disease, or simple aging. The most common culprits behind pinched nerves are the bones or discs of the spine; in rare cases, spinal tumors may be the culprit. Common conditions include:

• Herniated discs
  
• Bulging discs
  
• Degenerative disc disease
  
• Osteoarthritis of the spine
  
• Spinal stenosis
  

When these conditions are treated with traditional back surgery, it is often necessary to remove a significant amount of vertebral bone or disc material in order to decompress the nerve. After doing so, the stability of that portion of the spine is compromised.

In order to stabilize the spine, back fusion is used. Supplementary bone, or sometimes metal, is added to two vertebrae. The supplementary bone may be taken from either the patient's hip (autograft), or from a donor (allograft). As the bone heals, the vertebrae become fused together. This re-stabilizes the spine. It also reduces mobility in the treated vertebrae, which can sometimes help prevent future injury.

Back fusion can also be used in the treatment of spinal deformities, including scoliosis and kyphosis.

Risks 

Spinal fusion, like all major surgery, comes with a number of risks. These include:

• Infection
  
• Blood clots
  
• Bleeding
  
• Pain at the hip, where the bone was taken
  
• Poor wound healing
  

In addition, the recovery time after spinal fusion is lengthy (as long as several months).

Fortunately, in many cases there are alternatives to back fusion. While no procedure is without risks, choosing a minimally invasive surgery reduces the chance that stabilization will be needed. Minimally invasive surgery has a lower risk of infections, bleeding, and blood clots; the wound is much smaller and thus heals more quickly. In addition, spinal fusion usually requires surgery to be performed on two parts of the body, the hip and the back. Patients who do not undergo spinal fusion only need to heal from one surgical wound.

Routine spine conditions can often be treated using laser back surgery. Laser back surgery uses endoscopic cameras, lasers, and specialized tools to treat common conditions such as herniated discs, stenosis, and bone spurs. This eliminates the need to remove significant amounts of bone or disc material, which is what causes destabilization during traditional spine surgery.

On the other hand, there are some conditions which can only be effectively treated using spinal fusion; this includes some instances of spine deformities such as scoliosis.

In general, surgery for routine back conditions will not be recommended unless conservative treatments have proven ineffective. This is because even minimally invasive surgery is still surgery, and comes with risks and downtime, no matter how small. Most patients' back pain can be relieved without resorting to surgery. Among those who do need surgery, the majority of conditions can be treated using minimally invasive techniques, with no need to resort to back fusion. However, spinal fusion is still a good option for a minority of patients.

Only a doctor can tell you what the best course of treatment is in your particular case. To schedule your consultation today, please call the Datta Endoscopic Back Surgery and Pain Center at 212-420-0312.