Spine Fusion Surgery

Overview of Spine Fusion Surgery in India

Spinal fusion is a surgical procedure to connect two or more vertebrae in your spine (backbone). The vertebrae are ring shaped bones that form an interlocked column that supports your body weight while standing upright. Fusing these will help strengthen your back.

Multiple types of surgeons perform spinal fusion surgery, including neurosurgeons and orthopaedic surgeons. Which type of surgeon performs your spinal fusion surgery will depend on the underlying condition and specific patient factors. 

There are many ways to manage back pain and spine-related problems. In many situations the treatments other than surgery can be safer (less complications) and more effective. But for some people spinal fusion might represent their best option.

Are You A Candidate For Spine Fusion Surgery?

Spine fusion surgery is a major surgical procedure that is performed when all other options fail in individuals suffering from severe spinal disorders. You may be a candidate for minimally invasive spine fusion surgery if:

Non-surgical treatment options have not provided adequate reduction in symptoms of spinal disorder. Non-surgical treatment consists of:

• Medications
• Physical therapy
• Spinal injections

A patient must discuss with their physician or spine specialist the length and type of pain, the pain symptoms, and the results of all the different treatments they have tried. Taking all factors into consideration, your doctor may recommend surgical treatment for your pain.

Types of Spine Fusion Surgery:

There are a number of popular kinds of spine fusion surgeries:

Posterior Lumbar Interbody Fusion (PLIF):

In a PLIF that incision is made posterior (from the back) of the spine. The disc is removed between two bones in the spine before inserting a bone graft into the space between them. The metal implants are added to aid in providing stability to the spine.

Anterior Lumbar Interbody Fusion (ALIF):

The incision will be from anterior (the front) of the body (there will also be an incision made in the abdomen). The damaged disc is removed and a bone graft will be inserted into the space between the two bones. Metal implants may be inserted to help provide stability.

Lateral Lumbar Interbody Fusion (LLIF):

Lateral lumbar is performed using a minimally invasive approach, usually from the side of the body. In this case, surgery is performed to remove the damaged disk and uses grafts or metal implants to replace the damaged disk.

Transforaminal Lumbar Interbody Fusion (TLIF) 

TLIF is comparable to PLIF; however, it is frequently done posteriorly and from one side of the spine. Doing the procedure at an angle creates better access to remove the disc space, insert the bone graft, and place the metal implants.

Cervical Fusion 

Cervical fusion surgery is a type of fusion that is performed in the neck region. Two or more bones of the spine are fused, typically with either the bone graft or the metal implant.

Thoracic Fusion 

Thoracic fusion surgery is performed on the upper back of the spine. It may involve the removal of a damaged disc or a repaired fractured vertebra where the damaged space is filled with a bone graft and metal implants to achieve a fusion.

Procedure:

Preoperative

Before surgery, doctors must ensure the patient is fit for surgery. The patient will undergo some tests and screening processes to be assessed with consideration to surgery. Some medications may be prescribed to the patient a week or two before the surgery to prevent infections during or after the surgery.

The patient will be put under general anaesthesia before being wheeled into the operating room, which means the patient will be unconscious during the surgery.

Operative

Step 1: Doctor will make a small incision adjacent to area being treated, either in neck or back (over the spine), either side of the spine, lower abdomen or neck.

Step 2: The doctor gains access to the vertebrae being fused and will actually use bone graft materials to fuse two vertebrae surgically. The bone graft in one instance can be harvested from the patient's pelvis or it may be obtained from a bone bank.

If a patient is the donor, the doctor will surgically collect the bone graft through making an incision above the pelvis and removing a portion and closing the incision. The second way is to obtain a bone graft is from a bone bank or donor.

Step 3: The doctor will then permanently fuse the two vertebrae (cervical or lumbar) using the bone graft material. The bone graft may be surgically introduced using metal plates, screws or rods.

Step 4: The doctor will suture close the incision and place surgical tape on top.

Postoperative

Postoperatively, the patient will be kept in the recovery room for observation, at which point the doctor will transfer them to the ICU. The patient's stay in the ICU usually lasts a day or two, after which the staff will transfer them to a regular ward. The patient will also remain there until they are well enough to be discharged.