Undergoing Spinal Fusion Surgery – All You Need to Know

Robert Watkins IV';

By Robert Watkins IV

Posted on March 3rd, 2022 in Spine Center

Every year, surgeons in America perform over 1.6 million spinal fusions, a procedure during which two or more vertebrae are fused permanently. Spinal fusion is often carried out using a bone graft or metal hardware to stabilize the spine.

There are numerous conditions and injuries spinal fusion can help with, including spondylosis, fractures, stenosis, herniated discs, scoliosis, kyphosis, and even infections.

Even so, because it is a surgical procedure, your doctor will first try to relieve your symptoms by prescribing you non-invasive treatment such as medication.

By virtue of the advance of medical technology, increasingly more people who require the procedure opt for minimally invasive spinal fusion, which shortens recovery time and the chances of postoperative complications. However, regardless of how your spinal fusion will be performed, you may still have questions. This article will offer answers to the most common questions and concerns of people who are about to undergo spinal fusion, such as who is a good candidate, what happens during the surgery, the recovery period, and the benefits and risks of spinal fusion.

Who Is a Good Candidate for Spinal Fusion?

People whose doctor recommends spinal fusion are usually those who have not benefited from conservative treatment such as pain medicine, wearing a brace, physical therapy, or getting injections. If the person with back problems still experiences significant discomfort and pain in their daily life even after trying non-invasive treatment approaches, they will most likely be guided to a spine surgeon. The spine surgeon will thoroughly examine the back problem of the patient to determine whether they are a good candidate for spinal fusion. These are the most common back conditions and injuries for which spinal fusion might be the perfect solution:

  • spondylolisthesis
  • fracture
  • degenerative disk disease
  • tumor
  • kyphosis
  • herniated disk
  • scoliosis
  • infection
  • stenosis
  • arthritis
  • osteoporosis
  • neuromuscular disease

Your doctor might suggest you undergo spinal fusion because most of these conditions usually cause a lot of pain in the daily life of the patient, which might prevent them from enjoying their favorite activities or even from performing basic, everyday tasks. If you struggle with severe back pain, no matter the cause, you probably have to take breaks to rest after doing a slightly strenuous activity, which might not be normal for your age. The most affected region of the spine is the lumbar area, as roughly 210,000 spinal fusions are performed on this region every year, followed by the cervical area with 157,000 procedures and the thoracic region with 24,000 surgeries.

How Are Good Spinal Fusion Candidates Selected from Those Who Are Not?

The factor with the utmost importance in determining whether a patient qualifies for spinal fusion is perhaps whether their back pain is localized or diffuse. If their back pain can be pinpointed to a certain region, the person is most likely a good candidate for spinal fusion, as the procedure was thought out to treat specific regions of the spine, such as the lumbar area or the cervical area. The surgeon will locate the source of pain with the assistance of X-rays or a CT or MRI scan. If pain cannot be localized, fusing two vertebrae will not treat the underlying problem.

Another factor that might deem a patient a good candidate for spinal fusion is whether they meet condition criteria, more specifically, if they have a condition that would benefit from the procedure, which entails a restrengthening of two or more vertebrae. On the other hand, what could disqualify someone from undergoing spinal fusion is bad lifestyle habits and having certain conditions or diseases, such as:

  • smoking cigarettes
  • using steroids
  • having diabetes
  • having osteoporosis
  • being malnourished
  • being obese

Finally, a paramount aspect the patient should be aware of before undergoing spinal fusion is finding the right surgeon. Unless the procedure is carried out with utmost accuracy and precision, the spinal fusion may not stabilize the vertebrae as intended, and the patient may still experience pain afterward. Therefore, if you are considering undergoing spinal fusion, make sure you find a known, reputable, experienced surgeon who has successfully performed many spinal fusions, including complex surgeries.

What Happened During Spinal Fusion?

Your doctor will timely instruct you on how to prepare for spinal fusion, as you will have to avoid certain things, such as cigarette smoking, for up to 2 weeks before the procedure. You must follow the advice of your doctor religiously, as not doing so might interfere with your spinal fusion. For instance, if you do not cease taking certain medication, you can experience a lot of bleeding during the surgery, which is dangerous.

First, you are given general anesthesia to make sure you will be completely unconscious during the surgery, as it is usually quite complex and lengthy. Then, the surgeon will make a small incision in one of these three areas: in your neck or back over your spine, on either side of your spine, or in your throat or abdomen so that they can access the spine from the front.

Nonetheless, your spinal fusion might require a long incision that is made along the middle of your back if the goal of the procedure is to correct a severe spine deformity such as scoliosis. There are multiple surgical approaches to spinal fusion, so the placement of your incisions and how long they are will be different from those of other patients.

Subsequently, once the surgeon has access to your spine, they will use a bone graft, which may come from a donor or your body, usually your pelvis, to fuse the vertebrae. In addition to the bone graft, metal plates and pedicle screws might be used. Alternatively, your spinal fusion can be performed using pedicle screws and other metal pieces only.

In some cases, the surgeon will use a synthetic substance instead of bone grafts or metal pieces. These substances promote bone growth and speed the fusion of the vertebrae. The incision will be securely closed with stitches when the surgeon completes your spinal fusion.

The Recovery Period After Spinal Fusion

Following spinal fusion, it can take several months for the vertebrae to heal and fuse together. Your physician may suggest you wear a brace for a while to keep your spine aligned correctly. Furthermore, physical therapy can teach you how to move, sit, stand, and walk in a way that keeps your spine properly aligned.

When it comes to returning to work, it usually takes 4 to 6 weeks to return to a sedentary office job, but it can take up to 3 months or even longer to return to a more physical job. Here are some valuable tips on spinal fusion recovery you should keep in mind to experience a smooth recovery without accidentally causing damage to your healing spine:

  • Learn to practice adequate back care: Complex spinal fusions require more bed rest than other spine surgeries. Actually, your initial spinal fusion recovery routine might involve only sitting up in bed and logrolling, which means turning to a side so as not to twist your back. However, you will have to walk again at some point, which is important for maintaining good blood circulation. Proper spinal alignment is essential during your recovery. It can take between 3 and 6 months for your vertebrae to fuse. During this period, you should take special care and wear any bracing your doctor recommends.
  • Engage in activities that relieve your pain: In addition to taking the prescribed painkillers, you should also engage in light activities that promote pain alleviation. Keeping active is one of the best things you can do to speed up your recovery and minimize pain. You will not want to overdo it, but regular light movement helps prevent more than just blood clots. It also prevents your muscles from weakening, maintains digestive health, and boosts your energy levels.
  • Maintain a healthy diet: Obesity increases stress on the spine tremendously and can hinder your mobility, which will slow your recovery. You should eat small portions of fresh foods during your spinal fusion recovery, including lean protein and plenty of fruits and vegetables. You should also drink the right amount of water and reduce your sugar and caffeine intake.

Other valuable tips on how to speed up your recovery and make sure your vertebrae fuse together the way they should include going to the follow-up appointments with your physician, practicing the breathing exercises you were given, waiting to return to work until your surgery is completely healed, and asking a family member, relative, or friend to help you with daily tasks during the first weeks of your recovery. However, the most important things you should do are those your doctor recommended, as each patient who undergoes spinal fusion does it for a different reason, and each patient is unique in terms of health needs.

What Are the Benefits and Risks of Spinal Fusion?

Like any other invasive procedure, spinal fusion has a series of risks. Nevertheless, it also yields numerous benefits for the person undergoing it if they are a good candidate. The following are the most notable benefits of spinal fusion:

  • pain relief – most people undergo spinal fusion to address their back pain, which can stem from numerous conditions, such as scoliosis or arthritis
  • reduces spine deformity – people with scoliosis and kyphosis, which are two of the most common spine deformities, can benefit a lot from spinal fusion, as their spine will be properly aligned following the procedure, they will no longer experience pain, and their trunk will look as it should
  • addresses instability – another goal of spinal fusion is to reduce the movement between vertebrae that causes instability and pain, so if you undergo the procedure, you will no longer experience instability in your spine, or you will experience it to a minimum

The patient who undergoes spinal fusion should know that the surgery also entails risks, but if a competent, experienced surgeon is performing it, the rate of spinal fusion risks will be minimal. Some of the risks of this procedure are:

  • infection
  • bleeding
  • pain at the graft site
  • recurring symptoms
  • nerve damage
  • blood clots

If you were recommended to undergo spinal fusion, the information we have included in this article should give you a starting point regarding what to expect and what the procedure entails. Nowadays, undergoing spinal fusion is very common and safe if you find the right surgeon, namely a spine surgeon with years of experience who has preferably carried out complex spinal fusions.