A patient whose spine has been made unstable due to injury, disease or the removal of a herniated disk might opt for spinal fusion surgery. In this type of surgery, a bone graft is placed between the two affected vertebrae and secured in place by cages, rods, metal plates, screws or hooks. Over time, the bone fuses into the bones above and beneath it to create one long, inflexible bone.
The graft can be harvested from the hip of the patient or from a cadaver. It can also be made of synthetic bone.
Preparing for Spinal Fusion Surgery
The patient needs to do several things in the weeks before they have surgery. If they smoke, they need to stop, as smoking interferes with healing. They need to discontinue medications or supplements that interfere with blood clotting. During a consultation, the surgeon and patient decide on the type of spinal fusion surgery that would be best. The surgery can be done from the back, front or side. They include:
Posterior Lumbar Interbody Fusion
This surgery is done from the back. The surgeon removes the damaged disc and replaces it with the bone graft. A similar operation is transforaminal lumbar interbody fusion.
Anterior Lumbar Interbody Fusion
This is basically the same surgery as the PLIF, but is done from the front.
This surgery is done from both the front and the back.
Extreme Lateral Interbody Fusion
This operation is done from the side.
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The patient is placed under general anesthesia for these operations.
Another type of fusion is endoscopic transforaminal decompression interbody fusion, a minimally invasive surgery that is performed with the assistance of an endoscope, a tiny camera connected to a flexible tube attached to a monitor. The incisions used in this operation are tiny, and the surgical instruments are miniaturized.
With this technique, the patient spends less time under general anesthesia than they would with the open operations. There is less loss of blood and a shorter recovery period.
After Spinal Fusion Surgery
Most people spend about three or four days in the hospital, though some can go home the same day. The hospital stay depends on the extent of the surgery. Some patients are also fitted with a back brace. If they are, they’ll wear it for six weeks to three months.
The patient’s vital statistics are monitored throughout their hospital stay. They are encourage to get out of bed as soon as they are able and move around somewhat. This helps prevent dangerous blood clots from forming in their lower legs.
Pain is controlled by medication delivered via injection or IV line. The patient can be put on oral pain medications when they are able to eat and drink again. The severity of the pain should fade after about a month, though some patients report discomfort for up to six months.
While they are healing, the patient should not do strenuous activity, bend or twist.
The patient will need help at home for the first week or so after the surgery and will have a follow up appointment with their doctor two weeks after surgery. A physical therapist is brought in about six weeks after the operation to help the patient strengthen their back through gentle exercise.
Most patients recover completely from spinal fusion surgery and are ultimately able to move about without pain.
For more information about spinal fusion surgery, called Dr. Jeffrey M. Epstein for a consultation. The number is (631) 657-2212.