Spinal fusion

Alternative Names: Vertebral interbody fusion; Posterior spinal fusion; Arthrodesis; Anterior spinal fusion; Spine surgery - spinal fusion

Spinal fusion is surgery to join together two bones (vertebrae) in the spine. Fusion permanently joins two bones together so there is no longer movement between them. Spinal fusion is usually done along with other surgical procedures of the spine.

Description of Procedure

You will be asleep and feel no pain (general anesthesia).

The doctor will make a surgical cut to view the spine. This may be done:

• On your back or neck over the spine. You will be lying face down. Muscles and tissue are separated to expose the spine.
• On one side of your belly, if you are having surgery on your lower back. The surgeon will use tools called retractors to gently separate, hold the soft tissues and blood vessels apart, and have room to work.
• With a cut on the front of the neck, toward the side.

Other surgery, such as a diskectomy, laminectomy, or a foraminotomy, is almost always done first.

The surgeon will use a graft (such as bone) to hold (or fuse) the bones together permanently. There are several different ways of fusing vertebrae together:

• Strips of bone graft material may be placed over the back part of the spine.
• Bone graft material may be placed between the vertebrae.
• Special cages may be placed between the vertebrae. These cages are packed with bone graft material.

The surgeon may get the graft from different places:

• From another part of your body (usually around your pelvic bone). This is called an autograft. Your surgeon will make a small cut over your hip and remove some bone from the back of the rim of the pelvis.
• From a bone bank, called allograft.
• A synthetic bone substitute can also be used.

The vertebrae are often also fixed together with rods, screws, plates, or cages. They are used to keep the vertebrae from moving until the bone grafts fully healed.

Surgery can take 3 to 4 hours.

Risks of Spinal fusion

Risks for any surgery are:

• Blood clots in the legs that may travel to the lungs
• Breathing problems
• Infection, including in the lungs (pneumonia), or bladder or kidney
• Blood loss
• Heart attack or stroke during surgery
• Reactions to medications

Risks for spine surgery are:

• Infection in the wound or vertebral bones
• Damage to a spinal nerve, causing weakness, pain, loss of sensation, problems with your bowels or bladder
• The vertebrae above and below the fusion are more likely to wear away, leading to more problems later

Scoliosis	Spinal fusion - series

Review Date: 6/4/2011
Reviewed By: David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc., and C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery.

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