Posterior
Spinal Fusion
An Overview
For patients with spondylolisthesis, scoliosis, or degenerative disc disease, spinal fusion is sometimes needed to correct a deformity or halt any excessive movement of the vertebrae. Degenerative conditions can generate spinal instability that leads to premature wear and tear of the intervertebral joints and nerve compression. In addition, having an abnormal curve in the spinal column can cause similar complications.
When you receive a spinal fusion the surgeon ‘locks” two or more vertebrae together in an effort to relieve pain and increase spinal stability. A fusion of the vertebrates does not happen immediately – it is a gradual process that involves the insertion of stabilizing bone grafts and implants to “set” the bone; bone union can take place in a matter of months as the bones mend and grow together.
Procedure Overview
There are various ways patients can achieve spinal fusion and other minimally invasive procedures. Posterior spinal fusion is performed after a damaged disc has been removed. Not every fusion depends upon the placement of hardware (i.e. screws and plates), but all require a bone graft. Bone or bone substitutes are used in the graft to stimulate healing and activate bone growth, in addition to providing structure/maintaining space between vertebrae.
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The spine is approached from either the back (posterior), front (anterior), or a combination of the back/front.
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Posterior fusion is normally conducted in the lower back (lumbar) and the upper back (thoracic) regions.
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Bone for the graft is obtained from the patient (autograft) or collected from a bone bank (allograft), then wedged precisely into place between the vertebrae.
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Depending on the procedure imaging software, robotics and neuro-navigation may be used.
Treatment of a broken bone in the spine is similar to treatment of a broken bone in other parts of the body. Spinal fusion immobilizes the vertebrae (as in the case of a cast) so that proper healing can begin to occur Posterior spinal fusion usually requires a short stay at the hospital, with patients walking the day after surgery.
Bone Grafting Options
Spinal fusions require bone grafts to increase bone production and stimulate bone healing. During surgery, a small pieces of bone is placed in the space between the vertebrae to help fuse them together.
If you’re receiving a decompression procedure, collected bone from the decompression site is used as a graft (local autograft). As a note, artificial bone graft materials or an allograft obtained from a bone bank may be used.
Recovery
Your recovery time can vary depending on a number of factors but ultimately results in regained function and a return to an active quality of life. The total healing process can take three to six months, however this includes the initial recovery period and physical therapy regimen. For most patients it progresses as follows:
Hospital Stay
A posterior spinal fusion may require a hospital stay of approximately two to five days. During that time, the focus is on pain management, wound care, and learning how to get in and out of bed comfortably and safely, without twisting or bending the spine.
Recovery at Home
You will need to rest at home for a few weeks after being discharged from the hospital. During this time, you will gradually increase your range of motion and movements under Dr. Akamnonu’s guidance.
Physical Therapy
You will need to begin physical therapy six weeks after surgery and this can last for several months. Dr. Akamnonu will closely follow your improvements and provide you with a tailor-made timeline for your return to normal physical activity.
