A spinal fusion is a surgery to weld together two or more vertebrae. Vertebrae are the bones that make up the spine.

Questions about spinal fusion? Please call TriStar MedLine® at (615) 342-1919 to make an appointment with one of our specialists.

Reasons for Spinal Fusion Surgery

Spinal nerves exit the spine between the vertebrae. Damage to the vertebra and the disc that sits between them can put extra pressure on these nerves. The irritated nerves can cause pain and weakness in the areas of the body affected by the nerve. Spinal fusion may be considered if all other methods of treatment (medication, rest, physical therapy) have not been able to relieve pain or disability. A spinal fusion removes damaged tissue and locks the two vertebra in place to prevent irritation of the spinal nerve between the vertebrae.

Medical conditions that may lead to spinal fusion include:

  • Spinal stenosis - narrowing of the canal that the spinal cord runs through
  • Spinal injury, including vertebral fractures
  • Spondylolisthesis - vertebra is out of line with the others
  • Scoliosis - abnormal curve in the spine
  • Weak or unstable spine, usually due to infection or tumors
  • Herniated disk

What to Expect

Spinal fusion can be done by open surgery or using a minimally invasive technique. The exact steps will depend on the type of spinal fusion that is being done. Some examples include:

Interbody fusion uses the surfaces in between the vertebra for fusion. The disc in between the vertebrae is either partially or completely removed. A cage (spacer) will be placed between the vertebra where the disc was removed. The cage may be made of plastic or metal. It may also contain graft material that will help the bones heal and fuse together. Metal screws and plates may then be placed on the outside of the vertebra to help stabilize the bones. There are 3 types of interbody fusion based on the approach to the area:

  • Posterior lumbar interbody fusion (PLIF) - the incision is made in the back. To access the spinal bones, the surgeon must move muscles and nerves out of the way. Part of the spinal bone covering the spinal column, called the lamina, may be removed so the surgeon can access the area between the vertebra. The cage is inserted from the back of the spine.
  • Transforaminal lumbar interbody fusion (TLIF) - the incision is made from the side. This allows access to the vertebra without a lot of movement to the muscles and nerves. It also does not require removal of any bone covering the spinal column.
  • Anterior lumbar interbody fusion (ALIF) - the incision is made in the lower abdomen. Organs and blood vessels are moved aside so that the surgeon can access the vertebra. The muscles and nerves of the spine do not have to be moved. The cage is inserted through the front part of the spine. No surgery is done on the outside of the vertebra.

Another option called posterolateral fusion starts the fusion on the outer surface of the vertebra. An incision is made in the back. The muscles are pushed aside to access the vertebra. Damaged bone and structures may be removed to relieve pressure on spinal nerves. A graft material will be placed along the outside of the vertebra to encourage bone healing and growth, and stimulate the fusion. Titanium screws and rods may also be used to help stabilize the bones while they heal. This option may also be used to treat scoliosis.

With all surgeries, the incision will be closed with stitches or staples.

When to Call Your Doctor

It is important for you to monitor your recovery after you leave the hospital. Alert your doctor to any problems right away. If any of the following occur, call your doctor:

  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
  • Persistent nausea and/or vomiting
  • Pain that you cannot control with the medications you've been given
  • Cough, shortness of breath, or chest pain
  • Joint pain, fatigue, stiffness, rash, or other new symptoms
  • Numbness, tingling, pain, or weakness, especially in the arms, hands, legs, or feet
  • Pain, swelling in your feet, legs, or calves
  • Loss of bladder or bowel function
  • Pain, burning, urgency, frequency of urination, or persistent blood in the urine

If you think you have an emergency, call 911 right away.

Questions about spinal fusion? Please call TriStar MedLine® at (615) 342-1919 to make an appointment with one of our specialists.