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Spinal fusion is a procedure that fuses vertebrae together. There are many reasons that a fusion could be needed but some of the problems include spinal deformities, fractured vertebrae, and even herniated discs. The fuse is meant to create one solid bone, but in the process, it limits the range of motion because there are two bones fused into one. This limited range of motion is meant to alleviate the pain that is experienced in the back and prevent nerves or muscles from stretching or pinching when they aren’t supposed to.

While spinal fusions resolve problems in a specific area of the back, a spinal fusion won’t always fix all the problems that the patient is experiencing in the spine. In fact, before the spinal fusion procedure is performed, an x-ray or other diagnostic procedure will be used to find the specific area that the fusion can benefit. This way the doctor can find the specific place that is causing the pain, and eventually can treat that pain through fusion surgery.

When to have spinal fusion surgery?

Spinal fusion surgery is a last resort for people that are struggling with back pain, and those who have back pain should realize this. In fact, some surgeons won’t even perform surgery until a more conservative approach has been tried. Some of these other conservative approaches include physical therapy or even injections for the pain. The research states that MOVEMENT is the best treatment for your low back pain.  However, if these conservative approaches don’t do anything to take away the pain that the patient is experiencing, or if the patient has a severe enough spine deformity, then it is recommended to proceed with surgery.

How is spinal fusion surgery performed?

There are many different approaches that the surgeon can take to perform spinal fusion surgery. The different approaches that can be used is an anterior approach, a posterior approach, and a lateral approach. The anterior approach means that they work on the spine from the front side of your body, while the posterior approach is coming through the back to access the spine. The lateral approach is from the side of the body. The place where the patient has the problem dictates what approach is used, however, the most common approach for lumbar is the posterior approach while the most common approach is anterior for a cervical spinal fusion.

In order to perform the procedure, the surgeon will start with an incision. These incisions are small due to the development of new techniques. Then there is a bone graft that is prepared for the fusion to take place. This bone graft can be taken from the patient’s pelvis, but it can also be taken from a cadaver bone as well. There are even several artificial materials that have been created to act as a bone graft material for patients as well. After the surgeon and the patient determine what material would be the best for the situation, the surgeon will use the bone graft to perform the fusion. The fusion is performed by placing the bone graft between the vertebrae that are being fused together. Some hardware, like a screw, can be used to help the fusion hold until the bone graft heals and fully fuses together.

What is recovery like?  

Because it is a surgery that is performed, you will usually be in the hospital for a few days to make sure that everything is stable. After the surgery it is possible to have some pain and swelling, but medication can be taken to help alleviate the pain and swelling. After the surgery, it can take months for the spine to heal completely, but there are steps that can be taken to help with recovery and returning to full function. One of those steps is going to physical therapy. Physical therapy is important to know how to do all the activities like sitting, standing, and even moving around with the proper posture for your spine to be in the correct position.

Because of the nature of the fusion, fusions can put more stress on different parts of the spine which can then cause more problems or pain in other parts of the spine. This is especially true if the patient has arthritic problems.

I’ve seen many patients with just an L4-L5 fusion to a total fusion of C3-L5. Having a fusion should be carefully considered. I’ve seen many patients that have been able to just have one fusion and have done well, while others have had to have multiple fusions and overall don’t do as well. After you have a fusion the most important factor is maintain a healthy back is, EXERCISE. Patient lack mobility in the segment that is fused, so movement occurs above and below the fusion. With the excessive movement, it’s even more important to maintain good strength to maintain stability of the spine, after you are done with physical therapy for the rest of your life.

At Pick PT Physical Therapy, we want to make sure everyone maintains an Elevated Life and Live Life Moving! Our Doctor of Physical Therapy specialize in spine treatment and have seen many patients that have had spinal fusions. So, come in and see us before and after a fusion surgery so we can help you prepare for and recover from a spinal fusion surgery.