What Is Spinal Fusion Surgery?
The branch of surgery which deals exclusively with the correction of spinal cord impairments by the method of bringing about fusion of the spinal bones is known as spinal fusion surgery. Spine is composed of 31 small irregular bones which are named according to the region at which they are located. These bones are known as vertebrae. These are:
- 8 cervical (neck),
- 12 thoracic (chest),
- 5 lumbar (lower back),
- 5 sacral (pelvis) and
- 1 coccygeal (tail bone).
The procedure aims at eliminating the motion between the vertebrae. It prevents the excessive stretching of nerves, muscles and ligaments around the cord which result in pain. Motion does occur as a result of trauma, fracture or as a result of ageing. A spinal fusion will help union of the vertebrae involved and relieve the pain.
Causes Of Spinal Fusion:
- Injuries, fractures, trauma to the spinal cord
- Bacterial, viral, fungal infections in the spine
- Congenital disorders such as scoliosis
- A herniated disc may cause fusion of the vertebrae above and below
Signs and Symptoms Of Spinal Fusion:
- Limited and restricted movements of the back
- Extreme pain along the course of the back, non specific in nature, the exact site of pain cannot be pin pointed by the patient as such
- Heavy discomfort while performing daily activities
Diagnosis of Spinal Fusion:
- Imaging techniques: These help in locating the exact site of vertebral fusion. These are as follows:
- X-rays: A complete radiographic view of the spinal cord can be taken with the help of xrays in order to study each vertebrae in detail. The full set of cord beginning from cervical to coccygeal can be studied together.
- Computed tomography CT: To study each aspect of a vertebral bone in a three dimensional manner, a CT is advised.
- Magnetic resonance imaging MRI: These images help to study the ligaments, tendons, muscles, fascia associated with the vertebral column and any pathologies associated with the same.
- Ultrasound USG: These are used to study the soft tissues around the spinal cord.
Treatment Procedure Of Spinal Fusion Surgery:
A spinal fusion surgery is done in three major successive steps as follows:
- Approach: These are methods used to reach out to the spine. These include an anterior, posterior or a lateral approach. These approaches also depend upon the location of the spinal disease.
- Bone grafting: A bone graft is always used which will aid in the union of the spinal fusion. These are extremely small pieces of bone which are placed between the vertebrae and promote fusion. A bone graft will help in the healing process, produce more bone and combine both the vertebrae. Grafts can be in the form of an autograft or an allogarft. Autografts can be pieces of bone from the pelvis, iliac crest , thigh bone or ribs from the same individual. An allograft can be the same piece of bone from donor individuals. Many artificial bone growing elements can also be used. These are as follows::
- Demineralized bone matrices (DBMs): It is the calcium that has been removed from the cadaver bone and used for the creation of DBMs. The consistency of the bone becomes putty and gel like without inclusion of calcium. These grafts are combined with protein gels and used for fusion procedures.
- Bone morphogenetic proteins (BMPs): These are synthetic proteins which are used for the spinal fusion purposes.
- Synthetic bone. Synthetic bone grafts are made from calcium/phosphate materials and are often called “ceramics.” They are similar in shape and consistency to autograft bone.
Immobilization: After a bone graft has been placed, it becomes mandatory to keep the vertebrae in place and secure the newly placed graft. To keep a graft in place, a surgical plate, screw or may be a rod can be used. This is called as internal fixation and most commonly is the method of fixation used. It may or may not require removal after surgery and can safely be placed between the vertebrae.
Complications And Risk Factors Associated With Spinal Surgery:
- Post operative and hospital acquired infections may become lethal if care is not taken.
- Uncontrolled bleeding internally should be taken care of.
- Persistent pain can occur at the site of graft placement site
- In some cases, pain may recur
- Pseudarthrosis can result as a result of non union of bone
- Loss of sensation in certain parts can occur owing to nerve damage.
- Blood clot formation can be seen in the legs. A significant danger can be anticipated if they disintegrate and travel up till the lungs.
Am I A Good Candidate For Spinal Surgery?
If pain along the course of the spinal cord bothers you, leads to limited movements, tingling sensations in the limbs, loss of balance and uncoordinated movements, you surely need to visit a neurosurgeon and plan accordingly as soon as possible.
A spinal fusion will have the following advantages:
- It will restrict the movement completely
- Thus there will be no pain since movement tends to aggravate the pain sensations
- A bone graft will aid in the union of the vertebrae causing no harm to the other visceral organs near the spinal cord.
Why Choose India?
One of the finest neurosurgical institutes with highly qualified surgeons dealing with complications of the spine are available in India and in the knowledge of team MedcureIndia. These work in well structured manner beginning from a detailed and correct diagnosis, advancing to a proper treatment planning and ultimately ending with a highly skilled surgical approach ensuring best treatment outcomes.