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Spinal Fusion for Severe Back Pain

Spinal fusion is a surgical procedure that is performed to provide stability and eliminate movement by joining together two or more vertebrae in the spine.  It is commonly used to treat severe pain with motion that can occur from a number of conditions, including a vertebral fracture, degenerative disk disease, scoliosis, spinal stenosis and spondylolisthesis.  Spinal fusion may be recommended when severe neck and back pain with motion is not resolved by more conservative therapies such as physical therapy and medication.

The procedure is designed to eliminate or significantly reduce pain by stopping the movement in the disk space between two vertebrae, which is done by joining them together with bone grafts, metal plates and rods. Spinal fusion essentially creates stability in a procedure that mimics the body’s natural process of healing a broken bone.  Results are not immediate – it takes several months for the vertebrae to completely fuse into one solid structure.  Once the vertebrae are fused and the spine is stabilized, the presence of normal disk space allows for increased function and movement. 

Procedure

Several different methods of spinal fusion can be used, depending upon the severity of the patient’s condition, the precise location of the pain and the number of vertebrae that need to be fused.  The patient is placed under general anesthesia, and the surgeon will access the spine from the front (anterior) or the back (posterior) to remove any fragments or bone spurs that are causing pressure on the nerve or nerve root. A bone graft from either a cadaver donor or from the patient is then inserted into the open space and secured with hardware, where it will ideally fuse to the surrounding vertebrae and stabilize the spine. It typically takes several weeks or months for the vertebrae to completely fuse together.

Recovery and Physical Therapy

Once surgery is complete, the patient will remain in the hospital for monitoring and treatment of post-surgical pain with medication. Most patients remain in the hospital for two to four days, depending upon the extent of the spinal fusion.  Patients are encouraged to begin walking in the hospital with assistance as soon as possible after recovering from the anesthesia. It is normal for continued pain immediately after surgery, particularly around the incision.

In some cases, a brace may be required for additional spinal support. Outpatient physical therapy may be prescribed to help with pain, inflammation and to regain function and control and increased mobility. The surgeon will coordinate a specific postoperative recovery plan for patients based upon type of work they perform, their preoperative activity level, the extent of their surgery and how quickly they are healing. Patients are encouraged to increase their activity level gradually. Discomfort is normal after surgery, but pain is a sign that the body needs to stop and rest.

Spinal fusion recovery is generally longer than that of other spinal surgeries, and most patients will need help with daily activities such as dressing and bathing for the first few weeks. Recovery times vary for every patient, but on average, patients recover in six to twelve weeks.

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