Frequently asked questions about spinal fusion surgery

Fusion surgery is the attempt to keep the spine stable by joining two or more vertebrae together. Fusions can help patients who have back pain from instability or from degenerative disc disease. Fusions can be done using the anterior approach through the abdomen; using the posterior approach from the back of the patient; or by pairing these two surgeries. A spinal surgeon can suggest the best option with the least risk.

Fusing the spine causes increased workloads on the adjacent segments of the spine. This can lead to increased wear and tear and early degeneration, which may or may not cause symptoms in the future. Observing proper body mechanics while being active helps to preserve the adjacent areas for a longer period of time.

Because minimally invasive spine surgery, or MISS, does not involve a long incision, it avoids significant damage to the muscles surrounding the spine. Typically, this results in less pain and faster recovery after surgery.

The indications for minimally invasive spine surgery are the same as those for traditional open surgery. Spine surgery is usually recommended only when a period of nonsurgical treatment – such as medications and physical therapy – has not relieved the painful symptoms caused by your back problem. In addition, surgery is only considered if your doctor can pinpoint the exact source of your pain, such as a herniated disk or spinal stenosis.

There are numerous minimally invasive techniques. The common thread between all of them is that they use smaller incisions and cause less muscle damage. Minimally invasive techniques can be used for common procedures like lumbar decompression and spinal fusion.

Source: American Academy of Orthopaedic Surgeons

The complications depend on the surgical approach used:

• Spinal fusion surgery performed through the abdomen can result in problems with the muscles of the abdominal wall, or hernia; injury to the bowel; urinary tract; major blood vessels; nerves to the legs; and the nerves to the bladder/bowel.
• Spinal fusion surgery performed through the back can result in spinal fluid leaks; blood collections; scarring of nerves; damage to nerves; fracture of some of the bones; and problems with the metal implants.
• Spinal fusion surgery performed using either approach can be complicated by wound or bone infection and non-union, or failure of the bone to heal.

Sometimes a patient may have a complication related to the bone graft donor site if bone was taken from his or her pelvis for a graft. Also, there are always risks with having general anesthesia. Most patients should expect to have fusion surgery with a low risk of any long-term or lasting complications.

Your heart will be monitored during surgery. If it is necessary, your heart will be monitored after surgery during your hospital stay.

Many surgeons advise their patients to stop smoking before surgery and to think about quitting for good. Tobacco products have an adverse effect on blood vessels, which can affect the body’s way of healing wounds and bones. The risk of infection and lung problems after surgery is also greater for patients who use tobacco. There are many sources of information offered to help people quit smoking.

Most people who have laminectomy or discectomy-type surgeries can expect to return to work in about two weeks. An exercise program may be started within about six weeks. Expect full recovery in three months.

Recovery time after spinal fusion surgery is longer then with some other types of spinal surgery. Although a patient may return to most activities by about six months, full recovery may take up to a year.

Some surgeons want patients to wear a back brace after spinal fusion surgery. A brace may be needed due to the number of levels fused; the procedure performed; the patient’s age; the condition of the patient’s bone; and other health problems such as diabetes, smoking and obesity.