Why is spinal fusion performed?
Spinal fusion is performed to relieve chronic pain that interferes with everyday activities and can’t be relieved using more conservative approaches. The procedure may be recommended in patients who have:
- spondylolisthesis, a condition that occurs when one vertebra slips forward over another, resulting in nerve crowding and symptoms such as nerve tingling, pain and numbness;
- spinal instability due to arthritis or other degenerative diseases;
- spinal deformity, such as curvature or rounding of the spine;
- vertebral fractures that result in instability issues.
Spinal fusion is also commonly performed following other procedures such as disc removal or after laminectomy or foraminotomy, two procedure that remove portions of the spine bone to relieve nerve impingement. In some cases, it may be used to provide stability in patients with chronic and debilitating low back pain for which no specific cause can be found.
How is spinal fusion performed?
Several techniques have been developed to perform spinal fusion, and the specific technique used will depend on each patient’s individual needs and the location of the spine that’s being treated. In general, an incision will be made over the spine, either directly over the affected area or on either side. Some procedures use an anterior approach, which means the incision will be made in the abdomen or the throat. Muscles and other soft tissues are moved away from the treatment area to enable the doctor to see your spine clearly. Once the treatment area can be easily accessed, the bone graft is placed between or around the vertebrae and metal plates, screws or rods are implanted to keep the spine stable while the graft material fuses with your vertebrae, a process that usually takes several months.
Some minimally-invasive surgeries may use bone morphogenic proteins (BMPs) instead of bone grafts. These proteins stimulate bone growth in the affected vertebrae to achieve natural fusion. When grafts are used, they may be taken from the patient’s own body (autologous grafts) or they may come from a bone bank. Autologous grafts are often taken from the pelvis, and are removed and prepared just prior to being implanted.
What is recovery like?
Most spinal fusion procedures require a hospital stay of two to three days to enable the area to complete the initial stages of healing and enable inflammation to begin to recede. During the recovery period, pain medication will be given to minimize discomfort, and the doctor may also prescribe a brace or soft cervical collar to keep the spine in correct alignment. Strenuous physical activity like heavy lifting and twisting will be restricted for several weeks. During recovery, physical therapy can help restore strength, flexibility and mobility, as well as identifying proper postures while sitting and moving to keep the spine properly aligned and reduce strain on neighboring vertebrae. Usually, several months are required before the bone grafts will completely fuse with the rest of the spine.
Will insurance cover the procedure?
Spinal fusion is a well-established procedure. Most insurance companies offer coverage for the procedure when it’s considered medically necessary to relieve specific symptoms that affect everyday life and which cannot be treated with more conservative approaches such as medication and physical therapy. To determine the level of coverage provided by your plan, call your plan administrator or ask your doctor’s office staff to contact your insurance company on your behalf.