Spinal fusion

Spinal fusion, also called spondylodesis or spondylosyndesis, is a surgery performed by orthopaedic surgeons or neurosurgeons that joins two or more vertebrae.

[1] This procedure can be performed at any level in the spine (cervical, thoracic, lumbar, or sacral) and prevents any movement between the fused vertebrae.

[2] Additional hardware (screws, plates, or cages) is often used to hold the bones in place while the graft fuses the two vertebrae together.

[4] In severe cases, this pressure can cause neurologic deficits, like numbness, tingling, bowel/bladder dysfunction, and paralysis.

[6] The thoracic spine is more immobile, so most fusions are performed due to trauma or deformities like scoliosis, kyphosis, and lordosis.

[11] These techniques use advanced image guidance systems to insert rods/screws into the spine through smaller incisions, allowing for less muscle damage, blood loss, infections, pain, and length of stay in the hospital.

In general, there is a higher risk of complications in older people with elevated body mass index (BMI), other medical problems, poor nutrition and nerve symptoms (numbness, weakness, bowel/bladder issues) before surgery.

There are three main time periods where complications typically occur: Recovery following spinal fusion is extremely variable, depending on individual surgeon's preference and the type of procedure performed.

[6] Some patients can go home the same day if they undergo a simple cervical spinal fusion at an outpatient surgery center.

[8] In 2019, the news channel WTOL-TV broadcast an investigation, "Surgical implants raising contamination concerns", uncovering a dossier of scientific evidences that current methods of processing and handling spinal implants are extremely unhygienic and lacks quality control.

A petition was filed by the lead investigator, Aakash Agarwal, to rectify this global public health hazard of implanting contaminated spinal devices in patients.

Herniated disc pressing on spinal nerves.
Anterior approach to cervical spine.
X-ray of Transforaminal Lumbar Interbody Fusion (TLIF)
Stabilization rods used after spinal fusion surgery.