Spinal fusion is the surgical technique of combining two or more vertebrae. Fusion of the vertebrae involves insertion of secondary bone tissue obtained either through auto graft (tissues from the same patient) or allograft (tissues from the other person) to augment the bone healing process.
Lumbar (lower back) region of the spine are more prone to spine fusion when compared to the other regions such as cervical (neck) and thoracic (mid back) parts of the spine. Usually spinal fusion is recommended in patients with neurological problems or severe pain that have not responded to conservative treatment.
Indications for Lumbar Spinal Fusion
Various spinal conditions may be treated though lumbar spinal fusion such as:
- Spinal stenosis
- Damaged disc
- Spinal tumor
- Fractures of the spine
- Scoliosis and Kyphosis (abnormal curvatures of the spine)
Spinal fusion can be performed through different angles depending upon the specific advantages of each and the choice of your surgeon. It may involve interbody fusion where bone graft is placed in the space present between the two vertebras. Other techniques may also be employed for spinal fusion that involves the entire removal of the disc between the affected vertebrae. A specially designed device made either from plastic or titanium may be placed between the vertebrae. This helps in maintaining spine alignment and normal height of the disc.
The fusion process is followed by fixation that involves fitting of metallic screws, rods, plates or cages to stabilize the vertebrae and accelerate bone fusion. After surgery, 6-12 months is the ideal time for complete fusion to take place.
The complications associated with spinal fusion include infection, nerve damage, blood clots or blood loss, bowel and bladder problems and problems associated with anesthesia. The primary risk of spinal fusion surgery is failure of fusion of vertebral bones which may require an additional surgery.
Talk to your surgeon if you have concerns regarding spinal fusion procedure.
The sacrum is a triangle shaped bone found in the base of the spine. The iliac bones are the two large bones that form the pelvis. The sacrum and the iliac bones or ilium are connected together by strong ligaments and the junction where these bones meet is referred to as the sacroiliac joint. The hip area plays an important role in supporting the entire upper body weight during body movements (standing, walking, sitting, bending, etc.). This generally leads to wearing and tearing of the cartilage at the sacroiliac joint resulting in sacroiliac joint dysfunction. The people suffering from sacroiliac joint dysfunction may experience low back pain, inflammation, stiffness and pain in the leg, thigh, groin and hip. This condition is initially treated non-surgically with anti-inflammatory and analgesic medicines, sacroiliac joint belt, physical therapy and cortisone injections. If the nonsurgical methods do not prove to be effective then your doctor might recommend you to undergo sacroiliac fusion. Sacroiliac fusion is a surgical procedure which involves fusing of the iliac bones and sacrum for stabilization.
Your doctor may recommend sacroiliac fusion surgery if you are experiencing severe sacroiliac joint dysfunction due to arthritis, injury due to accidents or falls, being overweight, uneven leg lengths, gout, and spondylitis.
Sacroiliac joint dysfunction is diagnosed with X-ray, CT-scan and MRI. The medical history details are collected and you will have to undergo certain clinical examinations before surgery.
The surgical procedure involves fusing of the painful sacroiliac joint. The articular cartilage is scraped from the ends of both bones. The two bones are held together with the help of screws and plates until they fuse (grow together into one bone). This actually stops the movement between the bones and hence annihilates the joint pain.
It might take 6 months for you to recover completely. You can start the rehabilitation program after 6-8 weeks of surgery. Your doctor may use heat/ice packs, massage, electrical stimulation and ultrasound to decrease the muscle spasms and provide pain relief. Physical therapists will guide you with safe exercises and you will be able to resume your daily activities gradually.
Risk and Complications
As with any surgery, risks and complications can occur. These may include:
- Nerve damage
In many patients, the benefits of surgery outweigh the complications as the surgery can help relieve the debilitating pain and discomfort of sacroiliac joint dysfunction.