From the Guidelines
Spinal fusion is primarily performed to provide a durable and physiologically dynamic support system that protects neural structures and decreases mechanical pain by permanently connecting two or more vertebrae in the spine. The purpose of this surgical procedure is to eliminate motion between vertebrae, thereby reducing pain and stabilizing the spine when movement between them causes severe discomfort or neurological symptoms 1.
Key Points
- The procedure involves removing the entire disc and surrounding bones, even if complete corpectomy is required, and using graft material, such as autologous bone harvested from the iliac crest or ribs, to facilitate fusion 1.
- A mature bony fusion provides long-term support and stability to the spine, reducing the risk of further complications and improving the patient's quality of life.
- The choice of approach, such as anterior or posterior, depends on the location and extent of the spinal condition, with the anterior approach being suitable for infections confined to the disc space or vertebral body 1.
- The use of the patient's own tissue as graft material is preferred, but collateral medical illness and the patient's general medical condition can impact the quality of the bone and the duration of the fusion maturation process 1.
Considerations
- Spinal fusion is typically recommended for conditions such as degenerative disc disease, spinal stenosis, spondylolisthesis, spinal fractures, and spinal deformities like scoliosis, where movement between vertebrae causes significant pain or neurological symptoms.
- While spinal fusion can effectively address specific spinal problems, it may reduce flexibility in the treated area of the spine and potentially increase stress on adjacent vertebrae over time.
- As with any surgical procedure, the decision to undergo spinal fusion should be made after careful consideration of the potential benefits and risks, and typically after conservative treatments have failed to provide adequate relief.
From the Research
Purpose of Spinal Fusion
The purpose of spinal fusion is to:
- Treat instability due to trauma, infection, or neoplasm 2
- Treat regional or global spinal deformity 2
- Treat low back pain without overt instability or deformity 2
- Act as an adjunct to decompression for patients with neurogenic claudication or radiculopathy caused by stenosis associated with spondylolisthesis 2
- Relieve pain, deformity, and instability of various spinal pathologies 3
Indications for Spinal Fusion
Spinal fusion may be indicated for:
- Degenerative disc disease 4, 5
- Isthmic spondylolisthesis 6
- Metastatic carcinoma of the spine associated with spinal cord compromise 6
- Thoracolumbar burst fractures 6
Goals of Spinal Fusion
The goals of spinal fusion include: