Spinal fusion surgery may sound somewhat scary, but it is a fairly common procedure that corrects problems with the small bones in the spine (vertebrae). It is essentially a “welding” process, said Michael E. Gomez, M.D., neurosurgeon and director of Minimally Invasive Spine Surgery at Baptist Health’s Miami Neuroscience Institute.
The basic premise is to fuse together two or more vertebrae so they can heal into a single, solid bone. This will eliminate painful motion or restore stability to the spine.
“It involves placing an implant into the disc space in order to essentially weld the two vertebrae together,” explains Dr. Gomez. “And by doing so, it allows us to restore alignment. It allows us to restore the disk space height and also to restore the size of the spinal canal and the size of the foramina, which are the holes where the nerve roots exit on the side.”
You might need spinal fusion for a variety of health conditions that might be causing you back pain, such as: degenerative disc disease; spinal stenosis; spondylolisthesis; scoliosis; a break (fracture) of your spinal column; infection of your spinal column; or a tumor in your spinal column.
Dr. Gomez answers commonly asked questions about spinal fusion:
What are typical approaches to spinal fusion?
Dr. Gomez: “If a patient has compression of nerves and a deformity at this bottom level, at L5-S1 (lumbosacral joint) which is a fairly common level to have degeneration, we can perform a surgery where we directly access the disk from the front through a small incision, kind of like a C-section incision with the help of a vascular surgeon. We get to the front of the spine and it allows us to remove the entire disc.
“Using a series of small metal shims, we can restore the disc space height and place an implant in there that separates the vertebra and also stabilizes the spine with a separate plate and four screws. At L4 and L5, we’re able to take a lateral approach to the disk space where a similar spacer is placed into the disk space, after removing the disk, in order to restore the disk space height — thereby opening up these small holes on the sides and also opening up the spinal canal where the nerves travel.”
Is spinal fusion a last resort type of treatment?
Dr. Gomez: “Typically, patients will undergo a vast array of conservative treatments — from physical therapy to exercises such as yoga and Pilates, as well as injections with pain management. And ultimately, after failing all appropriate conservative management, then if patients have a deformity, or have some sort of need to undergo a spinal fusion, then that tends to be the final result.”
Who qualifies for spinal fusion treatment?Dr. Gomez: “Most patients are candidates for spinal fusion as long as they’re fairly healthy and have good bone health. Typically, spinal fusion is reserved for patients who have already had surgery before that didn’t involve a spine fusion, and now either have a new disc herniation or have developed a deformity or narrowing of the holes on the sides where the nerve roots exit.”