Benefits of Balloon Kyphoplasty Balloon Kyphoplasty for Spinal Fracture

Because Kyphoplasty is a minimally invasive procedure, no hospitalization or general anesthesia is required, no surgical incision is needed—just a small nick in the skin—and no stitches are required.

Most patients who undergo Kyphoplasty for spinal fractures report that their pain is gone or significantly better within 48 hours and that they return to normal activity shortly after the procedure. Studies have shown that 75 to 90 percent of people treated with Kyphoplasty will have complete or significant reduction in pain.

What Causes Spinal Fractures?

Spinal fractures, also called compression fractures, are caused by a weakening of the bone in the spine. A fracture occurs when the weakened vertebrae of the spine collapse, usually in the middle (thoracic) or lower (lumbar) spine.

In older adults, osteoporosis—a progressive weakening of the bone over time—is the primary cause of spinal fractures. Fractures typically occur in women over the age of 60 who are affected by osteoporosis. Spinal fractures can also occur among younger people whose bones have become fragile due to the long-term use of steroids or other drugs to treat diseases such as lupus, asthma and rheumatoid arthritis.

The balloon is then filled with bone cement that then can permanently keep the vertebrae in position. It has proved popular because it is a relatively simple procedure that can be performed in an outpatient clinic.

Fast and Effective

The procedure is beneficial because the patient can be treated and sent home without requiring an extended stay in hospital. It is normal for the patient to have the procedure while under a local anesthetic so that they quickly recover and can be sent home on the same day. This is because it does not involve an incision and only requires the use of a large needle to place the balloon, inflate it and then when it has positioned the vertebrae correctly add the bone cement.

Low Impact

Unlike many other procedures that are used on a patient’s back this procedure will allow them to be able to walk immediately after they have recovered from the effects of the anesthetic. It is commonly done under a local anesthetic but can also be done with a general anesthetic.

The patient can then be driven home and is generally advised to stay in bed for the next day. Restricted activities are recommended for the next four to six weeks so that the area can fully heal. After this period they can resume all activities after being checked by the Doctor.

What Is It Used To Treat

The Kyphoplasty procedure is used for people that have compression fractures of the spine. It can be used on people that have had an injury that has caused compression fractures, people that have cancer that affected the spine and people with osteoporosis.

It is normally recommended if there is severe pain associated with the compression fracture. In some cases the patient will first be given time to recover with bed rest and physical therapy. This time period is usually from 60 to 90 days but can vary according to the severity of the pain, amount of damage and assessment of the chances of the likelihood of recovery without intervention.

Complications

One of the main benefits of this procedure is the use of a single needle to complete the necessary work. This lowers the risks of post operative infection and speeds recovery time.

There is a small risk that the bone cement can leak into the surrounding tissue. In some cases when this happens the spine or nerves can be affected and this may cause pain in the area. This procedure has a very low risk of complications and you should speak to your Doctor so that you can fully understand the risks compared to the possible benefits in your particular situation. Then you can make an informed choice to proceed with Kyphoplasty.

Kyphoplasty at Best Spine Surgery Hospitals in India

Our network hospitals have the most advanced spine surgery facilities. The spine surgeons here use minimally invasive and computer guided techniques in spine surgery. In a Minimally Invasive spine surgery the surgeon makes a few small incisions unlike the open surgery where a single large incision is made. Minimally Invasive spine surgery has several important benefits for the patients. If you have been advised spine surgery your first choice should be the latest minimally invasive technique developed by our world best hospitals in India. 

Most advanced Technology like Intra Operative MRI, Brain Suite and Computer Assisted Navigation System are deployed by highly trained surgeons for accurate and safe Spine Surgeries through a small incision.

Why should you choose to get Indian hospitals offer the best spinal surgery treatment in India at affordable prices. MedWorld india associated best spine surgery hospitals in India have the latest technology and infrastructure to offer the most advanced spine surgery at low cost.

Salient features of these hospitals are:

• Comprehensive management of spine disorder from birth defects to degeneration of tumor and trauma.
• Dedicated team of International trained and vastly experienced Spine Surgeons, Rheumatologists, Neurologist, Physicians and Physiotherapist.
• Expert evaluation of spinal problems by dedicated team of experienced spine Surgeons, Rheumatologists, Neurologist, Physicians and Physiotherapist.
• Latest Generation Diagnostic and Imaging facilities including dynamic digital X rays, Spiral CT scanning , MRI and Electrophysiology unit all under one roof.
• Physiotherapy and Rehabilitation by experts after the surgery help you regain functional abilities quickly helping in vastly improved overall results.

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The Common Upper Back Pain Causes and Treatment options in India

 Although upper back pain is not a very common spinal disorder, it can cause significant discomfort and pain when it does occur. The most common causes of upper back pain are muscular irritation (myofascial pain) and joint dysfunction.

There can be an injury to a disc in the upper back (such as a thoracic herniated disc or degenerated disc) that causes upper back pain, but such injuries are very rare.

It is important to note that the thoracic spine (also called upper back, middle back, or mid-back) is very different in form and function than the cervical spine (neck) or the lumbar spine (lower back). While the neck and lower back are designed to provide us with mobility, the thoracic spine is designed to be very strong and stable to allow us to stand upright and to protect the vital internal organs in the chest. Because this section of the spinal column has a great deal of stability and only limited movement, there is generally little risk of injury or degeneration over time in the upper back.

Anatomy of the Upper Back

The word "thoracic" means pertaining to the chest, and the thoracic spine (also called the upper back or mid-back) is the portion of the spinal column that corresponds to the chest area.

·         Twelve vertebrae in the middle of the spine with ribs attached make up the thoracic spine. When viewed from the side, this section of the spine is slightly concave.

·         Each vertebra in the thoracic spine is connected to a rib on both sides at every level and these in turn meet in the front and attach to the sternum (the breastbone). This creates a cage (the thoracic cage) that provides structural protection for the vital organs of the heart, lungs, and liver, and also creates a cavity for the lungs to expand and contract.

·         The upper nine ribs start at the spine, curve around and are joined at the front of the chest. Because the ribs are firmly attached at the back (the spine) and the front (the sternum), they allow for very limited motion in the spine.

·         The lower three ribs do not join together at the front, but do function to protect the vital organs while allowing for slightly more motion.

·         The joints between the bottom thoracic vertebra (T12) and the top lumber vertebra (L1 in the lower back) allow twisting movement from 

Traditional decompression surgical options include:

·        

Corpectomy(or Vertebrectomy): Occasionally, surgeons will need to take out the entire vertebral body because disc material becomes lodged between the vertebral body and the spinal cord and cannot be removed by a discectomy alone. In other cases, bone spurs (osteophytes) form between the vertebral body and spinal cord. In these situations, the entire vertebral body may need to be removed to gain access to the disc material that's pressing on your nerve-that's a corpectomy.

·         Discectomy: If you have a bulging disc or a herniated disc, it may be pressing on your nerves. In a discectomy, the surgeon will remove all or part of the disc. The surgeon can do a discectomy using a minimally invasive approach.

Minimally invasive means that there are smaller incisions and the surgeon works with a microscope and very small surgical tools. You'll have a shorter recovery period if you have a minimally invasive discectomy.

·         Facetectomy: There are joints in your spine are called facet joints; they help stabilize your spine. However, facet joints can put pressure on a nerve. Ectomy means "removal of." So a facetectomy involves removing the facet joint to reduce that pressure.

·         Foraminotomy: If part of the disc or a bone spur (osteophyte) is pressing on a nerve as it leaves the vertebra (through an exit called the foramen), a foraminotomy may be done. Otomy means "to make an opening." So a foraminotomy is making the opening of the foramen larger, so the nerve can exit without being compressed.

·         Laminectomy: At the back of each vertebra, you have a bony plate that protects your spinal canal and spinal cord; it's called the lamina. It may be pressing on your spinal cord, so the surgeon may make more room for the cord by removing all or part of the lamina.

·         Laminotomy: Similar to the foraminotomy, a laminotomy makes a larger opening, this time in your bony plate protecting your spinal canal and spinal cord (the lamina). The lamina may be pressing on a nerve structure, so the surgeon may make more room for the nerves using a laminotomy.

After part of a disc or vertebra has been taken out, your spine may be unstable, meaning that it moves in abnormal ways. That makes you more at risk for serious neurological injury, and you don't want that. The surgeon will need to stabilize your spine. Traditionally, this has been done with a fusion.

In spine stabilization by fusion, the surgeon creates an environment where the bones in your spine will fuse together over time (usually over several months or longer). The surgeon uses a bone graft (usually using bone from your own body, but it's possible to use donor bone as well) or a biological substance (which will stimulate bone growth). Your surgeon may use spinal instrumentation—wires, cables, screws, rods, and plates—to increase stability as the bones fuse. The fusion will stop movement between the vertebrae, providing long-term stability.

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The PLIF and TLIF approach has an advantage over the posterolateral gutter fusion : Transforaminal and Posterior Lumbar Interbody Fusion in India

As with all spinal fusion surgeries, the PLIF and TLIF procedures involve adding bone graft or bone graft substitute to an area of the spine to set up a biological response that causes the bone to grow between the two vertebral elements and thereby stop the motion at that segment.

The success rate for posterior fusion in the treatment of refractory discogenic back pain is only 60-70%. The selection of the appropriate patient for this surgery has been blamed for the relatively poor results. Other possible causes of poor results are that the actual pain-causer, the disc, is not addressed. Studies have shown continued significant movement of the disc despite solid posterior fusion. One study showed that patients with continued back pain after solid posterior fusion were improved after anterior fusion of the disc space.

In an attempt to improve the results of fusion surgery, fusion of the disc has been performed to directly address the most common source of pain. Unlike the posterolateral gutter fusion, the PLIF achieves spinal fusion by inserting bone graft and possibly instrumentation directly into the disc space. The disc excision and fusion can be performed anteriorly, or through a posterior approach. When the posterior approach is used to remove and fuse the disc, this is called a PLIF, Posterior Lumbar Interbody Fusion.

An alternative approach is used to minimize retraction of the dura. By resecting the facet joint, a farther lateral approach can be used to remove the disc. This approach, with removal of the facet, is called a TLIF - Transforaminal Lumbar Interbody Fusion.

THE GENERAL PROCEDURE:

1. First, the spine is approached through a three-inch to six-inch long incision in the midline of the back and the left and right back muscles (erector spinae) are stripped off the lamina on both sides and at multiple levels.

2. After the spine is approached, to perform the PLIF procedure (shown below), the lamina is removed (laminectomy) which allows visualization of the nerve roots. The facet joints, which are directly over the nerve roots, are usually undercut to give the nerve roots more room and more room for performing the fusion and/or instrumentation. For the TLIF procedure (shwon below), the entire facet joint is removed.

3. The nerve roots are then retracted to one side and the disc space is cleaned of the disc material. Bone graft is then inserted into the disc space with or without interbody cages. For a standard PLIF procedure, the bone graft and/or instrumentation is performed on both sides. For the TLIF procedure, the disc space is accessed from one side, reaching over to remove and replace the disc on the other side.

The TLIF approach is shown below, with removal of the disc. Bone graft, bone from the bone bank, or instrumentation in the form of a cage can be placed through this approach.

The PLIF and TLIF approach has an advantage over the posterolateral gutter fusion in that the large spinal muscles do not need to be dissected off the transverse processes, so there is less scarring of the muscle and associated pain for the patient. The major advantage of PLIF and TLIF is that there is significantly more surface area for fusion in the disc space as compared to the posterolateral gutter.

However, the PLIF requires substantial retraction of the nerve roots to gain access to the disc space. Significant traction can injure the nerve root and has the potential to result in chronic leg pain and back pain. The pain associated with this type of nerve root injury can be severe, and there are no effective options for treatment. The TLIF requires less retraction of the dural sac, but nerve injury can occur at the level of the nerve cell bodies (dorsal root ganglion). Pain associated with manipulation of the DRG can also be very severe and debilitating. Fortunately, these complications are rare with meticulous care of the nerves.

There are numerous veins (epidural veins) over the disc space, and surgery in this area creates the potential for excessive blood loss during the surgery.

Recurrent pain after a successful spinal fusion procedure is more likely due to a “transfer” lesion at the motion segment above or below the fusion, because stress is transferred to the next level and may cause that vertebral segment to degenerate and breakdown.

Nonunion rates of between 0% and 20% have been quoted in the medical literature. Nonunion rates are higher for patients who have had prior surgery, patients who smoke or are obese, patients who have multiple level fusion surgery, and for patients who have been treated with radiation for cancer.

Other than nonunion, the risks of a spinal fusion surgery include infection or bleeding. These complications are fairly uncommon (approximately 1% to 3% occurrence).

Post-Operative Care

Most patients are usually able to go home 1-3 days after surgery. Patients will typically stay longer, approximately 2-5 days, if an anterior spinal surgery is also performed. Before patients go home, physical therapists and occupational therapists work with patients and instruct them on proper techniques of getting in and out of bed and walking independently. Patients are instructed to avoid bending at the waist, lifting (more than five pounds), and twisting in the early postoperative period (first 2-4 weeks) to avoid a strain injury. Patients can gradually begin to bend, twist, and lift after 4-6 weeks as the pain subsides and the back muscles get stronger.

Brace

Patients are generally not required to wear a back brace after surgery. Occasionally, some patients may be issued a soft or rigid lumbar corset that can provide additional lumbar support in the postoperative period, if necessary.

Wound Care

The wound area can be left open to air. No bandages are required. The area should be kept clean and dry.

Shower/Bath

Patients can shower immediately after surgery, but should keep the incision area covered with a bandage and tape, and try to avoid the water from water hitting directly over the surgical area. After the shower, patients should remove the bandage, and dry off the surgical area. Patients should not take a bath until the wound has completely healed, which is usually around 2 weeks after surgery.

Driving

Patients may begin driving when the pain has decreased to a mild level, which usually is between 7-14 days after surgery. Patients should not drive while taking pain medicines (narcotics). When driving for the first time after surgery, patients should make it a short drive only and have someone come with them, in case the pain flares up and they need help driving back home. After patients feel comfortable with a short drive, they can begin driving longer distances alone.

Return to Work and Sports

Patients may return to light work duties as early as 1-2 weeks after surgery, depending on when the surgical pain has subsided. Patients may return to moderate level work and light recreational sports as early as 1-2 months after surgery, if the surgical pain has subsided and the back strength has returned appropriately with physical therapy. Patients who have undergone a fusion at only one level may return to heavy lifting and sports activities when the surgical pain has subsided and the back strength has returned appropriately with physical therapy. Patients who have undergone a fusion at two or more levels are generally recommended to avoid heavy lifting, laborious work, and impact sports.

Benefits of Arthroscopic techniques in minimally invasive spine surgery

This type of minimally invasive surgery is performed on an outpatient basis using a local anesthetic. Since general anesthesia is not used, surgical risks are less. Arthroscopic surgery and use of endoscopic tubes minimizes muscle and other soft tissue damage. Patient benefits include less bleeding during surgery, reduced postoperative discomfort, fewer and smaller incisions, minimal scar tissue formation, and a speedier recovery. In addition, patients can avoid hospitalization and spinal fusion.

Arthroscopic Spine Procedures

Depending on the patient's diagnosis and surgical needs, sometimes more than one procedure is performed during a single surgery.

There are 4 primary arthroscopic spine procedures : -

1. Foraminotomy : - A foraminotomy helps to relieve symptoms caused by nerve root compression. The foramen are passageways between the vertebrae through which nerve roots exit the spinal canal. A foraminotomy may be performed to treat foraminal stenosis, bulging or herniated discs, pinched nerves, scar tissue formation, bone spurs (osteophytes), spinal arthritis, or sciatica.
   
   During a foraminotomy, the surgeon arthroscopically removes bone and tissue compressing the spinal nerve root. The endoscope is slowly removed to allow muscles and other soft tissues to move back into place. Occasionally, a stitch or two is needed to close the small incision.

2. Laminotomy : - A laminotomy is performed to increase the space around nerve roots and the spinal cord. The procedure helps to remove (decompress) pressure from these neural tissues. The lamina is the bony plate covering each vertebra's posterior arch, or entryway to the spinal canal and nerve structures.
   
   A laminotomy may also be performed to remove the ligamentum flavum. This is the spine's largest ligament. Sometimes the ligamentum flavum becomes thick and compresses the spinal cord contributing to spinal stenosis. When the surgeon removes part of the lamina, he can access the ligamentum flavum for removal.
   
   A laminectomy is similar to a laminotomy. The difference between the procedures is a laminectomy is usually performed during a traditional open back surgery to remove the entire lamina. A laminotomy does not remove the entire lamina, but only a portion of the bony plate
   
   A laminotomy is performed to treat bone spurs (osteophytes), bulging and herniated discs, pinched nerves, scar tissue, spinal arthritis, and spinal stenosis.

3. Percutaneous Arthroscopic Discectomy : - Percutaneous means through the skin. A percutaneous arthroscopic discectomy is the surgical removal of bulging or herniated disc material. Bulging and herniated discs are a common cause of nerve root and spinal cord compression.
   
   During this minimally invasive procedure, the surgeon uses a laser to vaporize disc material to reduce pressure on the spinal cord and nerve roots. When the procedure is completed, the endoscopic tube is slowly removed to allow muscles and soft tissues to move back into place. A percutaneous arthroscopic discectomy is a short procedure only taking 30 to 45 minutes.

4. Facet Thermal Ablation : - A facet thermal ablation is performed to treat facet disease, facet joint syndrome, facet hypertrophy (enlargement), facet arthritis, or facet joints affected by degeneration. The facet joints are the spine's joints. Found at the back of the spine, 2 vertebrae share 1 facet joint.
   
   Thermal ablation refers to disabling or destroying a nerve using a laser. During the procedure, the surgeon uses a laser to clean the facet joint and deaden the nerve that innervates the joint and causes pain.
   
   After a local anesthetic is administered, a small incision is made and the endoscope is inserted. The endoscope (about the size of a straw) helps protect surrounding anatomical structures from damage during thermal ablation. The procedure only takes about 40-minutes.

Laser Spine Surgery : -

The most commonly performed spinal operation in the United States is the lumbar discectomy. Lumbar discectomy is the cornerstone of surgical treatment of disc herniations. A disc herniation is a protrusion of the inner core of disc material beyond the confines of the disc space to compress on the lumbar nerve root(s). This nerve root compression causes a variety of symptoms, but most notable is that of sciatica. Sciatica is a radiating pain from the low back around the hip joint into the leg and down the leg to the foot. Fortunately, 80% of symptomatic disc herniations respond to non-surgical treatment. For the remaining 20%, lumbar discectomy is the treatment of choice 

How long does surgery typically last?

The average spine procedure lasts about an hour. When the procedure is complete, the surgeon removes the tube to let the tissue and muscle go back to their natural position. The last tube is gently removed and absorbable sutures are used to close the incision. The patient is wheeled into the post-anesthesia care area where their vital signs are monitored, medications are given as needed and some light refreshments can be enjoyed. That same day, patients are encouraged to walk around. Soon after, they are discharged home or to their hotel.

What's the recovery process like?

After a day of rest and recovery, the patient returns for a postoperative appointment. An epidural injection may be given to reduce swelling and increase range of motion. Physical therapy may be prescribed. Physical therapy consists of a series of stretching exercises, walking, ice or heat, gentle electronic stimulation and a nice relaxing massage. Each patient is given instructions for postoperative activity and limitations. Over the weeks and months to come, gradual and continuous improvement will be seen, as the nerves and tissues heal. With time and exercise, the body can repair any damage, gain strength, and a gradual increase in daily activities can occur.

Most commonly, laminectomy is performed to treat spinal stenosis

Laminectomy or Laminotomy (a partial laminectomy) is sometimes called a decompression procedure and is a spinal procedure to remove a portion of the vertebral bone called the lamina. The lamina is a posterior arch of the vertebral bone lying between the spinous process, which juts out in the midline and the more lateral of each vertebra. The pair of lamina, along with the spinous process, make up the posterior wall of the bony spinal canal.  Although the procedure indicates excision of the lamina, the operation called conventional laminectomy, removes the lamina, spinous process and overlying connective tissues and ligaments, cutting through the muscles that overlie these structures. Minimal surgery laminectomy is a tissue preserving surgery that leaves the muscles intact, spares the spinal process and takes only one or both lamina. Laminotomy is removal of a mid-portion of one lamina and may be done either with a conventional open technique, or in a minimal fashion with the use of tubular retractors and endoscopes.

BRIEF ABOUT THE PROCEDURE

There are many variations of laminectomy, in the most minimal form small skin incisions are made, back muscles are pushed aside rather than cut and the parts of the vertebra adjacent to the lamina are left intact. After an incision is made in the midline of the neck or back, the muscle is moved away to expose the lamina, which are the bony shingles that overlay the neural (nerve) elements. The lamina can be removed in whole or in part to expose a single nerve root or more of the neural elements as needed. In the case of a lumbar disc herniation, a laminotomy, or partial removal of the lamina is usually sufficient to gain access to the affected nerve root.  The nerve root will usually be visible just beneath the lamina, with a disc herniation underneath it. The nerve root is gently held out of the way with a retractor and the disc herniation can be accessed. The traditional form of laminectomy (conventional laminectomy) excises much more than just the lamina, the entire posterior backbone is removed, along with overlying ligaments and muscles. The usual recovery period is very different depending on which type of laminectomy has been performed: days in the minimal procedure and weeks to months with conventional open surgery. A lamina is removal is done to break the continuity of the rigid ring of the spinal canal to allow the soft tissues within the canal to expand or as one step in changing the contour of the vertebral column, or in order to allow the surgeon access to deeper tissues inside the spinal canal. Conventional open laminectomy often involves excision of the posterior spinal ligament and some or all of the spinous process and facet joint. Removal of these structures, in the open technique, requires cutting the many muscles of the back which attach to them. Laminectomy performed as a minimal spinal surgery procedure, however, allows the bellies of muscles to be pushed aside instead of transected and generally involves less bone removal than the open procedure. The recovery period after laminectomy depends on the specific operative technique; minimally invasive procedures having a significantly shorter recovery period than open surgery. Removal of substantial amounts of bone and tissue may require additional procedures to stabilize the spine, such as fusion procedures and spinal fusion generally requires a much longer recovery period than simple laminectomy. Most commonly, laminectomy is performed to treat spinal stenosis. Laminectomy for Spinal Stenosis Spinal stenosis is the single most common diagnosis leading to any type of spine surgery and laminectomy is a basic part of its surgical treatment. The lamina of the vertebra is removed or trimmed to widen the spinal canal and create more space for the spinal nerves and thecal sac. Surgical treatment that includes laminectomy is the most effective remedy for severe spinal stenosis, however most cases of spinal stenosis are not severe and do not require surgery. When the disabling symptoms of spinal stenosis are primarily neurogenic claudication and the laminectomy is done without spinal fusion, there is generally a very rapid recovery with excellent long term relief. However, if the spinal column is unstable and fusion is required, there is a recovery period of months to more than a year and relief of symptoms is less likely.

Spinal Fusion Benefits : Get Facts About Surgery and Recovery Time

Spinal Fusion Surgery

Lumbar spinal fusion is a type of back surgery in which a bone graft is inserted in the spine so that the bones in a painful segment of the spine fuse together. The fusion aims to stop the motion at a vertebral segment, which should decrease the pain caused by the joint. After the surgery it will take several months (usually 3 to 6, but sometimes up to 18 months) before the fusion is set-up. This surgery has been improved over the last 10 to 15 years, allowing for better success rates, and shorter hospital stays and recovery time. 

Indications and contraindications for spinal fusion
The vast majority of people with low back pain will not need fusion surgery and will be able to manage the pain primarily with physical therapy and conditioning. A fusion surgery may, however, be recommended for patients with: 

• Low back pain caused by degenerative disc disease that limits the patient's ability to function (after non-surgical treatments, such as physical therapy and medication, have failed)
• Isthmic, degenerative or postlaminectomy spondylolisthesis
• A weak or unstable spine (caused by infections or tumors), fractures, or deformity (such as scoliosis)

Before beginning the main part of a spinal fusion procedure, your surgeon will need to gather material for a bone graft, which is used later on to join the targeted spinal bones together. Depending on individual circumstances and your surgeon’s preferences, this graft material can come from bone harvested from one of your own hips or ribs, from bone harvested from a special donor cadaver, or from artificial materials such as plastics or ceramics.

Once the graft material is ready, your surgeon will make an incision and create an opening that exposes the site of the fusion. Potential locations of this incision include your abdomen, your back and the side of your neck or torso. After exposing the site of procedure and removing the spinal disc that sits between your spinal bones, your surgeon can place the bone graft in one of several ways. First, he can place the graft material directly into the empty space left by the removed spinal disc. Alternatively, he can place the graft material inside a device called a spacer or cage, then insert this device into the gap between your spinal bones. Your surgeon can also lay the graft material over the rear surfaces of the targeted spinal bones.

All of these techniques will lead to fusion of your bones and incorporation of the graft material by triggering your body’s natural healing process. Frequently, bone grafts are held in position by metal rods or plates and screws during this healing period.

Spinal Fusion Uses

Problems in your spinal column that can lead to a need for spinal fusion include a form of bone slippage called spondylolisthesis, debilitating forms of abnormal spinal curvature or deformity, and mechanical spinal instability caused by problems such as accidents or injuries. Surgeries that can produce enough spinal instability to require fusion as a follow-up procedure include complete or partial removal of a damaged spinal disc (discectomy); removal of all or part of the section of spinal bone that forms the back of the spinal canal (laminectomy); and widening of the gaps in your spinal column that allow nerves to pass through from your spinal cord (foraminotomy).

Spinal Fusion Benefits

The rigidity and stability provided by spinal fusion can prevent dangerous degrees of spinal motion, ease pain and other symptoms associated with unwanted or excessive spinal motion, and help prevent damage in the soft tissues situated near your spine. In the vast majority of cases, these benefits are either permanent or remain for extremely extended periods of time.

Success rates for fusion

Fusion surgery success rates vary between 70% and 95%, and there are several factors that will impact the success rate of the surgery, including:

• Spine fusion for conditions that arise from gross instability (e.g. isthmic or degenerative spondylolisthesis) tends to be more successful than surgery done for pain alone (e.g. degenerative disc disease).
• Individuals with only one badly degenerated disc (especially L5-S1) but an otherwise a normal spine tend to fare better than those undergoing multilevel fusions. Fusion surgery is generally considered for one or possibly two levels, and multilevel fusions should be avoided except in cases of severe deformity.
• Individuals who have significant disc degeneration usually find more pain relief from a fusion than those with only minor degeneration on the MRI scan (e.g. still have a tall disc).

The most important success factor in fusion surgery is confirming that a patient's back pain is truly caused by degenerative disc disease, rather than some other condition. This is done by a combination of a careful review of the patient's history, a physical exam, and diagnostic tests (such as x-ray and MRI), and/or possibly a discogram.

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