Sometimes back pain is unbearable, isn't it? There are times when the pain just won't go away even after taking medication, undergoing physical therapy , and doing various exercises. If you are one of those who suffer from this experience, your doctor may have suggested a surgery called 'Spinal Fusion'. You may feel a little scared when you hear the name, but once you understand what it is, that fear will disappear. So today, let's talk about this simply, in a way that you can understand.
Simply put, what is Spinal Fusion?
It's very simple. This surgery involves gluing two or more vertebrae (or vertebrae in our colloquial language) in your back together, forming a single solid structure. Imagine if you were experiencing pain due to movement between two vertebrae, you would fuse those two vertebrae together and completely stop that movement.
The main goal of this is to stop the movement that causes pain. Then, when those bones are fused together, they won't move back and forth like they used to. This stops the pulling and pushing of the nerves, ligaments, and muscles nearby, and the pain and discomfort you're feeling will go away.
Why do you need this surgery?
This is not a surgery for every back problem. If your back pain hasn't improved despite taking medication, physical therapy, and getting injections like steroids, your doctor will consider surgery as the next option. Also, surgery is usually only recommended if the doctor knows exactly what's causing the pain .
If your back pain is caused by any of the following conditions, this surgery may provide relief.
| Condition | A simple explanation |
|---|---|
| Degenerative Disk Disease | As we age, the cartilage (discs) between the vertebrae in the spine wears down. Then the vertebrae start to rub against each other, causing pain. |
| Fracture | A fracture or bursting of a bone in the spine. |
| Scoliosis | Abnormal curvature of the spine to one side. |
| Spinal Stenosis | Narrowing of the passageway through the spinal cord, which can cause nerve compression. |
| Spondylolisthesis | A protrusion of one vertebra in the spine over the vertebra below it. |
| Tumors or Spine Infection | Tumors or infections in the spine. |
How do you prepare before surgery?
About a week before surgery, you will need to have several blood tests and tests such as a back X-ray.
Your doctor and medical team will explain every detail about the operation to you. Never be afraid to ask if there is something you don't understand. It is a great help to the doctor that you are well informed and prepared.
Consider these things a few days before surgery:
- Know exactly when you need to arrive at the hospital. Also, it is essential to arrange for someone to take you to the hospital and back home after the surgery.
- Ask your doctor for a list of medications you can and cannot take in the days before surgery. Some medications, such as aspirin, may increase bleeding and should be stopped. Never stop taking any medication without your doctor's approval.
- Find out exactly what you can eat and drink before surgery and how long you need to fast .
- Prepare your home environment. Since it will be difficult for you to bend over or sit on the floor after surgery, it can be helpful to prepare things like raised toilet seats, a shower chair, slip-on shoes, and reachers.
How is the surgery performed?
Spinal fusion surgery can be performed in two main ways.
1. Anterior Fusion: In this, the doctor makes an incision on the side of your abdomen.
2. Posterior Fusion: In this, the incision is made from the back.
After making the incision, the doctor carefully moves aside the muscles and other tissues to access the spine. Then, the joint or joints between the damaged joints that are causing the pain are removed.
Next, screws, rods, or a bone graft are used to hold the two joints together so that they don't move. If the bone graft is taken from your own body, it is usually taken from your hip bone. In some cases, bone from another person (a donor graft) is used. Some doctors inject a substance called Bone Morphogenetic Protein into the spine, which stimulates bone growth.
This surgery may take several hours.
What are the possible complications?
There are some risks with any surgery. That's normal. But it's very important to be aware of them in advance, to prevent them, and to recognize them quickly if they do occur.
Below are some of the possible risks associated with this surgery.
| Risk type | Description |
|---|---|
| Common risks associated with any surgery | |
| Bleeding | Excessive bleeding during or after surgery. |
| Blood clots | There is a risk of blood clots, especially in the legs. |
| Infection | Surgical wound infection. |
| Risks associated with anesthesia | Possible reactions to medications given for anesthesia. |
| Risks specific to spinal fusion surgery | |
| Nerve injury | A condition such as numbness in the leg may occur. Severe conditions such as loss of movement are very rare. |
| Pseudoarthrosis | Sometimes the bones don't fuse together properly. If that happens, back pain can return in a few months. |
| Complications associated with bone grafting | If it's a bone taken from someone else, there's a very small risk of the body rejecting it or causing infection. |
Tell your doctor immediately if you have any of these warning signs:
- Excessive swelling, redness, or pus-like fluid draining from the wound.
- Fever (over 100 degrees Fahrenheit).
- The pain becomes unbearable.
- Feeling cold and shivering.
Recovery after surgery
After the surgery, you will need to stay in the hospital for a few days. The number of days depends on your health, fitness, and whether you have any other medical conditions. You will usually stay for about 4 days. You may be able to go home earlier, or you may need to stay for about a week.
During this time, you will be connected to machines that monitor things like your heart rate. You will also have several tubes inserted into your body.
- An IV tube (cannula): This is inserted into a vein in your arm to give fluids, antibiotics, and sometimes painkillers.
- Epidural Catheter: Some people are given pain medication through a thin tube inserted into their spine.
- Catheter: Since it will be difficult for you to get up and go to the bathroom for the first few days, a catheter will be inserted to drain your urine. This may feel a little uncomfortable, but you will probably not feel it at all. It is very important that you stay in one place until your back heals.
During your stay in the hospital, physical therapists and occupational therapists will help you. They will teach you exactly how to get out of bed, sit in a chair, and start walking again.
Before sending you home, the doctor will take an X-ray to make sure the bone is properly fused. You will need to come back in about 10 days to have your stitches removed. After that, you will need to come back for follow-up visits at 4-6 weeks, 6 months, 1 year, and 2 years.
Remember, recovering from back surgery requires both dedication and hard work . It can take up to 6 months or a year for your back to fully heal.
You should continue your physical therapy after you leave the hospital. Your doctor will tell you how often you should go. Be sure to follow these tips to protect your back during the first 6 months :
- Avoid twisting, bending, and heavy lifting.
- Don't even try to lift anything heavier than a large water bottle!
- Therefore, delegate chores like washing dishes and laundry to family members for a while.
Take-Home Message
- Spinal Fusion is a surgery that joins two or more vertebrae in the spine together to stop painful movement.
- This is usually recommended when other treatments, such as medication and physical therapy, have not yielded any relief.
- It is very important to follow the doctor's instructions exactly and to prepare well before surgery.
- As with all surgeries, there are risks, but they can be managed by being aware of them.
- Full recovery takes time, and your commitment and adherence to medical advice are essential. If in doubt, consult your doctor immediately.
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