# Spinal Fusion

> Citation bundle for Spinal Fusion on The Treatment Registry.
> URL: https://thetreatmentregistry.com/procedures/spinal-fusion
> Bundle URL: https://thetreatmentregistry.com/api/citations/procedures/spinal-fusion

- Category: orthopaedic

## Description

Spinal fusion, also called spondylodesis or spondylosyndesis, is a surgery performed by orthopaedic surgeons or neurosurgeons that joins two or more vertebrae. This procedure can be performed at any level in the spine and prevents any movement between the fused vertebrae.

## Overview

Spinal fusion, also called spondylodesis or spondylosyndesis, is a surgical procedure performed by orthopaedic surgeons or neurosurgeons that permanently joins two or more vertebrae so there is no movement between them. It can be carried out at any level of the spine, cervical, thoracic, lumbar or sacral. The surgery uses bone grafting, using bone taken from the patient (autograft), from a donor (allograft), or an artificial bone substitute, to encourage the vertebrae to heal together, and hardware such as screws, plates, rods or cages is usually added to hold the bones in place while the graft fuses; placement can be guided by fluoroscopy, navigation systems or robotics. Fusion is most commonly performed to relieve pain and pressure caused by mechanical problems of the vertebrae or on the spinal cord, particularly when a disc wears out (degenerative disc disease). Other conditions treated include spinal stenosis, spondylolisthesis, spondylosis, disc herniation, spinal fractures, tumours, scoliosis and kyphosis; the greatest benefit appears to be in spondylolisthesis, with weaker evidence for spinal stenosis. Fusions may be approached from the front (anterior), the back (posterior) or both, and posterior lumbar fixation using pedicle screws is the most common technique. Because it eliminates motion at the fused segment, spinal fusion changes the normal mechanics of the spine and places additional stress on the vertebrae above and below, which over the long term can contribute to degeneration of the adjacent segments. Motion-preserving alternatives, such as artificial disc replacement, exist for selected patients.

## Common risks

- Infection
- Significant blood loss
- Nerve damage or neurologic deficit
- Deep vein thrombosis and pulmonary embolism
- Fusion failure (pseudarthrosis), with higher risk in smokers and those deficient in vitamin D
- Degeneration of the spinal segments adjacent to the fusion
- Hardware failure

## FAQs

### What is spinal fusion?

Spinal fusion is surgery that permanently joins two or more vertebrae so there is no movement between them. It uses bone grafting, often with hardware such as screws, plates and rods, to help the vertebrae heal together, and can be done at any level of the spine.

### What conditions does it treat?

It is most often used for degenerative disc disease and to decompress and stabilise the spine. Other conditions include spinal stenosis, spondylolisthesis, spondylosis, disc herniation, fractures, tumours, scoliosis and kyphosis, with the clearest benefit in spondylolisthesis.

### How are the vertebrae joined together?

Bone graft, taken from the patient, from a donor, or an artificial substitute, is packed between the vertebrae to help them heal together. Hardware such as screws, plates, rods or cages is usually added to hold the bones in place while the graft fuses.

### What is a downside of fusion?

By eliminating motion at the fused segment, fusion changes the normal mechanics of the spine and places more stress on the vertebrae above and below. Over the long term this can contribute to degeneration of the adjacent segments.

### How long is recovery?

Recovery is highly variable. The average hospital stay is about 3.7 days. After a lumbar fusion most people walk the day after surgery, resume driving and sedentary work at around three to six weeks, avoid heavier lifting until about twelve weeks, and return to manual work between seven and twelve weeks.

### What increases the risk of complications?

Risk is higher in older people, those with a raised body mass index, other medical problems, poor nutrition or nerve symptoms before surgery. Smokers and people deficient in vitamin D are at higher risk of fusion failure.