Our Summary

People suffering from an unstable spine can be treated with a surgery known as interbody fusion. This procedure can be expensive and complex due to the use of materials like titanium or a plastic called polyetheretherketone (PEEK) that are implanted to facilitate the fusion. To improve these materials, scientists have developed surface modifications like spraying PEEK with titanium or covering the implants with a mineral called hydroxyapatite. There’s some evidence supporting the effectiveness of these new materials, but more research is needed to truly understand if these modifications can improve the long-term health of patients after surgery.

FAQs

  1. What is interbody fusion and when is it used?
  2. What materials are typically used in interbody fusion procedures?
  3. What are some of the surface modifications being developed for interbody fusion devices and how might they improve patient outcomes?

Doctor’s Tip

One helpful tip a doctor might tell a patient about spinal fusion is to follow a strict post-operative rehabilitation program to optimize healing and prevent complications. This may include physical therapy, exercises to strengthen the muscles supporting the spine, and proper body mechanics to avoid putting unnecessary strain on the fused area. It is important to follow the doctor’s instructions carefully to ensure a successful recovery and long-term success of the spinal fusion procedure.

Suitable For

Patients who are typically recommended for spinal fusion are those who have:

  1. Degenerative disc disease: This condition occurs when the discs between the vertebrae break down, leading to pain and instability in the spine.

  2. Spondylolisthesis: This is a condition where one vertebra slips forward over the one below it, causing instability and potential nerve compression.

  3. Spinal stenosis: This is a narrowing of the spinal canal, which can put pressure on the spinal cord and nerves, leading to pain and weakness in the legs.

  4. Herniated disc: When a disc in the spine ruptures, it can put pressure on the nerves, causing pain, numbness, and weakness.

  5. Spinal fractures: Fractures in the spine, whether due to trauma or osteoporosis, can cause instability and pain that may require fusion surgery to stabilize the spine.

  6. Failed previous spinal surgery: In cases where previous spinal surgery has not been successful in relieving pain and stabilizing the spine, fusion surgery may be recommended as a salvage procedure.

Timeline

Before spinal fusion:

  1. Patient experiences chronic back or neck pain that does not improve with conservative treatments such as physical therapy or medication.
  2. Patient undergoes diagnostic tests such as X-rays, MRI, or CT scans to determine the source of the pain.
  3. Patient consults with a spine surgeon to discuss the possibility of spinal fusion surgery as a treatment option.
  4. Patient undergoes pre-operative testing and preparation for surgery.

After spinal fusion:

  1. Patient undergoes spinal fusion surgery, during which the surgeon removes damaged discs or vertebrae and fuses the remaining bones together using implants or bone grafts.
  2. Patient is monitored in the hospital for a few days post-surgery to ensure proper healing and pain management.
  3. Patient undergoes physical therapy and rehabilitation to regain strength and mobility in the spine.
  4. Patient follows up with the surgeon for regular check-ups and monitoring of the fusion site.
  5. Over time, the patient may experience reduced pain and improved function in the spine as the fusion fully heals and stabilizes the affected area.

What to Ask Your Doctor

  1. What is the success rate of spinal fusion surgery for my specific condition?
  2. What are the potential risks and complications associated with spinal fusion surgery?
  3. How long is the recovery period after spinal fusion surgery?
  4. Will I need physical therapy after the surgery? If so, for how long?
  5. What type of implant materials will be used in the spinal fusion surgery?
  6. Are there any alternative treatments to spinal fusion that I should consider?
  7. How soon after the surgery can I return to my normal activities, such as work or exercise?
  8. Will I need to have any additional surgeries or procedures in the future due to the spinal fusion surgery?
  9. What can I expect in terms of pain management after the surgery?
  10. Are there any lifestyle changes I should make before or after the spinal fusion surgery to improve the outcome?

Reference

Authors: Enders JJ, Coughlin D, Mroz TE, Vira S. Journal: Neurosurg Clin N Am. 2020 Jan;31(1):57-64. doi: 10.1016/j.nec.2019.08.007. Epub 2019 Oct 24. PMID: 31739930