Our Summary

This study looks at the best place to end a spinal fusion surgery for adults with spinal deformities. The researchers compared fusing the spine at the L5 vertebra versus the sacrum (the base of the spine). They analyzed data from 11 previous studies involving 1211 patients. They found no major difference in the overall rate of complications or the need for additional surgeries between the two methods. However, fusing at the L5 vertebra resulted in fewer cases of pseudarthrosis (non-healing after spinal fusion), fewer complications related to the surgical implant, and less disease in the segments of the spine adjacent to the fusion. On the other hand, fusing at the sacrum led to a better correction of the curve in the lower back and less loss of alignment in the spine. Overall, both methods had their own advantages and were similar in terms of the correction of the spinal curvature, overall complications, further surgeries, and improvement in pain and disability.

FAQs

  1. What were the main findings of this research about the best place to end a spinal fusion surgery?
  2. What are the advantages of fusing at the L5 vertebra versus the sacrum in spinal fusion surgery?
  3. Was there a significant difference in the overall rate of complications between fusing at the L5 vertebra and the sacrum?

Doctor’s Tip

A doctor might tell a patient undergoing spinal fusion surgery to follow post-operative instructions carefully, including proper lifting techniques, avoiding excessive bending or twisting of the spine, and attending physical therapy as recommended. It is also important to maintain a healthy weight, quit smoking (if applicable), and stay active to help promote proper healing and prevent complications. Additionally, it is important to communicate any concerns or changes in symptoms to your healthcare provider promptly.

Suitable For

Patients who are typically recommended for spinal fusion surgery include those with:

  1. Spinal deformities such as scoliosis or kyphosis
  2. Degenerative disc disease
  3. Herniated discs
  4. Spinal stenosis
  5. Spondylolisthesis
  6. Spinal fractures
  7. Tumors or infections affecting the spine

It is important for patients to undergo a thorough evaluation by a spine specialist to determine if spinal fusion is the appropriate treatment option for their specific condition.

Timeline

Before spinal fusion surgery, a patient will typically undergo a series of consultations and tests to determine the best course of treatment for their spinal condition. This may include physical examinations, imaging studies (such as X-rays, MRIs, or CT scans), and discussions with the surgeon about the risks and benefits of the procedure.

During the surgery itself, the patient will be placed under general anesthesia and the surgeon will make an incision in the back to access the spine. The damaged discs or vertebrae will be removed and replaced with bone grafts or implants to stabilize the spine. The surgeon may use rods, screws, or plates to hold the spine in place while the bone heals.

After the surgery, the patient will typically spend a few days in the hospital for monitoring and pain management. Physical therapy may be recommended to help strengthen the muscles around the spine and improve flexibility. It can take several months for the spine to fully fuse and for the patient to return to normal activities.

Overall, the goal of spinal fusion surgery is to reduce pain, improve spinal stability, and prevent further damage to the spine. While the recovery process can be challenging, many patients experience significant improvements in their quality of life after undergoing this procedure.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with spinal fusion surgery?
  2. How long is the recovery process after spinal fusion surgery?
  3. Will I need physical therapy or rehabilitation after the surgery?
  4. What restrictions or limitations will I have after the surgery?
  5. How long until I can return to work or regular activities?
  6. What type of pain management will be used during and after the surgery?
  7. How successful is spinal fusion surgery in relieving pain and improving function?
  8. Are there alternative treatments to spinal fusion that I should consider?
  9. What is the expected outcome of the surgery in terms of pain relief and mobility?
  10. How many spinal fusion surgeries have you performed and what is your success rate?

Reference

Authors: Jia F, Wang G, Liu X, Li T, Sun J. Journal: Eur Spine J. 2020 Jan;29(1):24-35. doi: 10.1007/s00586-019-06187-8. Epub 2019 Oct 17. PMID: 31624908