Our Summary

The research paper provides a historical overview of lumbar interbody fusion surgery, a common type of spinal fusion surgery. It traces the development of this surgery from its early days in the 19th and 20th centuries to the present day. Over the years, the materials and techniques used in this surgery have evolved from basic wiring to a combination of transforaminal interbody fusion using polyether ether ketone cages and pedicle screw fixation with poly axial screws. The paper notes that the options for spinal fusion surgery have expanded significantly over the past century, with a considerable increase in the number of these surgeries being performed over the past few decades. Today, the focus is on perfecting these techniques and developing guidelines for their use. The paper calls for more standardized studies on spinal surgery and emphasizes the need to personalize these techniques based on the individual needs of each patient.

FAQs

  1. What is lumbar interbody fusion surgery and how has it evolved over time?
  2. What are the modern techniques used in instrumented spinal fusion surgeries?
  3. Why is there a need for more standardized studies on instrumented spinal surgery?

Doctor’s Tip

A helpful tip a doctor might tell a patient about spinal fusion is to follow the post-operative rehabilitation program prescribed by your healthcare provider. This may include physical therapy exercises to help strengthen the muscles surrounding the spine and improve flexibility. It is important to follow these exercises regularly to help ensure a successful recovery and long-term outcome of the surgery. Additionally, maintaining a healthy lifestyle with regular exercise and proper nutrition can also help support the healing process and overall spine health.

Suitable For

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

  1. Degenerative disc disease: Patients with degenerative changes in the discs of the spine may benefit from spinal fusion surgery to stabilize the affected area and relieve pain.

  2. Spondylolisthesis: This condition occurs when one vertebra slips forward over the one below it, causing instability and potential nerve compression. Spinal fusion surgery can help realign the vertebrae and reduce symptoms.

  3. Spinal fractures: Patients with fractures of the vertebrae, often due to trauma or osteoporosis, may require spinal fusion surgery to stabilize the spine and promote healing.

  4. Spinal deformities: Conditions such as scoliosis or kyphosis, which cause abnormal curvature of the spine, may be treated with spinal fusion surgery to correct the deformity and improve spinal alignment.

  5. Spinal tumors: Patients with tumors in or around the spine may need spinal fusion surgery to remove the tumor and stabilize the spine.

  6. Failed previous spinal surgery: Patients who have had unsuccessful spinal surgery in the past may benefit from spinal fusion surgery to address ongoing pain or instability.

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

Timeline

Before spinal fusion:

  1. Patient experiences chronic back pain or other symptoms that have not improved with conservative treatments such as physical therapy, medications, or injections.
  2. Patient undergoes diagnostic tests such as X-rays, MRI, or CT scans to determine the cause of their symptoms.
  3. Patient consults with a spine surgeon who recommends spinal fusion as a treatment option.
  4. Patient undergoes pre-operative evaluations and tests to ensure they are a suitable candidate for surgery.

After spinal fusion:

  1. Patient undergoes spinal fusion surgery, during which the surgeon stabilizes the spine by fusing together two or more vertebrae using bone grafts, metal rods, screws, or cages.
  2. Patient stays in the hospital for a few days to recover from surgery and receives pain medication and physical therapy.
  3. Patient is discharged from the hospital and continues with physical therapy and other rehabilitation exercises to strengthen their back muscles and improve mobility.
  4. Patient follows up with the surgeon for post-operative appointments to monitor their healing progress and address any concerns or complications.
  5. Patient gradually resumes normal activities, with some restrictions on lifting, bending, or twisting, as advised by the surgeon.
  6. Patient may experience improvements in their symptoms over time as the spine heals and the fusion becomes solid.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with spinal fusion surgery?
  2. What is the success rate of spinal fusion surgery for my specific condition?
  3. How long is the recovery period after spinal fusion surgery?
  4. Will I need physical therapy or rehabilitation after the surgery?
  5. Are there any alternative treatments to spinal fusion that I should consider?
  6. How long will the hardware used in the surgery remain in my body?
  7. Will I need to make any lifestyle changes or modifications after the surgery?
  8. What type of anesthesia will be used during the surgery?
  9. How soon after the surgery can I return to work or other daily activities?
  10. What is the long-term outlook for my condition after spinal fusion surgery?

Reference

Authors: de Kunder SL, Rijkers K, Caelers IJMH, de Bie RA, Koehler PJ, van Santbrink H. Journal: Spine (Phila Pa 1976). 2018 Aug;43(16):1161-1168. doi: 10.1097/BRS.0000000000002534. PMID: 29280929