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How spine fusion surgery works
At each level in the spine, there is a disc space in the front and paired facet joints in the back. Working together, these structures define a motion segment and permit multiple degrees of motion. Two vertebral segments need to be fused together to stop the motion at one segment, so that an L4-L5 (lumbar segment 4 and lumbar segment 5) spinal fusion is actually a one-level spinal fusion.

More Spinal Fusion Info:
  • Elements of Spinal Fusion
  • Spinal Fusion Recovery
  • Spinal Fusion History

A spine fusion surgery involves using bone graft to cause two vertebral bodies to grow together into one long bone. Bone graft can be taken from the patient's hip (autograft bone) during the spine fusion surgery, harvested from cadaver bone (allograft bone). or manufactured (synthetic bone graft substitute).

In general, a lumbar spinal fusion surgery is most effective for those.

conditions involving only one vertebral segment. Most patients will not notice any limitation in motion after a one-level spine fusion. Only in rare cases should a three (or more) level fusion surgery for pain alone be considered, although it may be necessary in cases of scoliosis and lumbar deformity.

When necessary, fusing two segments of the spine may be a reasonable option for treatment of pain. However, spinal fusion of more than two segments is unlikely to provide pain relief because it removes too much of the normal motion in the lower back and places too much stress across the remaining joints.

There are several types of spinal fusion surgery options, including:-
  • Poster lateral gutter fusion the procedure is done through the back
  • Posterior lumbar interbody fusion (PLIF/TLIF) the procedure is done from the back and includes removing the disc between two vertebrae and inserting bone into the space created between the two vertebral bodies.
  • Anterior lumbar interbody fusion (ALIF)—the procedure is done from the front and includes removing the disc between two vertebrae and inserting bone into the space created between the two vertebral bodies.
  • Anterior/posterior spinal fusion—the procedure is done from the front and the back.

It is important to note that with any type of spine fusion surgery, there is a risk of clinical failure (meaning that the patient's pain does not go away) despite achieving a successful fusion. Obtaining a successful result from a spine fusion requires and accurate preoperative diagnosis, a technologically adept surgeon, and a patient with a reasonably healthy lifestyle (non smoker, non obese) who is motivated to pursue rehabilitation and restoration of their function.
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