When non-operative treatments fail to control the back pain, neck pain or potential neurological symptoms associated with end-stage arthritis in the spine, spinal fusion surgery − which eliminates motion in the affected segment of the spine − may be very effective in relieving symptoms. Hospital for Special Surgery is nationally ranked No. 1 in orthopedics by U.S. News & World Report.

What is spinal fusion surgery?

Spinal fusion surgery is a procedure in which two or more vertebrae are fused together to eliminate movement between them. It can relieve symptoms caused by the vertebrae rubbing against each other or slipping out of place. When other treatments are unable to relieve these symptoms – which include pain and instability – this procedure can be very effective.

What conditions does spinal fusion surgery treat?

There are several orthopedic conditions for which patients most clearly receive benefits from spinal fusion surgery. These conditions include, spondylolisthesis, degenerative disc disease, spine fractures and deformities of the spine such as scoliosis.

• Spondylolisthesis is a type of mechanical instability of the spine. In this condition, the vertebrae slip forward and press on the spinal cord. It can cause pain not only in the lower back but also in the buttocks and legs. Spondylolisthesis is more common in people who have participated in high-impact sports like football, weightlifting, and gymnastics. It also tends to run in families. Spondylolisthesis can be caused by the degeneration of one or more facet joints or by a fracture of the pars interarticularis, a bony structure which connects the facet joints of the spine. (This is known as a pars fracture or spondylolysis.)
• Degenerative disc disease (DDD) is where intervertebral spinal discs and/or facet joints deteriorate and lose function.
• Spine fractures may result from a traumatic injury or from degenerative conditions such as osteoporosis or osteoarthritis. Fractures can lead to deformity or instability in the spine.
• Deformities of the spine include conditions like scoliosis and kyphosis. These deformities may be present at birth, develop during puberty, or result from injuries or certain genetic disorders in adults. They also may develop due to conditions like neuromuscular disease or osteoporosis.

How does spinal fusion surgery work?

When you undergo surgery for a joint like the hip, an implant is often used to permanently replace your own bone. Spinal fusion surgery, in contrast, encourages your body to heal itself with your own bone tissue. Surgeons place what are called interbody devices, such as cages that trap bone materials and growth factors and stimulate new bone to grow. In some cases, they may also use screws that stabilize the vertebrae while new bone is growing.

In some cases, the operation may be performed as a minimally invasive spine surgery called endoscopic spine fusion. The technique involves visualization through an endoscope to access the spine to decompress or stabilize the spine. The advantage of this approach is to minimize muscle and soft tissue injury during surgery, usually also minimizing postoperative pain.

Before spinal fusion surgery, you will be screened with a test called a quantitative computed tomography scan (CT scan). This gives your doctors the ability to precisely measure bone density within your vertebral building blocks. You may be given hormones and other medications for several months before your surgery to improve the strength of your bones and their ability to regrow. Some people continue to take these drugs after their operation as well.

How long is the recovery from spinal fusion surgery?

Full recovery from spinal fusion surgery can take up to six months, and you will go through a special exercise regimen to regain strength and range of motion. During that time, you can’t lift anything that weighs more than 15 or 20 pounds. But you’ll be encouraged to gradually increase your level of cardiovascular activity by biking, walking, and working out on an elliptical machine. You’ll also work on strengthening your core and doing other exercises to increase your range of motion.

After you heal from spinal fusion surgery, there are no restrictions on your activities.