How is Spinal Fusion Performed?

With spinal fusion surgery, bone grafts are placed around the spine. Your body then heals the grafts over several months – similar to healing a fracture – which joins, or “welds” the vertebrae together.

The goal of spinal fusion is to get a solid union between the vertebrae. Depending on a number of different factors, Dr. Blankenship may also use supplemental instrumentation such as plates, screws, and cages. These factors include your underlying problem, age, and number of levels of the spine being fused.

Regardless of whether or not instrumentation is used, it’s important that bone or bone substitutes be used to fuse the vertebrae together. These are either taken from another bone in the patient’s body, or from a bone bank. For years, your own hip bone was considered the gold standard fusion material. Dr. Blankenship began over a decade ago to look for other solutions. The graft site for hip graft harvest was universally painful and often would leave the patients in more pain, just in a different location.

This journey had led Dr. Blankenship to his current practice of not taking hip graft anymore. He uses a bone marrow concentrate obtained from your iliac crest (after you are asleep). This material is a concentrate of your own bone forming stem cells. He also uses a concentrate from your platelets that contains the bone growth factors. In the majority of cases he will use other bone extenders and always utilizes local bone from the area of surgery. It is also possible that if you smoke or have significant instability a bone stimulator will be used. All of these factors are individually weighed and then a plan to maximize the rate of fusion is formulated.