spinal fusion
spinal fusion surgery
Spinal fusion is a surgical technique that is performed to link together (“fuse”) one or more vertebrae within the spine so there is no longer motion between them. Fusion is still the gold standard for surgical treatment of painful discs and/or spinal instability.

Your spine is made up of individual bone segments called vertebrae. Strong connective tissue holds one vertebra to the next and acts as a cushion between the vertebrae. This cushion is called a disc, and is what allows us to bend our backs and necks forward, backward and side-to-side. The type and degree of motion depends on what level of the spine the vertebrae are located: cervical (neck), thoracic (chest), or lumbar (lower back).

When there is a problem with your spine (see “When is Spinal Fusion Necessary” below), Dr. Blankenship may recommend a spinal fusion to eliminate the motion of the affected portion of your spine in an effort to eliminate the source of your back problem.


When is Spinal Fusion Necessary?

Because Dr. Blankenship takes a conservative approach to any type of spine surgery, a spinal fusion will be recommended only after other non-surgical treatments have failed, or if your condition can only be improved through surgery.

Some of the potential reasons Dr. Blankenship may consider spinal fusion surgery include:

• Some types of vertebral fracture
• Correction of a deformity such as scoliosis
• Elimination of pain from painful motion
• Vertebral slippage (spondylolisthesis)
• Treatment of instability
• Treatment of some cervical disc herniations.


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.


Recovery.

Recovery from spinal fusion surgery was considered to be a matter of months to years in the past. When Dr. Blankenship first started performing fusions six months to a year of recovery were the norm. Now with maximal access and preemptive analgesic techniques, the recovery is more a matter of weeks. Immediate discomfort following the surgery is also usually greater, although there are excellent methods of postoperative pain control available. Once again, with the new techniques that Dr. Blankenship uses, the degree of post-op pain is generally less than in decades past.

The length of time you will need to be off work depends on the type of surgery you have and the kind of work you do. It can vary from patient to patient depending on multiple factors. Most patients are able to return to work in the first four weeks. Some require longer recovery times.


Long-term expectations.

After a period of recovery time, Dr. Blankenship may also recommend a postoperative rehabilitation program that could include strengthening exercises, possible cardiovascular conditioning, and a custom-designed program for your work environment in order to get you safely back to work as quickly as possible. How much rehabilitation and what level depends on factors such as the extent of your surgery, age, health, and anticipated activity level.

It’s important to remember that although spinal fusion surgery can be a good treatment for your condition, it doesn’t return your spine to “normal.” It’s important to remember that although spinal fusion surgery can be a good treatment for your condition, it doesn’t return your spine to “normal.” Once healed, you will be at the end of that chapter in your spines story, not the end of the story. A life long commitment to spinal health is needed. The center of this commitment is exercise.

Your decision whether or not to undergo spinal fusion needs to be made carefully after discussing it thoroughly with Dr. Blankenship, your family, and weighing your options carefully.

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