Spinal fusion: what to expect, common problems and how to deal with them

What is spinal fusion?

Spinal fusion is a surgical procedure in orthopedic medicine, used to treat conditions like scoliosis by permanently joining vertebrae. The goal is to stabilize the spine, reducing pain and preventing further progression of many conditions like degenerative disc disease or fractures. Spinal fusion surgery serves as an important scoliosis treatment option, providing hope and improved quality of life for individuals.

Procedure for spinal fusion surgery

The procedure involves permanently joining two or more vertebrae together to form a single, solid bone, thereby stabilizing the spine and alleviating pain.

There are several types of spinal fusion procedures, each tailored to the specific condition and needs of the patient. They are mostly differentiated by the location through which a surgeon will access the spine. 

The most common approach is posterior lumbar interbody fusion (PLIF), where the surgeon accesses the spine through the back and removes the damaged disc material before fusing the vertebrae together using bone grafts. 

Anterior lumbar interbody fusion (ALIF) is another approach, involving accessing the spine through the front of the body to remove damaged discs and insert bone grafts, often supplemented with screws or rods for added stability.

Other techniques include transforaminal lumbar interbody fusion (TLIF), which accesses the spine through a unilateral approach from the back, and lateral lumbar interbody fusion (LLIF), which accesses the spine through the side. Minimally invasive techniques have also become increasingly popular, offering smaller incisions, reduced muscle damage, and quicker recovery times compared to traditional open surgery.

Why is spinal fusion needed? What are the benefits?

Spinal fusion surgery offers several potential benefits for individuals with various spinal conditions:

• Pain relief

• Improved spinal stability

• Enhanced functional ability

• Prevention of progression

• Potential for increased longevity

• Reduced dependency on medications

Overall, spinal fusion surgery holds promise for improving spinal health, relieving pain, and enhancing quality of life for individuals suffering from various spinal conditions. However, it's essential to consult with a healthcare provider to determine whether spinal fusion is the most appropriate treatment option based on individual circumstances and medical history.

Common complications and problems due to spinal fusion

Like any surgery, spinal fusion can cause some problems down the line and complications may arise. However, it is important to keep in mind that spinal fusion is a common procedure. 

Here are some common complications associated with spinal fusion surgery, categorized as short-term and long-term.

Short-term complications

Common short-term complications are common with any surgery. This includes complications such as infections at the surgical site and blood loss throughout the surgery. Due to the nature of this type of surgery, other complications can occur, such as nerve damage which can result in permanent or temporary sensory or motor deficits, such as numbness, weakness, or changes in sensation.

In rare cases, complications such as pseudoarthrosis or implant failure can occur. Pseudoarthrosis can occur if the fusion site does not properly heal and causes persistent pain. Implant failure will occur when the hardware used for the surgery such as screws or plates, fail to prove adequate stabilization. Both complications will often be addressed by secondary surgery to resolve the issues.

Long-term complications

Hardware-related issues can often occur due to wear and tear. This can cause irritation, discomfort in the patient. The hardware is also at risk of migrating and can cause fractures. In this case, surgery is needed to remove or replace the hardware to avoid worsening of the complications. 

Patients can also experience loss of spinal mobility and chronic pain long-term following the spinal fusion which can cause discomfort and affect quality of life. 

In certain cases, patients can develop adjacent segment disease (ASD). Spinal fusion can increase stress on vertebrae near the spinal fusion location and cause development of ASD. This stress can lead to accelerated degeneration of spinal segments in these locations nearby, which can cause conditions such as disc herniation and spinal stenosis. This often occurs in older individuals or individuals with pre-existing spinal conditions which affects segment integrity. This is why long-term monitoring post spinal fusion is important following surgery. 

Surgery is always a last resort!

Keep in mind, surgeries are only done when a doctor deems it is necessary to improve your quality of life. Like any other surgery, there are risks. However, surgeons would not deliberately harm you and do their absolute best to avoid complications. If you are worried, do not hesitate to speak with your doctor about this. They will be able to reassure you and go through all your questions with you. 

The best way to avoid surgeries is to monitor your spine throughout your life, strengthen your core and make sure to report any pain to your physician. Momentum Spine can help you monitor your posture and spinal health through its AI-based platform. Through a simple video, it can output relevant spinal metrics that can inform you on the health of your spine and overall posture.

See how it works with this short video!

Frequently asked questions

How long am I supposed to be in the hospital after spinal fusion? What is the recovery time?

The full healing process can be long and require a lot of patience and work. Depending on the extent of the surgery, you will be required to stay about 2-4 days in the hospital following surgery. 

1-4 weeks after your surgery, bed rest is still recommended with some small movements. Moving slightly will help your vertebrae heal and keep your back muscles strong. As you get better, you can start doing some light work around the house and walking around.

With physical therapy and gradual rehabilitation, it can take anywhere from 6 months to a year to fully recover from the surgery. This depends on the extent of your surgery and the progress you are making in physical therapy. It’s important during this time to follow recommendations from your healthcare team and to be careful when moving around.

How long does pain last after surgery? 

Unfortunately, there is no clear answer, as every individual has a unique procedure and tolerates pain differently. Spinal fusion can take 6-12 months to fully heal and therefore, you could experience a certain level of pain throughout. During the first 3 months, you will be given pain medication to help manage any pain you may be experiencing.  

Will my legs become weak after spinal fusion? 

In very rare cases, if a nerve in the spine is damaged throughout the surgery, this could affect your legs. 

A phenomenon called foot drop can occur in these rare cases, where you may have difficulty lifting your foot. However, this is rare and there are different methods that can help you manage. 

Can I have a normal life after spinal fusion?

Absolutely! If you follow the recommendations of your physician and physiotherapist, a normal life is possible following surgery. 

Depending on the extent of the fusion, you might need to adjust certain things in your day-to-day life, especially any movement that may require to bend your back. However, these small adjustments do not stop you from leading a healthy normal life. 

How can I alleviate my pain after surgery? What can I do to help?

There are many ways to alleviate the pain you may feel following surgery. 

First, your physician will most likely prescribe you pain medication for the following weeks after you are discharged. Once you have depleted those, medication such as acetaminophen and NSAIDS (such as ibuprofen) can help alleviate moments of sharp pain. Please use these medications according to packages and do not go over the recommended daily dosage.

Placing an ice or a cold compress on the region of your back, can also help manage the pain. This can help lower the blood flow and reduce muscle spasms which could be painful shortly after surgery.

If you are feeling pain, and the medication is not helping you, contact your physician and let them know your situation. They should be able to help reduce the pain and prescribe whatever they think is best for you in this situation.