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Spinal Fusion Surgery

Spinal fusion also called  spondylodesis  is a surgery done to join together two or more vertebrae in spine so as to stop movement at the painful vertebrae and thus decrease pain.

In the following sections you will know about:

1.Types and procedure for spinal fusion

2.Cost of spinal fusion surgery

3.Diagnosis and tests for Spinal fusion

4.Leading doctors and hospitals for spinal fusion surgery

5.Frequently asked questions about spinal fusion surgery

Treatments and Cost Related to Spinal Fusion Surgery

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Spinal Fusion Surgery Cost In India For A Patient From United States Change Selection

No. of Travellers 2
Days in Hospital 4
Days Outside Hospital 8
Total days in India 12
Treatment Cost USD 5,000

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Spinal Fusion Surgery in India

Types of Spinal fusion surgery

Part of spine- Spinal fusion can be done at any location of spine

  • Lumbar fusion- commonly done procedure mainly due to degenerative disc changes in lumbar spine  which causes pressure on the spinal cord nerves
  • Cervical fusion- also commonly performed due to increased motion and stress on  cervical spine.
  • Thoracic fusion –thoracic spine being more immobile, so usually the cause of fusion  in thoracic spine is trauma or deformities.

 

Multi levels of spinal fusion

  • One level spinal fusion- used to stop motion at one segment eg  L4-L5, two vertebra need to be joined together to stop motion at one segment.
  • Two level spinal fusion used to stop motion at two segments  L4-L5, L5-S1, that is it involves joining of three vertebra , however spinal fusion of 2 or more levels is unlikely to provide pain relief as hampers normal motion of back and puts stress across remaining joints .
  • Fusion of 3 or more levels is not done except in cases of scoliosis or deformity .
  •  

Procedure of spinal fusion surgery

Before surgery

A complete health check up and diagnostic tests done before surgery ,it  involves  a series of blood tests , ECG , X ray and scans.Some medications like blood thinners need to be stopped atleast 2 weeks before surgery .It is important to quit smoking as it decreases blood circulation and hampers bone fusion .

 

During surgery

Step 1-The patient is positioned and anaethesia  given

Step2- Incision is made in skin and tissues are gently moved aside to create a path to spine Minimally invasive techniques have also been developed these allow fusions with small incisions .

The procedure may be done by different techniques depending on the best possible for the patient and expertise of the surgeon

In lumbar spinal fusion different techniques may be

Posterolateral fusion – in this technique the bone graft is placed in between the transverse process and the vertebra are then fixed in place .

Interbody  fusion -In this technique entire intervertebral disc is removed and bone graft is placed in space between the vertebra, types of interbody fusion

  • Anterior lumbar interbody fusion(ALIF)- this procedure is performed from the front with an incision in lower abdomen  ,intervertebral disc is removed and bone graft placed .
  • Posterior lumbar interbody fusion (PLIF)- as the name suggests this procedure is performed through the back and also includes removing the disc and inserting bone between two vertebrae.
  • Transforaminal lumbar interbody fusion (TLIF)-this procedure is also performed from the back
  • Oblique lateral lumbar interbody fusion (OLLIF)- the surgeon may approach the spine from the side .

Step 3- Bone grafting is done - For fusion to occur between two vertebra a bone graft is needed to serve as bridge, generally bone grafts are placed into the space between the vertebrae to be fused .Bone graft helps bone healing and also increases bone production.

The graft used may be

  • Allograft – from bone bank / cadaver
  • Autograft-  usually a piece of bone from around patients own pelvis
  • Artificial -Synthetic bone substitute may be used

 

Step 4-Immobilization-The bone graft and vertebrae must be immobilized while the bone graft heals and fuses .The fusion area is immobilsed and held together with metal rods , screws or cages

Step 5-Incision is then closed , a brace may be prescribed to support the  spine

 

After surgery

You will be monitored in the hospital for 2-3 days , maybe required to wear a brace while you recover.You will feel some pain after surgery which will be controlled by medications

Bed rest is usually not needed .Rehabilitation may take time and may be several months before the bone is solid .

While the  healing is ongoing the fused spine must be kept in proper posture. You will be instructed the correct manner to sit , stand and walk so as to not hamper the fusing process.

After 3-6 months after surgery , the bone graft should join the vertebra above and below to form one solid piece of bone  that securely attaches to the spine creating permanent fusion , gradually improving your symptoms and also your activity level.

 

Diagnostic Tests for  Spinal Fusion surgery

  • Usually complete symptomatic history of patient taken ,clinical examination  Imaging techniques done to confirm diagnosis and also to rule out other problems
  • MRI is performed to look for disc problems and check spinal nerves status
  • CT Scan for ruling out  joints and bones problems
  • X-ray to check for arthritis or injuries in vertebrae
  • Bone scan to rule out cancer
  • Myelogram ,  electromyogram

 

 

Factors affecting cost of Spinal fusion  Surgery

The cost to the patient depends on a variety of factors like

  • The hospital, the patient chooses.
  • Room –Standard single room, deluxe room, super deluxe room for the number of nights specified (including nursing fee, meals, room rate, and room service).
  • Fee for the team of doctors.
  • Medicines.
  • Standard test and diagnostic procedures.
  • Cost of the follow –up care required after the procedure

 

Read More: All About Spinal Fusion Surgery

 

Recovery from Spinal Fusion Surgery - Doctor's Interview - 3.5 Minutes Video

 

 

Cost of Other Spine Surgeries

 

Frequently asked questions involving Spinal fusion surgery

What is spinal fusion ?

Spinal fusion is a surgical technique  wherein  two or more vertebral bones are permanently joined to maintain alignment and provide stability to spine .The theory  behind spinal fusion is that  if painful vertebrae are immobilized  they will not hurt.

 

   What are the disease conditions requiring spinal fusion surgery ?

  • Degenerative disc disease
  • Spondylolisthesis (condition wherein one vertebrae slips forward on top of another )
  • Spinal stenosis- usually due to arthritis in spine
  • Spinal fractures- due to injuries
  • Kyphosis , Scoliosis- due to abnormal curvatures
  • Tumor causing weak or unstable spine

 

What are the common symptoms of Displaced vertebrae ?

  • Stiffening and loss of mobility of spine
  • Neurological symptoms like numbness, paralysis, loss of reflexes
  • Severe back pain , even occasionally sciatic pains
  • Difficulty in sitting and standing for long durations
  • Weakness of legs
  • Changes in Gait

 

What is the time taken to perform spinal fusion surgery ?

 It depends on the level of the fusion and exent of surgery,usually simple one level fusion surgery  takes between 2-3 hours.

 

What are the risks involving spinal fusion surgery ?

Spinal fusion is a major surgery, there may be some infrequent  complications

  • Damage to the nerves and surrounding structure during procedure
  • Pain at the graft site / Graft rejection
  • Wound infection-antibiotic cover is usually given to prevent infections
  • Bleeding 
  • Deep vein thrombosis (DVT) leading to pulmonary embolism – there is a possibility of formation of clots in leg. These may break off and travel to lungs leading to pulmonary embolism .
  • Pseudarthrosis – when there is no union between the fused bones, if this occurs a second surgery may be needed to fuse the vertebrae.
  • Adjacent segment disease-  as the area that was fused cannot move  so there is increased stress and motion on the adjacent vertebrae causing their degeneration.

 

What are the signs of infection after surgery ?

  • Redness, swelling
  • Drainage from incision site
  • Tenderness
  • Elevated temperature

 

What is the recovery period following spinal fusion surgery ?

Recovery time is variable , depending on the extent of surgery , there is restriction of certain activities and rehabilitation required  but patient usually returns to normal work by 6 weeks and physically active work by about 12 weeks.

  • Walking- there is no restriction, most people are walking  the day after surgery
  • Sedentary work – usually 3-6 weeks after surgery

 

What is the Success rate of spinal fusion surgery ?

Success rate of spinal fusion surgery in terms of pain relief is 70-80 percent

 

What reduces the chances of success of spinal fusion ?

Clinical outcome of surgery depends upon surgeons experience, accurate diagnosis and the patients general health condition

The success rate can be lower in patients who smoke , are overweight , have diabetes or suffering from any other major medical illness, have osteoporosis.

 

 

 

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