What is spinal fusion?

Spinal fusion is the surgical joining of two vertebrae in your neck or back. Your vertebrae are the bones that make up your spine (backbone). Spinal fusion permanently stops movement between two or more vertebrae. It is a treatment for a variety of diseases and conditions of your spine. 

All spinal fusions use a bone graft to fuse or join two vertebrae. Sometimes your doctor will also use screws, rods or plates to hold your vertebrae in place. Spinal fusion can help restore pain-free function in a deformed, damaged or diseased spine.

Spinal fusion is a common but major surgery with significant risks and potential complications. You may have less invasive treatment options available. Consider getting a second opinion about all of your treatment choices before having a spinal fusion. 

Types of spinal fusion

Generally, all types of spinal fusion procedures use bone graft material. This involves placing bone graft material in strips along your vertebrae, in pieces between your vertebrae, or packed into a special cage that goes between your vertebrae. Your body heals the bone around the graft over several months. Spinal fusion is not immediate with surgery. It takes time for your body to form enough bone around the graft to permanently fuse your vertebrae.

The types of spinal fusion procedures include:

  • Allograft fusion uses a piece of cadaver bone for the bone graft. Allografts come from a bone bank. Allograft fusions require only one incision and cause less pain than an autograft fusion. However, bone fusion and healing is less predictable with an allograft.
  • Autograft fusion uses a piece of your own bone for the graft. Your doctor will usually take bone from your hip. This type of spinal fusion was the only option available in the past. However, an autograft requires an additional incision, lengthens surgery time, and causes more post-operative pain. 
  • Synthetic, or artificial graft fusion uses synthetic (totally man-made) materials and modified natural bone. Some artificial bone graft materials are used alone and others are combined with an allograft or autograft. 

Other procedures that may be performed

Your doctor may also perform other procedures in addition to spinal fusion. These procedures are usually done first and include:

  • Discectomy is the surgical removal of part or all of a spinal disc. A discectomy treats degenerated, herniated or ruptured spinal discs.
  • Foraminotomy is the widening of the opening where the nerve roots leave the spinal canal. Your doctor may use this procedure when the opening (foramina) is narrowed causing pressure on the spinal nerves.
  • Laminectomy is the removal of the lamina. The lamina is the back part of each vertebra of your spine. A laminectomy makes your spinal canal larger. This reduces pressure in your spinal canal and nerves.

Why is spinal fusion performed? 

Your doctor may recommend spinal fusion to treat a variety of diseases and conditions of the spine. Your doctor may only consider spinal fusion if other treatment options with less risk of complications are not working. Ask your doctor about all your treatment options and consider getting a second opinion. 

Your doctor may recommend spinal fusion for persistent spinal pain caused by: 

  • Degenerative disc disease, a breakdown of the cushioning discs between the vertebrae. This can lead to compression of the spinal cord and nerves.
  • Fracture of a vertebra
  • Infections of the spine
  • Scoliosis or kyphosis, which are abnormal curvatures of the spine
  • Spinal stenosis, which is a narrowing of the spinal column causing pressure on the spinal cord and nerves
  • Spondylolisthesis, which is dislocation of one vertebra over the one below it
  • Tumorsof the spine

Who performs spinal fusion?

Orthopedic surgeons and neurosurgeons perform spinal fusion. Orthopedic surgeons specialize in the surgical treatment of diseases of the bones and connective tissues. Neurosurgeons specialize in neurological surgery involving the brain, spine and nerves.

How is spinal fusion performed?