Spinal fusion (arthrodesis)

Surgery Overview

Spinal fusion (arthrodesis) is a surgical procedure that joins, or fuses, two or more vertebrae. Spinal fusion is major surgery, usually lasting several hours. There are different methods of spinal fusion.

  • Bone is taken from the pelvic bone or obtained from a bone bank. The bone is used to make a bridge between adjacent vertebrae. This bone graft stimulates the growth of new bone.
  • Metal implants are secured to the vertebrae to hold them together until new bone grows between them.

What To Expect After Surgery

You will need to be watched in the hospital for a few days after spinal fusion surgery.

Bed rest is not usually necessary during your recovery period at home.

Your doctor may recommend that you wear a back brace during recovery.

Rehabilitation can be a prolonged process and includes walking, riding a stationary bike, swimming, and similar activities.

Why It Is Done

Spinal fusion may be done by itself or in combination with decompression to treat painful symptoms caused by misalignment or instability of the vertebrae, such as spondylolisthesis.

Spinal fusion may also be done as a follow-up to decompression and debridement procedures done to treat spinal stenosis, herniated discs, spinal injuries, infection, tumors, and deformities.

How Well It Works

This surgery was originally developed as a way to stabilize the spine and treat deformity or fractures of the spine. Its use has now spread to treatment of degenerative bone or disc changes and spinal stenosis.1

Spinal fusion is often necessary to stabilize the spine after a traumatic injury, infection, or tumor. There is no solid body of research supporting the effectiveness of spinal fusion for various other spinal conditions. One study showed no clear difference between spinal fusion surgery and intensive rehabilitation for treating chronic low back pain.2 In addition, the surgery is expensive and has significant risks. Therefore, although this type of surgery is common, it is controversial, and there is no guarantee of treatment success.

Risks

The risks associated with this procedure vary depending upon your age and overall health, diagnosis, and the type of procedure that is done.

Spinal fusion procedures frequently cause other problems. Risks include:

  • Pain at the bone graft site.
  • Failure of the fusion process and/or breakage of metal implants.
  • Deep venous blood clots that may also lead to pulmonary embolism.
  • Nerve injury.
  • Graft rejection.
  • Superficial infection.
  • Deep infection.

What To Think About

Because there are so many things to consider when spinal fusion is recommended, seek a second opinion before making a decision.

Complete the surgery information form (PDF)(What is a PDF document?) to help you prepare for this surgery.

References

Citations

  1. Deyo RA, et al. (2004). Spinal-fusion surgery—The case for restraint. New England Journal of Medicine, 350(7): 722–726.
  2. Fairbank J, et al. (2005). Randomised controlled trial to compare surgical stabilisation of the lumbar spine with an intensive rehabilitation programme for patients with chronic low back pain: The MRC spine stabilisation trial. BMJ, 330(7502): 1233–1239.

Last Updated: February 3, 2010

Author: Shannon Erstad, MBA, MPH

Medical Review: William M. Green, MD - Emergency Medicine & Robert B. Keller, MD - Orthopedics

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