3 Spinal Fusion Advances To Improve Outcomes

Posted on: 19 October 2015

There are many conditions that may require spinal fusion as a method of last resort to alleviate pain and prevent nerve injury. Although the idea of spinal surgery can be intimidating, there have been several advances in techniques to improve surgical outcomes and post-operative healing.

Improved Internal Fixation

Internal fixation is the term given to the devices, such as plates and screws, used to provide stability to your spine after surgery. Instead of relying significantly on physical immobilization after surgery, better techniques in internal fixation not only provide much needed stability throughout the healing process, but can lead to fewer post-operative complications. Although you will be limited in your ability to perform different activities for a while after surgery, the sooner you are able to stand and walk around after surgery, the lower your risk is of two major post-operative complications: pneumonia and blood clots.

Pneumonia is more of a risk post-operatively as you age, because daily movements help clear fluid from your lungs. The inactivity combined with the risk of hospital-acquired infections or, in rare cases, the need for intubation, can make pneumonia a serious concern. Walking around as soon as possible after surgery can reduce stiffness and help improve circulation in your legs, where blood clots are more likely to form.

Alternatives For Bone Grafting

The traditional technique used for bone grafting is to remove bone from your pelvis to implant in your spine. This relocation of bone helps encourage bone growth in the new location, and eventually, the spine will fuse together when the new bone finishes growing. One problem associated with using your own bone for grafting is the harvesting of bone from the pelvis is an added procedure, which can be quite painful. The harvesting of bone from the pelvis can further limit post-operative mobility. However, using your own bone decreases the risk of the graft being rejected.

Newer techniques for bone harvesting include using donor bone from cadavers or the creation of artificial bone for grafting. Instead of using a graft completely made from cadavers, demineralized bone matrix (DBM) can be used. With this technique, the bone from the cadaver is demineralized, leaving behind collagen and other biological components. DBM has the ability to actively regrow bone and fuse the two segments of the spine together. Since the DBM only contains properties that can actively reconstruct bone, it may regenerate at a quicker rate than simply using a traditional bone graft.

In some situations, your surgeon may choose a completely synthetic bone graph, such as a calcium phosphate bone substitute. Since many of the synthetic compounds used for bone grafts are reabsorbed back into your body within a matter of weeks, bone substitutes can serve as a foundation on which new bone will grow.

Minimally Invasive Surgery

Minimally invasive surgery (MIS) encompasses a wide range of techniques used for spinal surgery that do not involve large incisions. MIS helps reduce healing time due to the smaller incision. Furthermore, with smaller incisions comes a decreased risk for damage to nerves or blood vessels during the procedure.

Smaller incisions also translates into less blood loss during and after surgery, which decreases the need for spinal surgery patients to have post-operative blood transfusions. In many cases of significant planned surgery, such as spinal or joint replacement surgery, patients are asked to harvest some of their blood pre-operatively in case it is needed. With less expected blood loss during surgery, patients can retain more of their own blood volume before going into surgery.

Although spinal fusion remains a major surgery, progress has been made in lowering the risk of complications and post-operative pain in patients. With these changes, many patients are returning back to their routine quicker and with less residual pain.