Prior To Surgery
Before surgery, a full physical examination and diagnostic evaluation are performed. This includes a series of blood tests, an ECG, X-rays, and scans. Certain Medicines like blood thinners have to Be Ceased at least Two weeks before the operation. Smoking should be avoided because it interferes with bone fusion and reduces blood flow.
- The patient is positioned and an anesthetic is given.
- Minimally invasive procedures have also been developed that allow fusions with small incisions. An incision is made in the skin, and cells are gently pushed aside to create a path to the backbone.
- The surgery may be done by different procedures based on the best possible for the patient and the expertise of the surgeon
Several methods can be used in thoracic spine fusion:
In a posterolateral fusion, a bone graft is inserted between the transverse process, and the vertebra is then fixed in place.
In this procedure, the entire intervertebral disc is removed, and the space between the vertebrae is filled with a bone graft.
- Anterior lumbar interbody fusion (ALIF)
- Posterior lumbar interbody fusion (PLIF)
- Transforaminal lumbar interbody fusion (TLIF)
- Oblique lateral lumbar interbody fusion (OLLIF)
4. For fusion to occur between two vertebrae a bone graft is necessary to function as a bridge, generally, bone grafts are put into the area between the vertebrae to be joined. The bone graft promotes bone healing and increases bone formation.
The graft utilized may be:
- Allograft – from bone bank/cadaver
- Autograft- usually a piece of bone from around the patient’s own pelvis
- Artificial -Synthetic bone substitute may be used.
The bone graft and vertebrae should be glued until the bone graft cures and fuses. The Blend Area is immobilized and secured along with metal rods or screws.
5. An incision is then sealed, and a brace may be administered to strengthen the backbone.
- Following surgery, one needs to stay in the hospital for a minimum of two to three days and may need to wear a brace as one heals. Some pain may be felt following the surgery which may be managed by medications.
- Usually, no one needs to stay in bed. Before the bone is solid after rehabilitation, it may take a few months.
- The fused spine needs to be maintained in the appropriate position while the healing process is ongoing. The patient learns the proper ways to sit, stand, and walk so as not to interfere with the fusing process.
- The bone graft should join the vertebrae above and below within the first three to six months after surgery to form a single, sturdy piece of bone that firmly fuses to the backbone, slowly relieving the symptoms and restoring the level of activity.