What is Spinal Fusion Surgery?
Spinal fusion is a surgical technique used to join two or more vertebrae. Supplementary bone tissue, either from the patient (autograft) or a donor (allograft), is used in conjunction with the body's natural bone growth (osteoblastic) processes to fuse the vertebrae. This procedure is used primarily to eliminate the pain caused by abnormal motion of the vertebrae by immobilizing the vertebrae themselves.
Spinal fusion is a surgical technique used to join two or more vertebrae. Supplementary bone tissue, either from the patient (autograft) or a donor (allograft), is used in conjunction with the body's natural bone growth (osteoblastic) processes to fuse the vertebrae. This procedure is used primarily to eliminate the pain caused by abnormal motion of the vertebrae by immobilizing the vertebrae themselves.
When I finally found my way to the Orthopedic Surgeon's Office, I had experienced low back pain for over 10 years; that is over 1/3 of my life...
When is Spinal Fusion Surgery Necessary?
Certain types of spinal deformity, such as scoliosis, are commonly treated with spinal fusion. Scoliosis is an “S” shaped curvature of the spine that sometimes occurs in children and adolescents. Fusion is indicated for very large curves or for smaller curves that are getting worse.
I was diagnosed with scoliosis when in 1994. I saw a specialist for 3 years; however, was never treated beyond consult. The specialist said that while my curve was "moderate" it was not severe enough for treatment...
Another condition that is treated by fusion surgery is actual or potential instability. Instability refers to abnormal or excessive motion between two or more vertebrae. It is commonly believed that instability can either be a source of back or neck pain or cause potential irritation or damage to adjacent nerves.
During my Junior Year at college (2001), I first began experiencing severe back pain that greatly impacted my mobility and lifestyle. I was prescribed 12 sessions of physical therapy. After the 12th visit, the PT explained that I "knew how" to execute the exercises and as long as I "kept it up" the pain would be minimized...
In 2003, I was the victim of a drunk-driving accident. While my car was totaled, my back was "only sprained." The driver did not have insurance; I was young. I was treated by a chiropractor for a few weeks then released... The pain; however, never ceased.
Spinal fusion is sometimes considered in the treatment of a painful spinal condition without clear instability. A major obstacle to the successful treatment of spine pain by fusion is the difficulty in accurately identifying the source of a patient’s pain. The theory is that pain can originate from painful spinal motion, and fusing the vertebrae together to eliminate the motion will get rid of the pain. Unfortunately, current techniques to precisely identify which of the many structures in the spine could be the source of a patient’s back or neck pain are not perfect. Because it can be so hard to locate the source of pain, treatment of back or neck pain alone by spinal fusion is somewhat controversial. Fusion under these conditions is usually viewed as a last resort and should be considered only after other conservative (nonsurgical) measures have failed.
In 2007 the intense pain that had been in mild remission resurfaced. I saw a chiropractor who asked me, "Do you want to have surgery or do you want to try alternative methods?" Of course, I said, "I do not want to have surgery!" What the doctor failed to tell me was that upon reviewing my x-rays, he saw that I had bulging discs on multiple levels of my spine. He withheld this information so that he could "fix me" himself. I saw this chiropractor for 3 years; at times, I was required to attend three appointments a week; other times, I saw him once every three weeks for "maintenance." Despite the appointments and the adjustments, he never "fixed me..."
In June of 2009, my (then future) mother-in-law suggested that I get an MRI. The results revealed that I have Degenerative Disc Disease. For a year, I saw a Pain Management Specialist. We started with cortisone injections. They didn't work. Then, I went to a radiologist and received 3 rounds of Epidural Steroid Injections. No difference in pain. I was prescribed medication after medication which only masked the pain. The Pain Management Specialist then prescribed another round of physical therapy. I went dutifully every week for months. After no significant changes were made, she recommended that I consult with an Orthopedic Surgeon.
In October of 2009, I saw my surgeon for the first time. He sent me to my third physical therapist. After working diligently with her for months, the doctor finally agreed to a pre-operation procedure called a discogram which would determine if I was a candidate for Spinal Fusion Surgery. Lucky for me, I was...
Recovery following Spinal Fusion Surgery
Recovery following fusion surgery is generally longer than for other types of spinal surgery. Patients generally stay in the hospital for three or four days, but a longer stay after more extensive surgery is not uncommon. A short stay in a rehabilitation unit after release from the hospital is often recommended for patients who had extensive surgery, or for elderly or debilitated patients.
I was scheduled to be in the hospital for 6 days. The surgery went beautifully (as described by my doctor); what was supposed to take 8 hours only took 4 due to lack of complications. The surgeon ordered 6 days of in-patient recovery. (Even thinking about the pain I felt while lying in that hospital bed, I get tears in my eyes...)
By the morning of the day after my surgery, the hospital staff had me sitting up and walking. By day 3, I was doing laps around the hospital floor. By day 4, I was walking stairs. By day 5, I was so desperate to go home, I begged the fellowship doctor to release me. I wanted to go home with my husband.
It also takes longer to return to a normal active lifestyle after spinal fusion than many other types of surgery. This is because you must wait until your surgeon sees evidence of bone healing. The fusion process varies in each patient as the body heals and incorporates the bone graft to solidly fuse the vertebrae together. The healing process after fusion surgery is very similar to that after a bone
In general, the earliest evidence of bone healing is not apparent on X-ray until at least six weeks following surgery. During this time, the patient’s activity is generally restricted. Substantial bone healing does not usually take place until three or four months after surgery. At that time activities may be increased, although continued evidence of bone healing and remodeling may continue for up to a year after surgery.
The length of time required you must be off of work will depend upon both the type of surgery and the kind of job you have. It can vary anywhere from approximately 4-6 weeks for a single level fusion in a young, healthy patient with a sedentary job to as much as 4-6 months for more extensive surgery in an older patient with a more physically demanding occupation.
My doctor released me to return to work at the beginning of the '10-11 school year for half-days for two weeks. I was in my 5th week of recovery. My doctor thought I could return to work full-time at week 7.5. My body told me otherwise...
Following spinal fusion surgery, a postoperative rehabilitation program may be recommended by your surgeon. The rehabilitation program may include back strengthening exercises and possibly a cardiovascular (aerobic) conditioning program, and a comprehensive program custom designed for the patient’s work environment in order to safely get the patient back to work. The decision to proceed with a postoperative rehabilitation program depends upon many factors. These include factors related to the surgery (such as the type and extent of the surgery) as well as factors related to the patient (age, health and anticipated activity level.)
On Christmas Eve of 2010, I will reach my 6-month mark of recovery. I am only working 3 and 1/2 days each week (barely). I am still on pain medication. I still am required to do physical therapy (walking 3 miles) every day. I am still restricted of a "normal" life because the pain is so severe...
At my 4-month check-up, my surgeon told me that I was "an outlier" and that "he did his part" when he successfully completed my surgery. The rest is up to me, even though the pain is real and present daily.
For the past month, I have begun the process of Biofeedback Therapy with a wonderful specialist named Mr. Mark. He was one of the many people who encouraged me to write this blog. This is my story...
Information from:
WWW.SPINE.ORG
And
http://en.wikipedia.org/wiki/Spinal_fusion
