Posterior and anterior fusion of the lumbar spine
Purpose and conduct of fusion
Fusion refers to a category of operational techniques that can completely immobilize one or more vertebrae.
During this surgical intervention is the process of combining two or more vertebrae.
This is very important if, for example, increased mobility in the spine or other problems associated with his back.
The main functional purpose of the methodology is to install between several adjacent vertebrae special bone transplant, providing splicing immobilized vertebrae.
We can conclude that this surgery is one of the most common in modern medicine it is possible to get rid of such serious problems as breaches in the normal structure of the lumbar spine and the surgery of spinal fusion is often used when you want to fix several vertebrae in the case of strong deformation of the spine.
Today, the technology of intervention is substantially improved if a few years ago, she treated a serious surgery today this surgery is used with comparative ease.
The main indications for
Spinal fusion is recommended in cases of spinal deformities and intense pain in the back.
This surgical intervention is performed in the case of small effectiveness of conventional conservative treatment.
The main indication for the operation are such problems as:
- narrowing of the canal of the spinal cord;
- this operation is usually carried out in the moments of detection of a herniated disc;
- any spinal injury received as a result of injuries or other deformities;
- the indications for fusion is scoliosis, which is a pathological change in the normal shape of the spine;
- also carrying out this surgical procedures is conducted in the presence of the patient advanced forms of osteochondrosis;
- furthermore, important indications for fusion are different benign and malignant tumors in the spine.
In modern medicine is done as a separate surgery and can also act as an additional manipulation while carrying out other operations.
By far the most common and commonly used are considered to be two type of surgery:
- Back interbody fusion of the lumbar spine, the essence of which is complete removal of the intervertebral disc. Usually it is replaced with a special plate.
- The second common type of surgery – anterior lumbar interbody fusion. The essence of this operation does not change significantly, the difference lies only in the fact that surgical intervention is performed from the front of the patient’s body.
The stages of the operation
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Carrying out surgery is usually preceded by the preparation process of the patient.
The preparatory phase
The patient in preparation for surgery can be administered:
- A full medical examination that will help to establish not only the presence of existing deformations in the spine, but also to establish underlying chronic disease that may have a significant impact on the operations of the event.
- Before carrying out surgical measures for treating this type of patient primarily assigned routine x-ray studies, as well as additional computer tomography, with which the attending specialist will be able to fully study the clinical picture of the disease.
- In some cases, patients before surgery it is recommended that the passage of magnetic resonance imaging. This procedure is aimed at identifying the smallest deformations in the normal structure of the spine.
- Immediately prior to this procedure the patient must stop taking virtually any medication is advised to make not less than 7 days prior to surgery. Even the most innocuous analgin may cause very mixed reactions of the body during the fusion.
- Also directly 7 hours before the operation the patient should refrain from eating and drinking.
The intervention process
As mentioned above, the main purpose of this operation is to place a special unit directly between multiple vertebrae.
The operation is carried out by access from the front or from the back. Usually the procedure of spinal fusion is performed under local anesthesia – this helps the patient to get rid of the unpleasant sensation of pain during surgery.
The incision necessary for access to the spine is usually in the neck or lower back. The following is the process of careful spreading of the muscles, then the doctor puts directly dorsal plate.
In some cases, the establishment of a special bone grafts or modern metal plates that serve as transplants.
Typically, the duration of surgical intervention does not exceed the limit in 5-6 hours.
In the presence of serious chronic diseases or major deformities of the spine time of surgical intervention may be extended at the discretion of the attending specialist.
During the operation most often assigned to General anesthesia, which ensures that no discomfort for the patient.
The postoperative period
After the spinal fusion the patient usually has to spend in hospital under the supervision of the attending specialist, at least 3 days.
During the postoperative period, the patients assigned a special course of anesthetic drugs, can reduce the occurrence of pain syndrome to a minimum.
This is due to the fact that such surgery could cause the patient considerable discomfort. In the most severe cases, patients can be prescribed a course of special anaesthetic injections, which are administered intravenously by.
Within 6-8 weeks after surgery patients are strictly prohibited, intensive physical activity – exercise should be kept to a very low level.
In the most common cases of complete recovery and healing of the spine can take up to 6 months, and in some cases – and up to a year.
For convenience and fixation of the spine in the correct position it can be recommended to wear a special corset. But the question about wearing such a corset is decided only by the treating specialist based on the severity of the disease, possible complications.
Excellent results during rehabilitation have methods of physiotherapy and special exercises conducive to rapid recovery.
What complications can arise after surgery?
After every surgical intervention there is a risk of complications, and fusion is no exception.
After the vote may occur such complications as:
- edema, redness and bruising at the site of incision, which are accompanied by inflammation;
- in some cases it may be intense internal bleeding;
- the risk of infection, the characteristics of which is the emergence of a strong fever;
- incorrect or partial accretion of the joined fragments of the spine;
- an allergic reaction to the anesthesia used.
There are a number of factors that can significantly increase the risk of complications.
In the so-called «risk category» include patients over middle age, people with certain concomitant diseases of a chronic nature.
In addition, the risk of complications is increased in patients with bad habits – Smoking, drinking alcoholic beverages, or poor nutrition.
Also serious complications after the spinal fusion often occur in people with obesity.
In order to avoid possible complications, you should carefully follow all recommendations of your specialist and be sure to consult with him about any problems in the rehabilitation period.