Vertebral arthrodesis
Spinal fusion is a widely used procedure for the treatment of various degenerative diseases of the spine. The procedure can be applied as a single method or after a previous foraminotomy, discectomy, or laminectomy.
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Both lumbar vertebral arthrodesis and cervical vertebral arthrodesis are surgeries with a very high level of complexity and precision; therefore, they must be performed by a specialized medical-surgical team with extensive experience in the area of spinal surgery.
In the following publication, we will explain the step by step of this important surgical intervention, how many types of spinal fusion there are, how you can prepare and what the risks are.
What is Spinal Arthrodesis?
Spinal fusion is a surgery that allows two or more vertebrae of the spine to be permanently fused together, in order to limit movement between them. Spinal fusion is often used in the treatment of severe pathologies and the correction of structural deformities that cause pain and instability in the spine.
Why is Spinal Arthrodesis done?
The main causes why the spine specialist may recommend a spinal fusion include:
Spinal stenosis (narrowing of the intervertebral foramina).
Spinal instability.
Vertebral injuries or fractures.
Infections or tumors in the spine.
Spondylolisthesis (displacement of a vertebra).
Scoliosis.
Kyphosis.
Post-discectomy syndrome.
Among others.
How to prepare for Spinal Arthrodesis?
In the days leading up to surgery, the specialist will recommend avoiding tobacco, alcoholic beverages, and taking drugs that slow blood clotting. If you have had the flu, cold, herpes, fever or infection, it is most likely that your intervention will be postponed until you fully recover.
Because it is an operation where general anesthesia is applied, you should not eat or drink for 8 to 12 hours before the procedure; likewise, it is advisable to take the medications prescribed by the specialist and follow each of his indications.
What is the Spinal Arthrodesis procedure like?
Spinal fusion requires general anesthesia, so the patient will remain asleep and will not feel any pain. During the procedure, the surgeon makes an incision in the back or neck to access the spine; Next, it separates the skin, muscles, vessels and other tissues to the side to have a better visualization of the area to be intervened.
The specialist removes the bone fragments or worn discs and then replaces them with natural or synthetic grafts, fusing the vertebrae permanently. This fusion can be reinforced with bars, screws or plates to consolidate vertebral stability while the progressive growth of new bones occurs.
The bone graft to be used can be obtained from the patient himself, from a bone bank or synthetically. Finally, the incision is manually sutured and covered with a clean bandage. In case of leaving drains, they will be removed within 24 to 48 hours.
As for recovery, we must say that this is a slow process (approximately 3 months), starting with a hospitalization period of 3 to 4 days. Incorporation into the work activity can occur after 3 or 6 months after surgery; However, this estimated time may vary depending on the level of physical effort involved in the work of the operated patient.
What types of Spinal Arthrodesis are there?
Spinal fusion can be approached in different ways, depending on the specialist’s criteria, the number of levels to be treated, the location and degree of the injury. In this sense, the most common techniques are:
Anterior lumbar vertebral arthrodesis
Approach from the front of the abdominal area.
Anterior cervical vertebral arthrodesis.
Approach from the front of the neck.
Posterior lumbar vertebral arthrodesis.
Approach from the lumbar area (back).
Posterior cervical vertebral arthrodesis.
Approach from the back or back of the neck.
Anterior posterior lumbar vertebral arthrodesis.
Mixed approach (two-way) between the abdomen and back.
These procedures have a common goal, to fuse unstable vertebrae derived from previous pathologies to obtain a solid and stable vertebral segment.
Risks of Spinal Fusion and Side Effects
Cervical vertebral fusion causes increased stiffness of the neck; however, this is not something that negatively influences the flexibility and optimal mobility of the neck. In addition to the use of anesthesia, the risks associated with lumbar or cervical spinal fusion are:
Failure of the merger.
Rupture of synthetic implants (if used).
Blood clot formation.
Injury to the nerves or spinal cord.
Infection.
Bleeding.
Pain in the area where the bone graft was obtained.
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