Vertebral arthrodesis . It is a surgery to fuse two bones (vertebrae) in the spine. The fusion permanently joins two bones so that there is no longer any movement between them. Vertebral arthrodesis is usually performed in conjunction with other surgical procedures of the spine.
Summary
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- 1 Description
- 2 Procedure
- 1 Risks
- 2 Before the procedure
- 3 After the procedure
- 3 Forecast
- 4 Alternative names
- 5 Bibliography
- 6 Sources
Description
You will be asleep and will not feel pain ( general anesthesia ).
The doctor will make a surgical incision to view the spine. This can be done:
- On the back or neck above the spine. You will lie on your stomach. Muscles and tissue are separated to expose the spine.
- On one side of the abdomenif you are going to have surgery on your lower back. The surgeon will use tools called retractors to gently move and hold soft tissues and blood vessels and have room to work.
- With a cut in the front of the neck, towards the side.
Another surgery, such as a discectomy , laminectomy, or foraminotomy , is almost always done first.
The surgeon will use a graft (like bone) to permanently support (or fuse) the bones. There are several different ways to fuse the vertebrae:
- Strips of the bone graftmaterial can be placed over the back of the spine.
- The bone graft material can be placed between the vertebrae.
- Special boxes can be placed between the vertebrae, which are filled with bone graft material.
The surgeon can obtain the graft from different places:
- From another part of the body (usually around the pelvic bone), which is called an autograft. The surgeon will make a small cut above the hip and remove some bone from the back of the pelvic rim .
- From a bone bank, called an allograft.
- A synthetic bone substitute can be used.
The vertebrae are also often fixed with screws , plates, or boxes . They are used to prevent them from moving until the bone grafts have completely healed.
The surgery can take 3 to 4 hours.
Process
Vertebral arthrodesis can be done in the following cases:
- Along with other surgical procedures for spinal stenosis, such as foraminotomy or laminectomy .
- After a neck discectomy.
- Injuryor fractures of the bones in the spine.
- Weakness or instability of the spine caused by infections or tumors.
- Spondylolisthesis, a condition in which one vertebra slides forward over another.
- Abnormal curvatures, such as those of scoliosisor kyphosis .
Vertebral arthrodesis can also be done in conjunction with other surgeries to treat spinal stenosis. These surgeries are done to get more room for the spine and spinal nerves (such as foraminotomy or laminectomy). You and your doctor can decide when you need surgery.
Risks
The risks of any surgery are:
- Blood clotsin the legs that can travel to the lungs .
- Respiratory problems.
- Infection, including in the lungs ( pneumonia), bladder, or kidney .
- Bleeding
- Heart attack or stroke during surgery.
- Drug reactions.
The risks of spinal surgery are:
- Infection in the wound or bones of the spine.
- Damage to a spinal nerve, causing weakness, pain, loss of sensation, and problems with the intestines or bladder.
- Vertebrae above or below the fusion are more prone to wear and tear, leading to more problems later.
Before the procedure
Always tell your doctor or nurse what drugs you are taking, including medicines or herbs you have bought without a prescription.
During the days before surgery:
- If you are a smoker, you need to quit smoking. Patients who have spinal arthrodesis and continue to smoke probably don’t heal as well. Ask the doctor for help.
- Two weeks before surgery, your doctor or nurse may ask you to stop taking drugs that make it harder for your blood to clot. They include acetylsalicylic acid (aspirin), ibuprofen (Advil and Motrin), naproxen (Aleve and Naprosyn), and other similar drugs.
- If you have diabetes, heart disease, or other conditions, the surgeon will ask you to see your regular doctor.
- Tell your doctor if you have been drinking a lot of alcohol.
- Ask your doctor which drugs you should still take on the day of surgery.
- Always let your doctor know if you have a cold, flu, fever, herpes outbreak, or any other illness you may have.
On the day of surgery:
- You will generally be asked not to drink or eat anything for 6 to 12 hours before the procedure.
- Take the drugs your doctor recommended with a small sip of water.
After the procedure
You will stay in the hospital for 3 to 4 days after surgery.
In the hospital, you will be given pain relievers, which can be taken by mouth or given by injection or a vein (intravenously or IV). You may have a pump that controls the amount of pain reliever you receive.
You will be taught how to move properly and how to sit, stand, and walk. You will be asked to use the rolling trunk technique when getting out of bed, which means that you move your entire body at once, without twisting your spine.
You may not be able to eat for 2 to 3 days and will be fed through an IV. When you leave the hospital, you may need to wear a corset or a plaster splint for your back.
Forecast
People who had chronic back pain before their surgery are likely to still have some pain after this. Vertebral arthrodesis is unlikely to eliminate all pain and other symptoms.
Even when MRIs or other tests are used, it is difficult for the surgeon to always predict which patients will improve and how much relief the surgery will provide.
Losing weight and exercising will increase the likelihood of feeling better.
Spinal problems in the future are possible for all patients after spinal surgery. After vertebral arthrodesis, the area that was fused can no longer be moved. Therefore, the spine above and below the arthrodesis is more prone to strain when the spine is moved and may have problems later on.
Alternative names
- Anterior vertebral arthrodesis
- Arthrodesis
- Posterior vertebral arthrodesis
- Intervertebral fusion
- Colunm surgery
- Vertebral arthrodesis
