Brain Health/Neurology

What are Spinal Fusions?

October 11, 2021

What are Spinal Fusions?

Back pain is the most common cause of disability in the United States. In select cases, surgery and most specifically spinal fusion is recommended. Spinal fusion can be a quality of life saving procedure, allowing patients to go back to a relatively normal life. Patients tend to have less pain, are able to go back to work and spend more quality time with their families.

A spinal fusion may be needed for patients who have back pain due to compression of the nerves in the spine. Based on your symptoms and the findings on the MRI your doctor may recommend a spine surgery. A spinal fusion may be indicated if you need an extensive decompression of the nerves in the spine that will lead to instability of the spine. A spinal fusion is designed to stabilize the spine, to prevent further injury to the nerves. It is a complex procedure, which involves placing screws and rods in the spine to stabilize the spinal segments and promote bone formation to prevent the spine from moving abnormally.

History of Spinal Fusions

Before the invention of spinal navigation, the results from spinal fusion were variable. Being able to place the screws accurately in the spine every time was difficult. Surgeons had to do wide dissections of the muscles of the spine and to visualize the spine extensively to find the landmarks to help them place the screws appropriately.

Unfortunately, most of the patients who required spine surgery had spine arthritis, which distorts the anatomy and makes the placement of the screws very difficult. Intraoperative X Rays or fluoroscopy were used to obtain real time images during the placement of the screws and thus slightly increase the accuracy of the placements. Unfortunately, in patients with certain medical conditions these imaging methods did not provide good results. For example, in patients with osteoporosis, which is a condition where the bones lose their strength, the low density of the bone causes them to have low visibility on Xray and therefore make the placement of screws inaccurate.

How Spinal Fusions Work Today

Today we are using spinal navigation and therefore are able to avoid many of the compilations from misplacing screws in the spine. The O-arm is a CT scanner that we use at St. Francis during surgery to place screws in the correct place every time. The O-arm obtains clear images of the spine. Then using neuronavigation, the surgeon is able to place very precise screws in the lumbar spine. In comparative studies, it was found the use of O-arm imaging system during surgery ensures accurate screw placement and therefore decreases the misplacement of screws compared with traditional methods like fluoroscopy or Xray. More accurate screws means better patient safety.

Patients who have spinal fusion with O-arm navigation also have less pain. Due to the fact that the patient is able to place accurate screws every time, the incisions are smaller and there is less muscle dissection and disruption. Therefore the patient experiences less pain and has a much faster recovery.

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