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Spinal Fusion – Lumbar and Cervical

Posted on 02 December 2010 by publisher (0)

Spinal fusion surgery can either be performed in the lumbar region of the spine (lumbar fusion) or the cervical region (cervical fusion) but is rarely performed in the thoracic region. Conditions rarely develop in the thoracic spine because of its stability.

A spinal fusion is a surgical technique that does exactly what the name implies: it fuses 2 or more spinal vertebrae together. By fusing 2 or more vertebrae together, an unstable spinal segment that is causing pain will now become stable, ending the symptoms caused by the instability.

Conditions Treated by Spinal Fusion

There are many conditions that a spine fusion procedure can treat, but as mentioned earlier a spinal fusion should be your last option as mobility will be limited after the procedure. Fusing 2 vertebrae together will show slight signs of limited movement in the spinal column whereas a multiple-level vertebral fusion will really start to show this.

The following conditions can be treated with spinal fusion surgery:

  • Herniated Disc
  • Vertebral Disc Pain
  • Degenerative Disc Disease
  • Spondylolisthesis
  • Spondylosis
  • Scoliosis
  • Spinal Tumor
  • Fractured Vertebra

There are of course more conditions that can be treated by a spinal fusion. In essence any condition that has symptoms caused by spinal instability can be treated with a cervical fusion or a lumbar fusion.

Types of Spinal Fusion Surgery

We already know that there are 2 main regions in the spine that a fusion can be considered, the lumbar and the cervical regions. The following are 3 main types of fusion that will be considered for lumbar fusion.

  1. Posterolateral Fusion – A posterolateral fusion is performed by placing a grafting bone between the transverse processes of the two vertebrae to be fused in the back of the spine. The transverse process is located at the top side of the vertebra. The vertebrae in question are held in place with screws and wire attached to the pedicle of each vertebra, which is then attached to a metal rod.
  2. Interbody Fusion – Prior to an interbody fusion the vertebral disc is removed. The fusion procedure is accomplished by inserting a spacer into the disc space where the vertebral disc once was and then placing a bone graft between the vertebrae in this location. The spacer is used to keep the spine properly aligned and to make up for the removed disc height. The spacer is made of bone, titanium, or plastic.
  3. 360 Degree Fusion – A 360 degree spinal fusion is a term used for when both fusion mentioned above are performed at the same location in the spine.

Lumbar Fusion Angles of Approach

There are 3 main angles of approach when dealing with lumbar fusion surgery.

  1. ALIF – ALIF stands for Anterior Lumbar Interbody Fusion and is the angle taken when the surgeon gains access to the spine from an anterior (abdominal) approach.
  2. PLIF – PLIF stands for Posterior Lumbar Interbody Fusion and is the angle taken when the surgeon gains access to the spine from a posterior (through the back) approach.
  3. TLIF – TLIF stands for Transforaminal Lumbar Interbody Fusion and is the angle taken when the surgeon gains access to the spine from a posterior approach but from the side instead of a direct approach.

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