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Scoliosis
Scoliosis

Spinal fusion
Definition:
Surgical treatment of abnormal spine bone (vertebrae), such as abnormal curvatures (scoliosis or kyphosis) or injuries (fractures). The surgery stabilizes (fuses) vertebrae together with bone grafts or metal rods. The most common spinal area involved is the lower (lumbar) spine, but upper (cervical) spine involvement can occur. This can also be done for arthritis or infection in certain cases.
Alternative Names:
Harrington rod insertion; Spinal fusion with instrumentation; Posterior spinal fusion; Arthrodesis; Luque rod insertion; Anterior spinal fusion
Description:

While the child is deep asleep and pain-free (using general anesthesia), an incision is made over the spinal area to be treated.

The lower spinal vertebrae are repaired through an incision directly over the spine (posterior lumbar approach). The upper spinal vertebrae are repaired through an incision in the front or side of the neck (anterior cervical spine). The middle spinal vertebrae are repaired through an incision made in the chest and abdomen (anterior thoracic spine).

The abnormal or injured vertebrae are repaired and stabilized with bone grafts, metal rods, or both.
Indications:
Spinal fusion may be recommended for:
  • abnormal curvature of the spine: (scoliosis or kyphosis)
  • injury to the spinal vertebrae
  • protrusion of the cushioning disc between vertebrae (slipped disc, herniated nucleus pulposus)
  • weak or unstable spine caused by infections or tumors
Risks:
Risks for any anesthesia are: Risks for any surgery are: Additional risks include:
  • urinary difficulties (urinary retention)
  • temporary decreased or absent intestinal function (paralytic ileus)


Expectations after surgery:
The outcome from this surgery is usually very successful today with the many available techniques and instruments.
Convalescence:
The patient will be hospitalized for several days after surgery. The repaired spine should be kept in proper position (alignment).

The patient will be taught how to move properly, how to reposition, sit, stand and walk. While in bed, turn frequently using a "log-rolling" technique, meaning that the entire body is moved as a unit, not twisting the spine.

There is usually considerable pain for the first few days after surgery and pain medication will be given regularly, perhaps by a patient-controlled analgesia (PCA). The patient will probably have a urinary catheter. Because of the risk of temporary decreased or absent intestinal function (paralytic ileus) after spinal surgery, the patient may not be able to eat for two to three days and will be fed intravenously.

The patient may be discharged with a back brace or cast and the family will be taught how to care for this at home.
Review Date: 5/25/2001
Reviewed By: Kevin B. Freedman, M.D., Department of Orthopaedic Surgery, Rush-Presbyterian Medical Center, Chicago, IL. Review provided by VeriMed Health Network.

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