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Spine fusion

Or spinal fusion is a surgical procedure used to correct problems with the small bones in the spine (vertebrae). It is essentially a “welding” process. The basic idea is to fuse together the painful vertebrae so that they heal into a single, solid bone.

Due to the lack of appropriate implants, the initial fusions were performed via decortication of the dorsal and lateral structures of the spine, followed by placement of an autograft.


Once a patient has met the criteria to be a candidate for spinal fusion, there are many procedure options to employ 1) and include either open or minimally invasive exposures (i.e., mini-open, endoscopic, tubular, and percutaneous) for anterior [direct anterior (ALIF), lateral anterior lumbar interbody fusion (LLIF)] or posterior approaches [posterior (PLIF) or transforaminal (TLIF)]. Regardless of surgical approach or procedure chosen, the goals of spinal fusion surgery remain the same: decompression of the neural elements, maximization of final construct stiffness through the placement of a large intervertebral implant and/or rigid fixation in order to promote fusion over as large a fusion area as possible while preserving or restoring segmental alignment and overall spinal balance.

These different procedures vary in their inherent ability to fulfill each surgical goal. Patient and pathologic considerations largely guide which procedures are possible and surgeon preference drives which of the viable procedures is selected for use. With the proliferation of a variety of minimally invasive surgical (MIS) approaches, particularly ones that use direct visualization (mini-open), there is a need for updated criteria for patient and procedural selection for the modern surgeon

2) 3)

Procedure

Lumbar Fusion

Cervical fusion

1)
Mobbs RJ, Phan K, Malham G, et al. Lumbar interbody fusion: techniques, indications and comparison of interbody fusion options including PLIF, TLIF, MI-TLIF, OLIF/ATP, LLIF and ALIF. J Spine Surg 2015;1:2-18.
2)
Irwin ZN, Hilibrand A, Gustavel M, et al. Variation in surgical decision making for degenerative spinal disorders. Part I: lumbar spine. Spine 2005;30:2208-13. 10.1097/01.brs.0000181057.60012.08
3)
Foley KT, Holly LT, Schwender JD. Minimally invasive lumbar fusion. Spine 2003;28:S26-35. 10.1097/01.BRS.0000076895.52418.5E
spine_fusion.txt · Last modified: 2018/05/10 20:38 by administrador