Spinal fusion is a surgery in which two or more vertebrae in the vertebral column or back are fused or joined to treat a slew of spinal problems and diseases, which cause debilitating back pain. This surgery helps to remove bone and tissue that are narrowing the spinal canal, squeezing the spinal cord and nerves, reducing pain and improving function.
There are many different causes of back pain like injury, poor posture, age, osteoarthritis, herniation of disc between two vertebrae, degenerative disc disease, narrowing of spine called stenosis, and spondylosis or lessening of space between the vertebrae- most of these can be treated using spinal fusion.
All of these causes put tremendous pressure on the vertebrae and pinch spinal nerves that pass through the back and radiate out into the arms, legs and torso. Apart from the pain, patients experience nerve and muscle weakness and irreversible damage affecting normal life.
Spinal fusion started off as just a treatment for fractures but now it has become the surgery of choice for a number of spine problems. Though it can be done anywhere in the spine, it is very effective when done in the lower part of the spine called lumbar spinal fusion or arthrodesis.
Spinal fusion is done by forming a direct bony connection between the vertebrae surrounding the painful discs, the cushioning between the vertebrae. Pain is stopped by stopping the motion of the painful discs.
There are different methods of spinal fusion each with its own advantages and limitations.
Techniques include fusion approached from the front, the back, or both of the vertebral column. Sometimes surgeons decide to use intervertebral cages or metal screws to provide internal structural support while the bone fuses. These cages may be placed between the vertebrae and packed with bone graft material taken from the patient or constructed out of synthetic materials.
What to expect?
Spinal fusion is not a risk-free procedure. It is a major surgery lasting several hours and carrying a number of risks like-
The patient has to be kept in hospital for a couple of days for post-operative care after which he will have to undergo rehabilitation for months. Hence, one should really think before going for spinal fusion. And when it is recommended, seek a second opinion before making a decision.
The spinal cord houses the most important nerves in the body. Therefore, any disease or disorder affecting the area can be difficult to manage and live with. A spinal cord tumour is a common occurrence and makes life difficult for patients. However, the treatment for tumours on the spinal cord differs based on the region that it affects and other factors.
Types of spinal cord tumours:
Tumours near the spine region can be classified into three types, based on the area that it grows.
• Inside the spinal cord - When a tumour grows inside the spinal cord, it is known as intramedullary. These types of tumours are the rarest. If a tumour affects your cervical spinal cord, it is likely to be intramedullary.
• Outside the spinal cord - A tumour may also grow outside the spinal cord, but still be inside the sac protecting the cord. This kind of spinal tumours is known as intradural/extramedullary.
• Outside the protective sac of the spinal cord - Lastly, the tumour may grow just outside the protective sac of the spinal cord. This is the most common type of a spinal tumour and is known as extradural. A tumour in this region can be malignant or benign.
Symptoms of spinal tumours:
Spine tumours may be difficult to diagnose because the associated symptoms are easily mistaken as other minor disorders or conditions. Here are some common symptoms of a spinal tumour-
• Extreme back pain is common for spinal tumours. This pain grows worse at night. Patients are unable to find relief from the pain even after rest.
• Numbness in the legs and arms
• Inability to walk or severe difficulty in certain movements
• Reduced sensitivity to stimuli, such as pain, heat and cold
• Loss of bowel and bladder control
Treatment for spinal tumours:
Treatment for a tumour depends on the kind of a tumour that affects the patient along with the region of growth. Some tumours may not cause any major difficulty in your quality of life. Doctors will recommend monitoring the growth in such a case. Treatment may not be needed.
In the case of benign tumours, surgery is recommended.
• Surgery - This is the most common form of treatment for benign tumours. If the doctor feels that a tumour is at a location where he/she can perform a safe surgical procedure to remove it, surgery is the best treatment option. However, such surgery can lead to minimal nerve damage.
In the case of cancerous tumours, the treatment is different.
• Radiation therapy - Radiation therapy is necessary to destroy the cancer cells in a tumour. Generally, radiation therapy is useful in cases, where surgery is impossible, due to the location of a tumour.
• Chemotherapy - Doctors may use medications to limit the growth of cancer. In such a case, the drugs help put your cancer in remission. However, the side effects of chemotherapy are severe.
If you experience back pain, visit your doctor. It may be spinal cord cancer. Early detection greatly helps in the treatment of the disease.
Refuse to fuse: advancements in spinal surgery
The spinal column is the best example of a structure which is strong enough to support hundreds of pounds of weight, yet flexible enough to allow nearly 180 degrees of bending, that too in all the planes. Spinal disorder limits either its supporting ability or flexibility.
Out of the two, loss of spinal stability is least tolerable as it directly affects the neural structures. The same dictum is also followed in the management of spinal disorders, as surgeons compromise the flexibility of the spine to provide more stability. Although it is good for relief of primary symptoms, it results in collateral damage to adjacent regions of the spine. This is medically known as "adjacent segment disease".
The recent surgical advances like dynamic interspinous stabilizers, disc replacement prosthesis and dynamic pedicle screws have opened new avenues for stabilization of diseased spine without compromising its flexibility. These surgical techniques in addition to preserving motion of the diseased segment, also minimize stress on adjacent regions which significantly decreases chances of adjacent segment disease.
Any choice of words is insufficient to elaborate on the importance of a stable and flexible spine.
Myelopathy refers to any neurological deficit pertaining to the spinal cord. The three most common types of myelopathy are Cervical myelopathy, Lumbar myelopathy and Thoracic myelopathy. Here are the causes and symptoms of myelopathy.
There are many indications that you are suffering from myelopathy and should consult a medical expert. Here are some of them:
These are just some of the symptoms of myelopathy, however, the doctor cannot diagnose myelopathy until he conduct certain tests. These tests include MRI scans and other tests as well as a regular physical check-up along with a check of your medical history.
Myelopathy refers to any neurological deficit in the spinal cord. The three most common types of myelopathy are cervical myelopathy, lumbar myelopathy and thoracic myelopathy. Here are the causes and symptoms of myelopathy.
This is a very common cause of myelopathy. Any type of accident or even a traumatic event can cause myelopathy and perhaps even paralysis.
2. Spinal stenosis
This is a condition in which the spinal cord narrows. It is one of the leading causes of myelopathy.
3. Degenerative disc disorders
As you get older, these get more likely as well as other conditions which affect the spinal column such as osteoporosis.
It is a little known fact that tumors very often do cause myelopathy.
5. Multiple sclerosis
There are many other diseases which may cause myelopathy and multiple sclerosis is one of them.
There are many indications that you are having a form of myelopathy and should consult a medical expert. Here are some of them.
1. Changes in coordination
What this means is that all of a sudden you may find it harder to move certain limbs the way you want to. Sometimes, this can affect the whole body.
2. Sudden muscle weakness
It is highly likely that if you have myelopathy then you will have sudden weakness in your muscles.
3. Decreased hand-eye coordination
This is perhaps the biggest indicator of myelopathy since hand eye coordination is directly linked to your spinal cord and brain and if they are not functioning properly then hand-eye coordination will be worse.
These are just some of the symptoms of myelopathy, however the doctor cannot diagnose myelopathy until he does certain tests. These tests include MRI scans and other tests as well as a regular physical check-up in addition to a look at your medical history.