Name of the Procedure:

Arthrodesis, posterior, for spinal deformity, with or without cast; 13 or more vertebral segments
Common Name(s): Spine Fusion Surgery, Spinal Fusion
Technical/Medical Term: Posterior Spinal Arthrodesis

Summary

Arthrodesis is a surgical procedure that involves fusing together multiple vertebrae in the spine to correct deformities and provide stability. When performed posteriorly, the surgery involves making an incision in the back. This specific procedure targets 13 or more vertebral segments, which are usually part of the thoracic and/or lumbar spine.

Purpose

Medical Condition or Problem: This procedure addresses complex spinal deformities such as scoliosis, kyphosis, or severe spinal instability.
Goals/Outcomes: The main goal is to correct the spinal deformity, stabilize the spine, alleviate pain, and improve the patient's functional capacity and quality of life.

Indications

Symptoms or Conditions: Severe spinal curvature (scoliosis or kyphosis), spinal instability, severe pain unresponsive to conservative treatments.
Patient Criteria: Individuals with advanced spinal deformities, progressive neurological symptoms due to vertebral misalignment, and those who have not responded to non-surgical treatments.

Preparation

Pre-Procedure Instructions: Patients may need to fast for 6-12 hours before surgery. Medication adjustments might be necessary, particularly blood thinners.
Diagnostic Tests/Assessments: Preoperative imaging (X-rays, MRI, CT scans), blood tests, and a thorough medical evaluation to assess overall health and readiness for surgery.

Procedure Description

The surgery begins with the patient under general anesthesia. The surgeon makes an incision in the back to access the spine. Using specialized tools, the surgeon removes the intervertebral discs and prepares the vertebrae for fusion. Bone graft material, often taken from the patient's pelvis or obtained from a donor, is placed between the vertebrae. Metal rods, screws, or plates may be used to hold the vertebrae together while the fusion heals. Casts or braces might be applied postoperatively to aid in stabilization.

Duration

The procedure typically takes 6-8 hours, but the duration may vary depending on the complexity of the case.

Setting

The surgery is performed in a hospital operating room.

Personnel

Healthcare Professionals Involved: Surgeons, nurses, anesthesiologists, surgical technologists, and possibly orthopedic or neurosurgical specialists.

Risks and Complications

Common Risks: Infection, blood loss, reaction to anesthesia, and pain at the graft site.
Rare Risks: Nerve damage, blood clots, hardware malposition, and failure of the fusion.

Benefits

The expected benefits include spinal deformity correction, pain relief, improved stability, and enhanced overall function. These benefits may start to be realized within a few weeks to months post-surgery, with full benefits often seen after the fusion completely heals, which can take 6-12 months.

Recovery

Post-Procedure Care: Pain management will include medications and physical therapy. Wound care instructions must be followed to prevent infection.
Expected Recovery Time: Initial recovery takes several weeks. Patients may need to wear a brace or cast and limit physical activity. Full recovery can take up to a year, with regular follow-up appointments to monitor progress.

Alternatives

Other Treatment Options: Physical therapy, bracing, pain management injections, or less invasive surgical options like spinal osteotomy.
Pros and Cons: Non-surgical options are less risky but may be less effective for severe deformities. Less invasive surgeries have quicker recovery times but may not be suitable for extensive deformities.

Patient Experience

During the Procedure: Patients will be under general anesthesia and will not feel pain during surgery.
After the Procedure: There may be significant pain managed with medications. Patients will need to stay in the hospital for several days. Discomfort and limited mobility are expected during the initial recovery phase. Pain management and physical therapy will focus on comfort and regaining function.