Name of the Procedure:

Arthrodesis, Anterior for Spinal Deformity (with or without cast; 4 to 7 vertebral segments)

Summary

Arthrodesis, commonly known as spine fusion, is a surgical procedure that aims to join two or more vertebrae in the spine to prevent any movement between them. This can involve fusing 4 to 7 vertebral segments through an anterior (front) approach. Sometimes a cast may be used to aid in the stabilization of the spine.

Purpose

This procedure is designed to address spinal deformities such as scoliosis or kyphosis. The primary goals are to correct abnormal spinal curvature, stabilize the spine, alleviate pain, and prevent further progression of the deformity.

Indications

• Chronic back pain due to spinal deformity
• Severe scoliosis or kyphosis
• Spinal instability requiring stabilization
• Ineffectiveness of non-surgical treatments

Preparation

• Patients may be advised to fast several hours before surgery.
• Pre-surgical screening and diagnostic tests including blood tests, X-rays, MRI, or CT scans.
• Adjustment or cessation of certain medications as instructed by the healthcare provider.
• Pre-operative discussions about anesthesia and post-surgery care.

Procedure Description

1. Under general anesthesia, an incision is made in the front of the body (anterior approach).
2. The surgeon accesses the affected vertebral segments.
3. Damaged or diseased disc material is removed, and bone graft material is placed between the vertebrae.
4. Metal plates, screws, or rods may be used to hold the vertebrae together and promote fusion.
5. In some cases, a cast may be applied to further stabilize the spine.

Duration

The procedure typically takes between 4-6 hours.

Setting

Performed in a hospital operating room equipped for complex spine surgeries.

Personnel

• Orthopedic or neurosurgeon specializing in spine surgery
• Anesthesiologist
• Surgical nurses
• Radiologic technologist (for intraoperative imaging)

Risks and Complications

• Infection
• Bleeding
• Nerve damage
• Blood clots
• Non-fusion or incomplete fusion of vertebrae
• Adverse reaction to anesthesia

Benefits

• Correction of spinal deformity
• Stabilization of the spine
• Reduction or elimination of pain
• Improved posture and mobility
• Prevention of the progression of the spinal condition

Recovery

• Hospital stay of 3-5 days post-surgery.
• Pain management with prescribed medications.
• Instructions on movement and activity limitations.
• Physical therapy might be recommended.
• Full recovery and fusion may take several months to a year, with follow-up appointments to monitor progress.

Alternatives

• Non-surgical treatments like physical therapy, bracing, or medications.
• Other surgical interventions might include different types of spine fusion or minimally invasive surgical options.
• Pros of alternatives: Less invasive, quicker recovery.
• Cons of alternatives: Might not be as effective in severe cases.

Patient Experience

• During the procedure, patients will be under general anesthesia and unaware of the surgery.
• Post-operatively, patients may experience pain and discomfort, managed with medications.
• Limited mobility and activity restrictions will be in place to aid in recovery.
• Gradual improvement with physical therapy and adherence to post-operative care instructions.