Your doctor will lead the surgical team and perform your spinal fusion in a hospital. Your surgeon will place bone graft material in strips along your vertebrae, in pieces between your vertebrae, or packed into a special cage that goes between your vertebrae.
Surgical approaches to spinal fusion
Spinal fusion surgery may be performed using one of the following approaches:
- Minimally invasive surgery involves inserting special instruments and an arthroscope through small incisions in your back. An arthroscope is a thin, lighted instrument with a small camera. The camera transmits pictures of the inside of your body to a video screen viewed by your surgeon as he or she performs the surgery. Minimally invasive surgery may have a faster recovery and less pain. This is because it causes less damage to tissues. Your surgeon will make small incisions instead of a larger one used in open surgery. Surgical tools are threaded around muscles and other structures instead of cutting through or displacing them as in open surgery.
- Open surgery involves making a larger incision in your back (posterior approach), abdomen or chest (anterior approach), or side (lateral approach). Open surgery allows your surgeon to directly view and access the surgical area. Open surgery requires a larger incision and involves more cutting and displacement of muscle and other tissues. Open surgery generally involves a longer recovery and more pain than minimally invasive surgery because it causes more trauma to tissues. Despite this, open surgery may be a safer or more effective method for certain patients.
Your surgeon will determine which type of surgery is best for you and how long you need to stay in the hospital or surgical center based on your diagnosis, age, medical history, general health, and possibly your personal preference. Learn about the different spinal fusion procedures and ask why your surgeon will use a particular type for you.
Types of anesthesia that may be used
Your surgeon will perform spinal fusion using either regional anesthesia or general anesthesia, depending on the specific procedure.
- General anesthesia is a combination of intravenous (IV) medications and gases that put you in a deep sleep. You are unaware of the procedure and will not feel any pain. You may also receive a peripheral nerve block infusion in addition to general anesthesia. A peripheral nerve block infusion is an injection or continuous drip of liquid anesthetic. The anesthetic flows through a tiny tube inserted near your surgical site to control pain during and after surgery.
- Regional anesthesia is also known as a nerve block. It involves injecting an anesthetic around certain nerves to numb a large area of the body. To numb a smaller area, your doctor injects the anesthetic in the skin and tissues around the procedure area (local anesthesia). You will likely have sedation with regional anesthesia to keep you relaxed and comfortable.
What to expect the day of your spinal fusion
The day of your surgery, you can generally expect to:
- Talk with a preoperative nurse. The nurse will perform an exam and ensure that all needed tests are in order. The nurse can also answer questions and will make sure you understand and sign the surgical consent.
- Remove all clothing and jewelry and dress in a hospital gown. It is a good idea to leave all jewelry and valuables at home or with a family member. The surgical team will give you blankets for modesty and warmth.
- Talk with the anesthesiologist or nurse anesthetist about your medical history and the type of anesthesia you will have.
- A surgical team member will start an intravenous (IV) line.
- The anesthesiologist or nurse anesthetist will start your anesthesia.
- A tube will be placed in your windpipe to protect and control your breathing during general anesthesia. You will not feel or remember this or the surgical procedure as they happen.
- The surgical team will monitor your vital signs and other critical body functions. This occurs throughout the procedure and your recovery until you are alert, breathing effectively, and your vital signs are stable.