Spinal Fusion Description
The following information is provided in assisting you to make an informed decision about your spine surgery. If you have any additional questions, please consult with Dr. Moza, as he is the only one who is qualified to comment on your specific condition and can better help you and inform you of your concerns.
Non-surgical and Surgical Treatments
There are many treatments for spine conditions and degenerative disc disease. Non-Surgical Treatments include: Rest, ice or heat, medication, steroid injections, exercise and physical therapy.
If these non-surgical treatments do not bring relief after a period of time, depending on the degree of degeneration, non-fusion and fusion surgeries are available. Spinal Fusion Surgery: This procedure takes pressure off of the nerves that are causing the pain. This is done by restoring the alignment of the spine or the space between the vertebrae, and then stabilizing and fusing the spine. A spinal fusion is when bone grows between the vertebrae, stopping any motion in the area, which reduces the pain.
Depending on the condition of the spine, Dr. Moza may use an anterior approach, which means the incision will be in the abdomen, or a posterior approach, which means the incision, will be in the back. He will discuss this with you prior to your surgery. Sometimes the doctor may choose to use a combination of the two. If he does use the posterior approach, then a pedicle screw system will be used to stabilize the spine while it fuses and heals. The pedicle screw system may be used alone or it can be combined with another stabilizing device. During surgery, Dr. Moza may relieve the nerve compression by removing the disc. This procedure is called a Discetomy. He may also relieve pressure on the nerve by trimming or removing the roof, or lamina, of the vertebrae to create more space for the nerve. This procedure is called a laminectomy. He then restores the space around the nerves and prepares to stabilize the spine with the pedicle screw system, and then Dr. Moza will choose the ones that will work best for your spine. The screws are placed through each side of the vertebrae in the part of the bone called the pedicle. Rods are then attached to connect the screws and hold the spine in its restored position. The pedicle screw system will now be secure. In the last step of the surgery, Dr. Moza will place bone graft, which are small chips of bone, alongside of the vertebrae to be fused or puts the graft in and around a device that is placed between the vertebrae. Bone graft can come from you or a bone bank, or a combination of both.
The pedicle Screw system will hold the spine stable until the bone graft fuses with the vertebrae. Although bone fusion is a natural biological process, complete fusion can take up to one year. In some cases, patients may have trouble fusing their spine. Many factors, such as smoking, including second hand smoke, various medications can interfere with a successful fusion. Dr. Moza will discuss these risk factors associated with your specific surgery with you.
Spinal Stabilization – How can it help?
This procedure uses a pedicle-screw fixation system, which is an implant device consisting of a spacer, cord, and pedicle screw. It offers an approach to stabilization and mobilization of the spine and pain relief that relies on flexible materials and preserves much of the spinal anatomy.
Am I A Candidate?
Spinal stabilization can be used in skeletally mature patient to provide immobilization and stabilization of spinal segments. It is used to treat degenerative slipped disc(s) (spondylolisthesis) in the thoracic, lumbar and sacral regions when there is evidence of resulting neurologic impairment and lumbar back pain.
Who is not a candidate? Spine Stabilization should not be used in the cervical spine or for patients that are obese, pregnant, abuse alcohol or other drugs or who have an active or systemic infection, mental illness, severe osteoporosis or osteopenia, sensitivities or allergies to metals, polymers, polyethylene, polycarbonate urethane and polyethylene terephthalate, soft tissue deficit, congenital abnormalities, tumors, inadequate pedicles of the thoracic, lumbar and sacral vertebrae. Spine Stabilization is also not appropriate for individuals with any medical or mental condition that puts them at high risk from surgery of this severity, those with a condition that will not allow then to benefit from the surgery or decrease the useful life of the device, and those who are unwilling or unable to follow post-operative instructions.
What does this surgery involve? Spine Stabilization is compatible with conventional surgical techniques, and in some cases, can be implanted using a minimally invasive approach. On average, the procedure to implant a Spine Stabilization implant takes two to three hours which is similar to the time required for traditional fusion procedures. During the procedure, Dr. Moza, a Simi Valley spine surgeon, will remove a portion or portions of the affected disc(s) and bone from the spine. The implant is then attached to the bony extrusion, called the pedicle on each side of the affected vertebrae. Once in place, the components create a dynamic push-pull relationship that stabilizes the affected joints and keeps your vertebrae in a natural position.
What to Expect Before and After Surgery
Before Surgery: There are a few things you can do to prepare for spinal surgery. Eating well-balanced nutritional meals in the weeks before surgery will help your body as it heals. If you smoke, quitting in the weeks before surgery is also helpful. Dr. Moza will inform you of any other things you need to know that will help you prepare for surgery.
After Surgery: Recovery from spinal fusion surgery happens in stages as your body heals. The first stage of recovery involves the healing of the incision and soft tissues, which will happen over the first few weeks. Movement, such as walking, does a lot to help with healing. You can expect to be doing some walking as soon as the day after surgery, and you be expected to walk every day after that. You may or may not be expected to attend physical therapy or occupational therapy for gentle exercise in the early weeks of recovery. This will be decided based on each patient’s individual case. You can discuss this with Dr. Moza for further recommendation.
Dr. Moza will monitor and evaluate the bone fusion throughout your recovery. This will mean visits to his office, x-rays to see how the bone fusing. He will tell you what things you can do to help your recovery. It’s common to have pain in your back for a period of time after surgery. He will be able to help you manage your pain with medication. Be sure to talk to him if you experience more pain that is more severe than you were told to expect. Most patients can return to work and their daily activities within six weeks after surgery. Complete fusion takes months, and full recovery is different for each patient. Depending on how many levels of your spine are fused, you may notice some changes in the flexibility of your back. Dr. Moza will tell you what you can expect during your recovery.
Spinal fusion surgery using pedicle screw system is designed to stabilize your spine, giving you the ability to move more easily and with less pain. For most patients, spinal fusion surgery offers significant relief and improved ability to move and function in their daily lives. After Spine Stabilization Surgery: It may take several weeks to fully recover from pain resulting from surgery. However, you may feel almost immediate relief of any leg pain, and back pain should diminish over time now that the vertebrae have been stabilized and nerves are no longer compressed. In most cases, a short hospital stay is required to ensure you adjust to oral pain medication and can move without any problems. Most patients return home within a few days. Following your surgery, Dr. Moza will prescribe follow-up visits as needed. It is important to follow his instructions carefully to help ensure a full and quick recovery.
Risk and Complications
As Dr. Moza will explain, any surgery involves risk. After surgery, if you have any of the following symptoms, you should contact Dr. Moza immediately. Signs of infection: Fever, chills, redness around the incision, increased pain, a feeling of pressure in the spine, bleeding or excessive drainage from the incision, sudden pain, or a significant increase in your pain level, loss of feeling in your hands or feet, increased or ongoing shortness of breath.
Surgery always involves some risk. General surgical complications may include: Reactions to anesthesia, heart attack, infection, blood vessel damage/bleeding, bruise or a hematoma, post operative pneumonia, blood clots, wound closure problems, or even death. Please consult with Dr. Moza with any concerns you may have about any of these risks or complications. He is the only one who is qualified to answer your questions.