Spinal fusion

Spinal fusion is a surgical procedure that joins two or more bones in the spine, called vertebrae. It's performed to stabilize the spine, which helps to reduce pain in the spinal cord and nerves when other treatments haven't been successful. During spinal fusion surgery, your doctor removes the damaged disc or bone and fuses the vertebrae using bone grafts, metal plates, screws, or rods. Over time, the bone grafts stimulate the growth of new bone, fusing the vertebrae into a single, solid structure.

Spinal fusion surgery is a serious medical procedure performed by experienced neurosurgeons at Penn Medicine. When preparing for spinal fusion surgery, our doctors carefully consider the surgical technique that gives you the best possible outcome. Using the latest muscle-sparing technologies and up-to-date surgical approaches, we're dedicated to relieving your symptoms and improving your quality of life.

Sometimes referred to as spondylodesis or spondylosyndesis, back fusion surgery is done through various approaches. Your doctor will recommend traditional surgery or minimally invasive techniques depending on your condition. Whenever possible, our surgeons recommend minimally invasive methods for surgical fusion of spinal vertebrae. With minimally invasive surgery, our spine surgeons make only a few small incisions and insert tiny instruments and microscopes when fusing a spine. This type of surgery minimizes the impact on muscles and surrounding tissues, which means that you're likely to experience less pain, have faster recovery, and see better results. Your provider will talk with you about the treatment approach that's best for you.

Types of spinal fusion surgeries include:

• Anterior cervical discectomy and fusion (ACDF) is used to treat conditions that affect the cervical spine, the part of the spine in the neck. During this procedure, the surgeon accesses your spine through the front of your neck.
• Anterior lumbar interbody fusion (ALIF) is used to treat spinal conditions that affect the lower back. During this procedure, the surgeon accesses your spine through your abdomen.
• Direct lateral interbody fusion (DLIF) is used to treat spinal conditions that affect the lower back. During this procedure, the surgeon accesses your spine from the side of your body.
• Lateral lumbar interbody fusion (LLIF), also referred to as extreme lateral interbody fusion (XLIF), is used to treat spinal conditions that affect the lower back. During this procedure, the surgeon accesses your spine from the side of your waist.
• Oblique lateral interbody fusion (OLIF) is used to treat spinal conditions that affect the lower back. During this procedure, the surgeon accesses your spine from the area between the hip and the rib.
• Posterior lumbar interbody fusion (PLIF) is used to treat spinal conditions that affect the lower back. During this procedure, the surgeon accesses your spine from the middle of your lower back.
• Transforaminal lumbar interbody fusion (TLIF) is used to treat spinal conditions that affect the lower back. During this procedure, the surgeon accesses your spine from the side of your waist.

Your Penn Medicine provider may recommend spinal fusion surgery to fix different types of spine conditions. It's typically recommended if you experience the following:

• Fracture between two vertebrae, called spondylolysis
• Curved spine, called scoliosis
• Herniated discs
• Infection in the bones or soft tissue of your spine
• Narrowed space around the nerves that come out of your spinal cord, called foraminal stenosis
• Narrowed space within your spinal canal, called spinal stenosis
• Pinched nerves in your neck or lower back
• Slipped vertebrae, called spondylolisthesis
• Spine conditions diagnosed at birth
• Spine fractures and other injuries
• Tumors in and around your spine

Before your spinal fusion surgery, your doctor will explain how the procedure is done and give you time to ask questions. Your care team will review your medications with you, discuss your health history, and let you know how to prepare for surgery. In addition, your provider will talk to you about our Enhanced Recovery After Surgery (ERAS) program. Using this program, Penn Medicine experts partner with you to ensure the safest path to surgery, recovery, and follow-up care. You can expect the following:

• Your surgery will be done at a hospital or surgery center.
• You'll have anesthesia with sedation, so you're asleep and pain-free during surgery. Your care team will monitor you throughout surgery to ensure your safety.
• The surgeon will operate on your spine depending on the technique that's right for your condition. They'll close your incision using surgical staples, sutures, or glue.
• The surgery can take up to five hours to complete.
• After the surgery, you'll be monitored closely as you wake up from anesthesia. Most patients are discharged from the hospital within a day or two after spinal fusion surgery.
• You may experience some discomfort or pain at the surgical site, which can be managed with medication prescribed by your Penn Medicine team.

By offering highly advanced and specialized care that's not found in any other health system in the Philadelphia region, your Penn care team provides the treatment you need close to home.

Recovery from spinal fusion surgery is a gradual process. You'll resume most of your day-to-day activities within a few weeks after surgery. Full recovery can take several months.

You may notice that your back doesn't feel as flexible as before surgery, which is normal for patients who have had spinal fusion surgery. Your doctor may recommend that you go to physical therapy to help you regain strength and adjust to these new changes in how your back moves. Some patients may need to make lifestyle changes, such as modifying certain physical activities while they heal. Other patients may need to temporarily wear a brace to keep their spine aligned. Our care team will provide you with detailed instructions to improve your recovery.

At Penn Medicine, our mission is to find the right treatment to relieve your pain. We're dedicated to guiding you through every phase of your medical journey to make sure you get the highest level of care and support.