If your spine surgeon has advised you to undergo spinal fusion surgery and you might have been overwhelmed with all the doubts, let us discuss and understand all this in this healthfeed
Q - What is spinal fusion?
A- Spinal fusion is a surgical procedure which fuses the spinal motion segment so that you are relieved of your back or neck pain. There are 33 bones in your back and 23 intervening shock-absorbers called intervertebral discs. Your back pain can be from any of the source as shown in the picture below and further movement only aggravates pain so to relieve the pain the whole segment is made into a block of bone thus called spinal fusion. And since we have so many motion segments in back fusing one does not have a major limitation in your back movement. This is the premise of this surgery.
Q - Why does one need spinal fusion surgery?
A - There can be many reasons why one needs a spinal fusion surgery - it can be due to a disc herniation, when your nerves are pinched, or any age related wear-and-tear which can lead to spinal compression, or any slippage of one bone over other or if your back is curved forward or sideways.
Q - What are the preoperative test I need to undergo before the surgery?
A- Other than tests to assess surgical fitness, you may need to under X-rays of your back, MRI scan and CT scan if needed. Some pre-existing medical conditions may need further evaluation.
Q - What are the medical conditions which can have an impact on outcomes of the procedure?
- Diabetes
- Obesity
- Preexisting liver, kidney or heart disease.
They all can have impact on outcomes or how well your pain is relieved after spine surgery. This needs thorough discussion with the operating surgeon and physician treating this condition.
Q - Surgical procedure details?
A - This is to be dealt with operating surgeon as to whether it is open or with small multiple incisions, whether it is from back or from side of the belly or front of it.
Q - How many stitches will I get and when will they be removed?
A- The number of stitches are not important if you have significant pain relief. If they are a priority for you then you can ask for a minimal invasive solution to your operating surgeon. Stitches usually come out in a couple of weeks but sometimes may take a longer time.
Q - My surgeon insists on using staples or a suture which dissolves by itself, is this okay?
A - All have same resultant scar, the material you use does not have major difference. There is scientific evidence and surgeon's experience backing it.
Q - Will I be bedridden after surgery?
A - No usually you can be made to sit and walk with walker the same day or the next day in most cases.
Q - What if my surgery goes wrong?
A - No surgery anywhere in the world is 100% safe. Some surgeries may have some difficulties which can get resolved in short- or long-term. But in general, spine surgery in existing era is very safe.
- Some common problems encountered during surgery are dural tear - breach in the covering of spinal cord, which can lead to some delay in wound healing and mobilisation.
- Infection - very few percentage of cases can have a wound infection which usually gets resolved with medicines and/or wound wash.
- Other complications to be discussed with operating spine surgeon.
Q - Will my pain get completely resolved?
A - Yes in most cases.
Q - Will I never have pain from this problem again?
A - Yes you may not have pain from this problem at the same segment.
Q - When do I need to visit you again after discharge?
A - You may need to visit at regular intervals until stitches come out. Subsequently you may need to visit at lesser regular intervals to monitor progress and to get back to pre-surgical or pre-injury functional levels.
Q - What are the things I have to be careful about?
A - You may move about in house with back support and do most activities until stitches come out.
Once after that you can rejoin and do a desk job with regular breaks.
You should avoid to bend forward or lift weight or turn around for atleast 6 weeks or later.
Q - When can I drive a car by myself?
A -It may take at least 6-8 weeks based on how your fusion is progressing.
Q - How long do I need to wear a back support?
A - Your back support is a reminder that you can not do all activities for the present time. You may need it for atleast 3 weeks during awake-time, all the time. Later on it can be used intermittently.
Q - I love to play this contact sport (football or cricket), when can I do it?
A - There should be a gap of atleast 3 months or more before you can play any contact sports or jog.
Q - I am about to marry, can I get intimate after this surgery?
A - Yes, absolutely you can but after the fusion process has completed.
Q - Can I conceive after this surgery?
A - Yes you can, if the fusion has been only for a couple of vertebra then you can even have a normal delivery but if a lot of back bones have been fused then you may need cesarean section. This also depends on an individual basis and decision has to be taken after consulting the treating spine surgeon and obstetrician.
DISCLAIMER: These are just general suggestions and advise and can vary from surgeon-to-surgeon.
For any further doubts or queries, feel free to consult me.