Lumbar Spine Surgery: Interbody Fusion
Background:
Arthritis
and degenerative disk disease resulting in low back pain are the leading causes
of loss of work in the United States at this time. Between 60 and 80 percent of
the population is affected by significant low-back pain at some time.
The cause of back pain is a
complex phenomenon. Back pain has many possible etiologies, including muscular,
degenerative, arthritic and neurogenic causes. When the cause of back pain has
been localized to degenerative disk disease or "discogenic" pain, and
conservative therapy has failed, fusion of the spine may be the treatment of
choice.
The object of a spine fusion
is to stabilize or eliminate the movement across a motion segment or a series of
motion segments that have degenerated to the point of causing pain. The concept
of spine fusion has evolved over the years. Spine fusions involves the
production of a solid bony fusion across a motion segment either with bone graft
alone or bone graft along with some type of instrumentation. This technique is
call interbody fusion.
A
new option for those patients who may not be candidates for conventional spinal
fusion or pedicle screws is the intervertebral cage fusion (See Picture). This
procedure can be very beneficial in patients whose back pain has been identified
as discogenic in nature and who have no significant slippage of the spinal
vertebra.
This
approach uses an intervertebral cage made of either metal (packed with bone) or
bone alone. With this placed the
body will fuse the two vertebra into one and thereby stop any movement. The
metal cage is a hollow, threaded titanium cylinder with multiple openings in the
wall for bone fusion. Typically, the cage is packed with bone graft that will
ultimately fuse with the vertebrae above and below. These cages are placed after
the degenerated disk is removed. The bone then grows through the openings in the
cage to create a solid bony fusion. In recent clinical studies, a successful
fusion rate of 90 to 92 percent has been reported. The cage that is made of bone
works in a similar fashion.
The
advantage to these cages is that the surgery is much less invasive when compared
to traditional lumbar fusion and produces immediate stability with less
disruption of normal tissues. Patients
can be mobilized more quickly, and often experience less pain and disability in
the post –operative period. And they can often return to their normal
activities more quickly. Patients will leave the hospital a day or two after
this type of fusion procedure and a brace should be wore for one to three
months.
The
use of intervertebral cages for spine fusion is a novel and exciting development
in the area of spine surgery. This is indicated in patients who have
degenerative disk disease characterized by discogenic back pain at one or two
levels in the lumbar spine. Most patients can return to normal activities in one
to three months.
Call
412-630-7640 or 1-877-635-5234 with questions.
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