Spinal fusion surgery is used to secure two bones together in the spine for people with back pain or spine instability. Traditional spinal fusion surgeries required a large incision, muscle stripping, and lengthy hospital stays. Advancements in spine surgery have provided surgeons with better techniques and tools to perform spinal fusion surgery. Minimally invasive posterior fusion surgery is easier on patients because it uses small incisions and avoids muscle stripping. Minimally invasive posterior fusion is associated with less pain, reduced bleeding, shorter hospital stays, and quicker recovery times.
The spine is composed of a series of bones called vertebrae. There are different areas of the spine, defined by their curvature and function. The seven small vertebrae in the neck make up the cervical spine. The chest area contains the thoracic spine, with 12 vertebrae. The lumbar spine is located at and below your waist. The lumbar spine contains five large vertebrae. The remainder of the lower vertebrae in the spine are fused or shaped differently in formation with the hip and pelvis bones.
The back part of each vertebra arches to form the lamina. The lamina creates a roof-like cover over the back opening in each vertebra. The opening in the center of each vertebra forms the spinal canal. The spinal cord, nerves, and arteries travel through the protective spinal canal. The spinal cord and nerves send messages between your body and brain.
Intervertebral discs are located in between the cervical, thoracic, and lumbar vertebrae. Strong connective tissue forms the discs. Their tough outer layer is the annulus fibrosus. Their gel-like center is the nucleus pulposus. A healthy disc contains about 80% water.
The discs and two small spinal facet joints connect one vertebra to the next. The discs and joints allow movement and provide stability. The discs also act as a shock-absorbing cushion to protect the vertebrae.
Minimally invasive posterior fusion is performed on the thoracic or lumbar spine of patients with back pain and/or leg symptoms caused by certain spine conditions, including spondylolisthesis, degenerative disc disease, traumatic injury, compressed spinal nerves, and recurrent disc herniation. Minimally invasive posterior fusion can be performed at the thoracic or lumbar spine levels.
People with low back pain or back pain that spreads to other parts of the body may be candidates for minimally invasive posterior fusion.
Minimally invasive posterior fusion surgery is an inpatient hospital procedure. The surgery approach is from the back, with the person laying face down. The surgeon uses X-ray guidance during the procedure.
First, the surgeon makes two small incisions on the back. Retractors are used to gently spread the muscles to access the spine. The lamina is removed. The surgeon inspects the nerve roots.
Next, the surgeon removes the disc from the spine. A bone graft and structural support cage are placed, followed by rod and screw insertion. The retractors are removed, and the incisions are closed.
Because the incisions are small, and the muscles are not stripped with the minimally invasive posterior fusion technique, there is less blood loss, less soft tissue trauma, reduced pain, shorter hospital stays, and faster recovery times. Over time, the vertebrae will fuse or grow together, stabilizing the spine. Your surgeon will let you know when you can begin physical therapy.