About the spine

Spinal discs, made of cartilage, separate each vertebrae, acting as shock absorbers,
holding the vertebrae together, and supporting movement. When a patient’s disc is
damaged or degenerates, the vertebrae can rub together, which can be very painful.

At Assuta Hospital, spinal fusion surgery is one of the most common surgeries
performed on patients suffering from back pain.

The purpose of spinal fusion surgery is to alleviate pain by preventing movement
between the vertebrae that are separated by damaged spinal discs.

About spinal disorders

Spinal links can become damaged for the following reasons:

• Spinal stenosis
  With spinal stenosis, the spaces within the spine narrow, which can put
  pressure on the nerves that travel through the spinal canal –causing pain.
  Because this is usually the result of degeneration, this condition typically
  afflicts older adults. With age, the structure of the cartilage-based discs
  that separate the vertebrae changes. The percentage of water in the discs
  decreases, causing them to dry out. This causes the vertebrae to place
  pressure on the spinal cord and nerve roots that branch from the spinal
  cord to the organs.
  
  Spinal stenosis can also be a congenital condition, or it can develop
  in people who have suffered spinal cord injuries. Spinal tumors, rheumatoid
  arthritis, and tuberculosis can also cause spinal stenosis.
• Nerve pressure
  When bone, muscle, cartilage, or other tissues in the spinal area put
  pressure on the nerves, it causes pain or a tingling sensation, and can
  hinder a person's overall ability to function. Greater pressure can impair
  sphincter control, which can cause incontinence of urine or feces. Nerve
  pressure in the lower back is one of the most common forms of stressed
  nerves.
• Spinal deformities
  Spinal deformities can be caused by wear and tear, a fall, or an accident. In
  adults, deformities are typically due to joint degeneration, cartilage
  degeneration, or intervertebral disc degeneration (between the vertebrae).
  
  These spine problems are solved mainly by spinal fusion, which is complex but
  highly effective back surgery.

About spinal fusion surgery

Spinal fusion surgery is performed under general anesthesia while the patient is
lying on his/her stomach.The surgeon creates an incision in the center of the back,
about 4 to 6 inches (10 to 15 cm) long. The surgeon inserts screws into the
vertebrae and connects them with a rod or a metal plate.

When necessary, the surgeon will also remove the disc tissue separating the
vertebrae and insert an implant into the space to increase the stability between the
vertebrae.

Use of innovative implants

• During the fusion operation, the surgeon may insert bone grafts between
  the vertebrae. These implants may be taken from the patient or a bone
  bank (allograft), or they may be synthetic grafts. Bone growth stimulators
  are often used, with or without implants. Bone grafts encourage bone
  growth between vertebrae and they fuse biologically.
• TOPS (Total Posterior Spine) implants: These new generation implants are
  designed to replace anatomical structures such as the vertebra or spine
  joints (facet joints), helping transfer the load between the vertebrae. The
  implants combine the strength of titanium metal with the kinetic flexibility
  of synthetic plastic.

The implants help maintain the flexibility of movement (within the natural
range of motion), while preserving spine stability and relieving pain.