Instrumented Spinal Fusion

Instrumented spinal fusion is a surgical procedure which facilitates spinal bones to grow together or fuse together with the help of instruments such as screws, rods, plates, hooks etc. The main goal of the surgery is to restore spinal strength and stability in people with weakened spines due to degenerative changes, trauma, fractures, tumors or previous surgeries. It helps the spine withstand stress and provides protection from excessive forces on the spinal cord and nerves. The basic concept behind spinal fusion is to build a bony bridge between the healthy bone above and below the weakened spinal segment by placing a bone graft. 

Indications of Instrumented Spinal Fusion

Instrumented Spinal Fusion may be indicated in the following conditions:

• Mechanical pain arising from movement of spinal joint
• Degenerative spine conditions like spondylolisthesis
• Spinal deformities including scoliosis, kyphosis etc
• Trauma/fractures leading to spinal instability
• Surgical procedures which affect spinal stability

Instrumented Spinal Fusion procedure

Instrumented Spinal Fusion is performed under general anesthesia, hence the patient will not feel any pain during the procedure. Spinal fusion instruments are made of different materials such as titanium, stainless steel etc. These instruments are inserted both into the weakened vertebrae and the surrounding healthy vertebrae. The screws or hooks provide anchorage to the spine, which are then attached to metal rods, forming a bridge.

There are mainly three types of fusion:

Posterior fusion: It involves fusion from the back region of the spine with pedicle screws, serving as attachment points for rods.

Anterior fusion: It involves fusion from the front region of the spine with implants which can be filled with bone graft. The bone graft eventually fuses with the healthy vertebrae above and below.

Circumferential fusion: It involves fusion from the front and back region of the spine, either as a single procedure or two separate procedures.

Once the instruments have been placed, the surgeon inserts bone graft which eventually leads to fusion of the bones. Fusion is aided with biological materials and a naturally produced protein called the Bone Morphogenic Protein (BMP).