Jeffrey R. Carlson, MD
Patients who are considering spine fusion have lots of questions about their outcomes related to their surgery. Will this procedure work? How will I be limited after my surgery? When can I get back to work? These questions are certainly valid, but all are secondary to the actual success of the fusion. In spine fusion, the goal is to provide stability across the disc space by connecting two independently moving bones and forcing them to become one bone. This type of procedure is counter to how spinal segments are supposed to function when healthy. However, when a spinal disc completely wears out, there is a fracture in the spinal bone or the vertebrae are sliding on each other, they need to be supported and stabilized. Surgeons differ about the best method for doing so, but just as putting a cast on a broken bone allows it to heal, the bones in the spine will not fuse together unless they are held completely still.
The primary way I achieve that stability is to insert screws and stabilizing rods into the spinal bones. This keeps the bone still so that new bone (fusion) can grow across the previously mobile joints. Bone graft is added, either from the patient’s own bone or a donor, which may include a structural piece of supporting bone or bone proteins that will lead to the fusion. Fusion is the primary goal, so we put all our efforts into making the bone bridge that gap between the two spinal segments.
One additional technique used to enhance the ability for the bones to grow and fuse together is for the patient to utilize an electrical bone growth stimulator after surgery. There are two types of devices: one that is implanted at the time of the surgery and one that is worn externally like a brace. These devices send electrical impulses into the body to stimulate the bone cells to produce more bone. A recent study from John’s Hopkins University (JNS: January 2020) looked at the overall effectiveness of these devices in spine fusion. They found that these electrical stimulating devices were able to provide an increase in the fusion rates for patients which made their fusion twice as likely. With the goal for this surgery being successful bone fusion, the addition of a spine stimulator is a significant benefit and can improve outcomes.
The spine surgeons at OSC advise all patients with lumbar or cervical spine fusions to use an electrical bone growth stimulator to give them the best chance at achieving bone fusion. The more successful the fusion, the more likely the patient is to have a positive outcome and return to the activities they enjoy.