Spinal fusion for spinal stenosis

Spinal fusion (arthrodesis) is surgery that joins (fuses) two or more bones so that the joints can no longer move. For people with spinal stenosis, spinal fusion may be done at the same time as decompressive laminectomy to help stabilize sections of the spine where vertebrae have been removed or loosened. Stabilizing the spine may improve function and relieve pain.

Spinal fusion is major surgery, usually lasting several hours. There are different methods of spinal fusion.

• In the most common method, bone is taken from elsewhere in your body or obtained from a bone bank. This bone is used to make a "bridge" between adjacent spinal bones (vertebrae). This "living" bone graft stimulates the growth of new bone.
• In some cases an additional fusion method (called instrumented fusion) is performed, in which implants (such as rods, wires, or screws) are secured to the vertebrae to hold them together until new bone grows between them.

There are a variety of specialized techniques that can be used in spinal fusion, although the basic procedure is the same. Techniques vary from what type of bone or implants are used to whether the surgery is done from the front (anterior) or back (posterior) of the body. The method chosen will depend on a number of factors, including your age and health condition, the severity of nerve root compression and associated symptoms, and the expertise of the surgeon.

Spinal fusion increases the time you are in surgery, the risk of complications, and the recovery time after surgery. Recovery and restrictions on activities may last for 6 to 12 months. After a laminectomy and fusion, spinal stenosis may develop directly above or below a previous fusion. Repeated surgeries for spinal stenosis increase your risk of complications and instability in the spine.