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Wednesday, May 14, 2014

What is a Spinal Fusion Surgery of the Low Back (Lumbar Spine)? Shown and explained with Color X-Ray Images

Spinal Fusion Surgeries have been performed for over 100 years. Initially these surgeries were used to treat Fractures and Infections of the Spine. However over the last 50 years, Spinal Fusion Surgeries are primarily performed to treat degenerative conditions of the Spine, such as Disc Degeneration and Instability.

The primary goal of a Spinal Fusion Surgery is to eliminate the painful motion between Vertebrae. For this reason, Titanium Screws are placed into each Vertebra, which are then connected by Titanium Rods. This Screw and Rod construct is meant to provide stability until bone can grow between the Vertebra. The bone is placed between the Vertebrae, next to the Fusion Screws and Rods, and sometimes between the Vertebrae if the Disc is also removed during the Surgery. The Bone growth eventually connects the Vertebra and gives them long-term stability. This is called a "Fusion". This Bone Fusion is stronger than the Titanium implants. In fact, once a Bone Fusion has taken place, the Fusion Rods and Screws can be removed. However, this is typically only recommended if a patient continues to suffer from Back Pain and the "hardware" is thought to be a potential source of pain.

Before we look at X-Ray Images of Fusions, lets first take a look at the Anatomy of the Low Back.
The Image below is a Color MRI which shows the basic Spine Anatomy. The Image on the left is a whole body MRI which helps to orient you. The main Image on the right shows you the low back (lumbar spine). The Spinal Cord and Spinal Nerves are shown in yellow. They are located inside the Spine within a large bone tunnel, called  the "Spinal Canal". Spinal Fluid (light blue) bathes the Spinal Cord and Spinal Nerves. The Spinal Discs, our natural "cushions" or "shock-absorbers" between the Vertebrae are shown in green. This Image contains Interactive Image Tags. Just move your mouse cursor over the Image to see the Tags. Each tag displays text information to explain each part of the Image.

Sagittal Color Lumbar Spine MRI Spine Anatomy
Interactive Color MRI Image of the Low-Back (Lumbar Spine) Anatomy
The next Image shows a front-view of a Spinal Fusion in the low back. The Fusion has been performed between the lowest low back Vertebra (L-5) and the Tail Bone (S-1). This Image is also Interactive.

AP Color Lumbar Spine X-Ray Spinal Fusion
Interactive Color X-Ray Image of a Front View of a Fusion of the Low Back (Lumbar Spine)

The next Image shows a side-view of a Spinal Fusion in the low back. This Image is also Interactive to explain each part of the Spinal Anatomy and Surgery.

Lateral Color X-Ray Lumbar Spine Fusion Anatomy
Interactive Color X-Ray Image of a Side-View of a Fusion of the Low Back (Lumbar Spine)
The "Fusion Rates" (chance for a complete bone fusion between the Vertebrae) have steadily improved over time due to newer materials and surgical techniques. In most Spine Surgery Practices the fusion rates are over 90%. A new protein called "BMP" (Bone Morphogenetic Proteins) can help accelerate and complete a Fusion more predictably.

Lumbar Fusion Surgery for instability of the Spine either due to Trauma or Degeneration (Spondylolisthesis) have a high rate of success in terms of achieving stability and reduction in pain. However, Spine Fusions when performed for general low back pain related to degeneration of the Spine are still controversial.

The outcome of a Fusion Surgery from a perspective of providing stability for the Spine are usually quite good. Newer surgical techniques are offering different approaches to the Spine which can be less traumatic than traditional ones. The traditional approach consists of surgery performed directly through the back of the Spine with a long incision. Newer approaches allow Surgeons to perform Spine Fusion Surgery from the side (called the "XLIF" approach) of the Spine, front of the Spine (ALIF), through the Tailbone (AxiaLIF) or even in a Minimally Invasive fashion.

While Artificial Disc Replacements have offered a real alternative to Spine Fusion Surgery for some Spine Conditions, Spine Fusions will continue to be the only definitive surgical option for severe Spine Trauma and Instability.

If you like the contents of the Blog, here are some related subjects featured on the Medical Media Images Blog:
1. Lumbar (low-back) Artificial Disc Replacements shown and explained with the help of Color  
2. What is a "Spondylolisthesis" of the Low Back (Lumbar Spine)? Shown and explained with Color X-Ray and Color MRI Images.
3. Spinal Stenosis of the Low Back (Lumbar Spine) shown and explained with Color MRI Images
4.  Disc Herniations of the Low Back (Lumbar Spine) shown and explained with Color MRI Images
5. What is an Epidural Injection? Shown and explained with Color MRI Images
6. What is Spinal Cord Stimulation (SCS)? Shown and Explained with Color X-Ray and Color
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7. What is Sciatica? Shown and Explained with Color X-Ray and Color MRI Images

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