Spinal fusion

Spinal fusion
Fusion of L5 and S1
Other names	Spondylosyndesis
Specialty	Orthopedics, Neurology
ICD-10-PCS	M43.26
ICD-9-CM	81.0
MeSH	D013123
MedlinePlus	002968
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Spinal fusion, also called spondylodesis or spondylosyndesis, is a surgery performed by orthopaedic surgeons or neurosurgeons that joins two or more vertebrae.^[1] This procedure can be performed at any level in the spine (cervical, thoracic, lumbar, or sacral) and prevents any movement between the fused vertebrae. There are many types of spinal fusion and each technique involves using bone grafting—either from the patient (autograft), donor (allograft), or artificial bone substitutes—to help the bones heal together.^[2] Additional hardware (screws, plates, or cages) is often used to hold the bones in place while the graft fuses the two vertebrae together. The placement of hardware can be guided by fluoroscopy, navigation systems, or robotics.

Spinal fusion is most commonly performed to relieve the pain and pressure from mechanical pain of the vertebrae or on the spinal cord that results when a disc (cartilage between two vertebrae) wears out (degenerative disc disease).^[3] It is also used as a backup procedure for total disc replacement surgery (intervertebral disc arthroplasty), in case patient anatomy prevents replacement of the disc. Other common pathological conditions that are treated by spinal fusion include spinal stenosis, spondylolisthesis, spondylosis, spinal fractures, scoliosis, and kyphosis.^[3]

Like any surgery, complications may include infection, blood loss, and nerve damage.^[4] Fusion also changes the normal motion of the spine and results in more stress on the vertebrae above and below the fused segments. As a result, long-term complications include degeneration at these adjacent spine segments.^[2]