New spinal fusion technique

A minimally invasive surgical approach offers some back pain patients new relief at Providence St. Joseph Hospital.

There may be a new treatment option available for those experiencing severe back pain and needing spinal fusion surgery. This traditional procedure, often performed for such conditions as scoliosis, spinal stenosis or instability, permanently joins two or more bones of the spine—your vertebrae—together, thus preventing them from moving against each other more than they should and causing pain.

“Traditional spinal fusion surgery can be lengthy and complicated, requiring larger incisions and repositioning of the patient during the operation,” says Jeremy Smith, MD, a specialist in orthopedic spine surgery at Providence St. Joseph Hospital. “It can lead to significant blood loss and muscle damage and require a long hospital stay.” But the good news is many patients are candidates for a newer, less invasive but equally effective spinal fusion technique.

With this technique, Dr. Smith explains, only a small incision is required, and the patient remains in the same position throughout the operation. “The surgeon can remove the disk between the affected vertebrae and replace it with a spacer, taking pressure off the nerves, and then anchor the vertebrae in place much faster and more safely,” he says. “The use of special instruments spares the surrounding muscles from damage and minimizes blood loss.”

This procedure can be up to two hours shorter than the traditional “open” one. And while open spinal fusion surgery requires a two- or three-day hospital stay, the minimally invasive approach can often be performed as an outpatient procedure, Dr. Smith says. There is also a lower infection risk, less postoperative pain and a shorter recovery time.

EASIER ON THE PATIENT
Not all patients qualify for this procedure, but when someone is an appropriate candidate, it has proven as safe and effective as the traditional approach. One such patient is a 36-year-old woman who suffered from disk disease and spondylolisthesis, a condition that occurs when a vertebra slips out of place onto the one below it, causing pain. Dr. Smith explained that she had tried epidural injections and physical therapy to relieve the pain. “When that didn’t work, he relates, “the woman underwent surgery to decompress the disk. When that also failed to help, she was referred to me.”

It ended well, according to Dr. Smith: “My patient said she was always fearful of having a spinal fusion, but I described a minimally invasive approach that would address her fear. She was able to leave the hospital the same night and now has been pain-free for almost six months.”