A fusion can be indicated for spinal stenosis, disc herniation, extruded disc fragments, nerve root compression, stenosis, instability of the spine, spondylolithesis, degenerative Disc Disease, internal Disc Derangement, and correction of Spinal Deformities.
A decompression involves removing the spinous process and lamina of the spine to give the spinal cord more room. This is referred to as “unroofing” the spinal cord. When the spine is so degenerative that the decompression makes it unstable then a fusion must also be performed to stabilize it. This involves inserting screws and rods to hold the spine steady.
The surgery is performed by making an incision in the back. The length of the incision depends on how many levels are being fused. Retractors are placed to hold the soft tissue and muscle back. The spinous process is removed. Since the spinal cord is now open the nerves are checked to make sure there is no pressure. Finally the screws are placed through the pedicle and a rod to connect them. The muscle and soft tissue are sewn back together with sutures under the skin and staples on top of the skin. Sometimes a drain is placed to prevent any pooling of blood. This will be removed the day after surgery or second day.