Spinal fusion

A spinal fusion permanently joins two or more vertebrae together with a bone graft so that motion no longer occurs between them.   Depending on your individual needs the neurosurgeon may approach the spine from the posterior (back), anterior (front) or even a combination of both.  The procedure may be performed either as an open surgery or using minimally invasive techniques. Your neurosurgeon will discuss the best approach and treatment specific for you.

Used to treat

  • One or more fractured (broken) vertebrae
  • Degenerative Disc Disease
  • Spinal Stenosis
  • Spondylolisthesis (slippage of one vertebral bone over another)
  • Abnormal curvatures of the spine, such as scoliosis or kyphosis
  • Instability of the spine

The Surgery

  • A graft will be placed on your vertebrae to create a fusion. As the body heals the vertebral bone and bone graft grow together and stabilize the spine.
  • Screws, cages, rodes or plates may be used to stabilize the vertebrae during the healing process until the vertebrae eventually fuse together to form a single bone.
  • Your surgeon may also remove any disks or bone spurs that are causing problems


Anterior lumbar interbody fusion (ALIF) is a spine surgery that involves approaching the spine from the front (anterior) of the body to remove all or part of a herniated disc from in between two adjacent vertebrae (interbody) in the lower back (lumbar spine), then fusing, or joining together, the vertebrae on either side of the remaining disc space using bone graft or bone graft substitute.  May also be done in conjunction with another approach.

  • The patient is positioned on his or her back and sedated under general anesthesia.
  • An incision in made into the abdomen and retraction of the abdominal muscles, organs and vascular structures for a clear view of the front of the spine and access to the vertebrae.
  • Remove all or part of the degenerated disc(s) from the affected disc space
  • Inserts graft into the disc space between the vertebral bodies, to support the disc space and promote bone healing.
  • Returns the abdominal organs, blood vessels and muscles to their normal place, and closes the incision.

Posterior lumbar interbody fusion (PLIF) is a type of spine surgery that involves approaching the spine from the back (posterior) of the body to place bone graft material between two adjacent vertebrae (interbody) to promote bone growth that joins together, or “fuses,” the two structures (fusion). The ultimate goal of the procedure is to restore spinal stability.

  • Your surgeon will make a small incision in the skin of your back over the vertebrae to be treated.
  • The muscles surrounding the spine will then be dilated to allow access to the section of spine to be stabilized.
  • The lamina (the “roof” of the vertebra) is removed to allow visualization of the nerve roots.
  • The facet joints, which are directly over the nerve roots, may be trimmed to give the nerve roots more room
  • The nerve roots are then moved to one side and disc material is removed from the front (anterior) of the spine.
  • Bone graft is then inserted into the disc space.
  • Screws and rods are inserted to stabilize the spine while the treated area heals and fusion occurs.
  • Your neurosurgeon will then close the incision

Transforaminal lumbar interbody fusion (TLIF) procedure is similar to the posterior lumbar interbody fusion (PLIF), however the approach is from the side not the posterior.  The foramen are located on the side of the vertebrae and are where the nerves from the spinal cord exit to the rest of the body. Your neurosurgeon will make a small incision in the side in align with the foramen.  The spine is then operated on through the foramen.

Your neurosurgeon will discuss with you the best approach for your individual condition.  No one approach is best for everyone.

Content adapted from Medtronic Catalyst patient education http://catalyst.medtronic.com/catalyst/business-of-medicine/patient-education/

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