Spinal fusions

Spinal fusions are the most common form of surgical intervention for scoliosis treatment in patients of all ages, with curves of all sizes and for all types of scoliosis. Considered the 'golden approach' spinal fusion gets the best correction compared to other surgeries for scoliosis and has the best success rates.

Spinal fusions involve fixing a rod to either sides of the spine and fusing the vertebrae that are involved in the curve together to make one bone. The fusion involves a bone graft that helps make the vertebrae one and immobilises the segments in the back so they are no longer going to move and will give the patient a straight or basically straight spine. In the area where the spine is fused it will not bend, this can be seen when someone bends over after having their spines fused there back wont bend and motion will be limited in activities like sit ups and backward walkovers. Although spinal fusions limit the range of movement a patient has, quality of life commonly improves and many activities can still be achieved such as everyday task, contact sports like basketball and football and touching your toes.

Spinal fusions are a very intense operations taking around 4-12 hours for the actual operation, because of the severity and long recovery time and strain it puts on the patients it is only considered for patients with 40 degree curves or larger. It can be done anteriorly or posteriorly, and when done on the back of the spine it involves a large cut down the back with the surgeon pushing muscle aside to reach the spine. The surgeon than attaches a screw on either side of the vertebrae that are involved in the fusion and puts the rod on top of the screws. The rod are then pulled across to correct the position of the spine. The bone grafts are than laid along the spine to allow the vertebrae to fuse together to form one long bone.

The thoracic region of the spine does not move much on a regular basis even in someone with a normal spine as it is not relied upon for everyday movement in an adult so fusion of these segments are not a big deal when it comes to future movement. When looking at lower curves fusion can be a trickier option as the lumbar vertebrae are important for ranges of motion like bending forward, pregnancy and overall movement. This is why surgeons tend to avoid fusing any lower than l4 if the patient can get away with this or turn to other equipment like a tether to put on the lumbar to hold the curve and stabilise it rather than getting complete correction.