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Minimally Invasive Posterior Fusion Spine Surgery

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Introduction

Spinal fusion surgery is used to secure two bones together in the spine for people with back pain or spine instability.  Traditional spinal fusion surgeries required a large incision, muscle stripping, and lengthy hospital stays.   Advancements in spine surgery have provided surgeons with better techniques and tools to perform spinal fusion surgery.  Minimally invasive posterior fusion surgery is easier on patients because it uses small incisions and avoids muscle stripping.  Minimally invasive posterior fusion is associated with less pain, reduced bleeding, shorter hospital stays, and quicker recovery times.
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Anatomy

The spine is composed of a series of bones called vertebrae.  There are different areas of the spine, defined by their curvature and function.  The seven small vertebrae in the neck make up the cervical spine.  The chest area contains the thoracic spine, with 12 vertebrae.  The lumbar spine is located at and below your waist.  The lumbar spine contains five large vertebrae.  The remainder of the lower vertebrae in the spine are fused or shaped differently in formation with the hip and pelvis bones.
 
The back part of each vertebra arches to form the lamina.  The lamina creates a roof-like cover over the back opening in each vertebra.  The opening in the center of each vertebra forms the spinal canal.  The spinal cord, nerves, and arteries travel through the protective spinal canal.  The spinal cord and nerves send messages between your body and brain.
Intervertebral discs are located in between the cervical, thoracic, and lumbar vertebrae.  Strong connective tissue forms the discs.  Their tough outer layer is the annulus fibrosus.  Their gel-like center is the nucleus pulposus.  A healthy disc contains about 80% water.
 
The discs and two small spinal facet joints connect one vertebra to the next.  The discs and joints allow movement and provide stability.  The discs also act as a shock-absorbing cushion to protect the vertebrae.
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Causes

Minimally invasive posterior fusion is performed on the thoracic or lumbar spine of patients with back pain and/or leg symptoms caused by certain spine conditions, including spondylolisthesis, degenerative disc disease, traumatic injury, compressed spinal nerves, and recurrent disc herniation.  Minimally invasive posterior fusion can be performed at the thoracic or lumbar spine levels.
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Symptoms

People with low back pain or back pain that spreads to other parts of the body may be candidates for minimally invasive posterior fusion.
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Treatment

Minimally invasive posterior fusion surgery is an inpatient hospital procedure.  The surgery approach is from the back, with the person laying face down.  The surgeon uses X-ray guidance during the procedure. 

First, the surgeon makes two small incisions on the back.  Retractors are used to gently spread the muscles to access the spine.  The lamina is removed.  The surgeon inspects the nerve roots.

Next, the surgeon removes the disc from the spine.  A bone graft and structural support cage are placed, followed by rod and screw insertion.  The retractors are removed, and the incisions are closed.
 
Recovery
 
Because the incisions are small, and the muscles are not stripped with the minimally invasive posterior fusion technique, there is less blood loss, less soft tissue trauma, reduced pain, shorter hospital stays, and faster recovery times.  Over time, the vertebrae will fuse or grow together, stabilizing the spine.  Your surgeon will let you know when you can begin physical therapy.
 

 

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This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.

The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on February 16, 2022. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.

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Columbia Orthopaedic Group in mid-Missouri provides treatment for all types of orthopedic injuries and pain of the foot, ankle, hand, wrist, hip, knee, neck, back, shoulder, and elbow. Staffed by 27 specialty trained Missouri orthopedic surgery specialists, we specialize in arthroscopy, sports medicine, cervical spine injury, lumbar spine injury, joint replacement, joint resurfacing, pediatric orthopaedics and spine deformities, trauma/ fracture care, physical medicine and rehabilitation. Our Columbia orthopedic surgeons offer onsite services including radiology testing, x-ray, CT Scan, Open MRI, fluoroscopy, Outpatient Surgical Center, platelet rich plasma therapy (PRP), autologous conditioned plasma therapy, (ACP) and Durable Medical Equipment (DME).

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