| Spinal
fusion and decompression:
|
A
spinal fusion is
simply the uniting of two bony
segments, whether a fracture or
a vertebral joint. The reason
for instrumentation with rods
and screws is to act as and 'internal
cast' to stabilize the vertebra
until the fusion, or bony re-growth,
can occur.
|
Why is
it done?
Historically spinal
fusions have been used to correct degenerative
spondylolisthesis. However, there are
many indications for a spinal fusion and
it is not the only procedure preformed
to treat those various conditions. You
should talk to your doctor about what
procedure is best for you.
The Operation
Incision
The patient is positioned on the operating
table in a prone position. The incision
is made over the anatomic position
of the spinous process. |
|
Bone
is Removed
When indicated, soft tissue and bony
decompression are performed to relieve
neurological compression. |
|
|
Screw
Placement
For a degenerative spondylolisthesis
case, a blunt probe is inserted through
the pedicle and into the vertebral
body. Once the pedicle canals are
prepared and the screw length determined,
the screws are sequentially inserted.
|
Bone
Graft
The facet joint capsules are removed
and cancellous bone graft is placed
into each facet joint. The transverse
processes, sacral alae, and the lateral
walls of the facet joints are decorticated
with high-speed burs and curettes.
Corticocancellous bone graft taken
from the iliac crest, along with any
fragments of bone taken during decompression
are firmly pressed into the bone fusion
bed. |
|
|
Compression
Once the construct has been assembled,
segmental distraction and compression
may be carved out. |
|
Tightening
Then a final tightening is performed.
Closing
the Incision
The incision is closed in the traditional
fashion.
|
>back
to "Neurosurgery"
|
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|
