Spinal Fusion, Decompression and Arthroscopy

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Spinal Fusion, Decompression, and Arthroplasty are separate medical procedures aiming to relieve patients of pain in the neck or back.  Patients may choose from various types of surgical or nonsurgical options based on their individual medical conditions.

What is it?

These three procedures are commonly used by doctors to alleviate back and neck pain, usually caused by some damage to the spinal cord.  Problems with the spine can be solved with or without surgery, depending on the medical condition and pain intensity. Spinal fusion is a common surgery that fuses two or more vertebrae together, thus limiting the movement between them. By preventing consecutive vertebrae from moving, surgeons can reduce the pain originating from that area. Decompression attempts to relieve back/neck pain without surgery. This usually involves a motorized device such as a traction table to stretch the spine. Finally, Arthroplasty is a surgical process aiming to repair, replace, or remodel a joint. This is done by shaving down bone to make it smoother or by implanting synthetic parts.

What should I do to prepare?

You may be asked to stop taking certain medications or supplements before surgery. The hair in the area where the surgery will take place needs to be shaved or trimmed. You may be asked to stop smoking, and you cannot eat or drink after midnight before surgery.  Depending on what procedure is performed, home and work spaces should be prepared for limited mobility, as you will not want to put much stress on your back during your recovery.

What happens during the process?

Patients will be under general anesthesia for spinal fusion and arthroplasty, causing them to become unconscious. Decompression, on the other hand, can be performed while the patient is conscious.  During spinal fusion, a bone graft is taken (usually from the pelvic bone or from a cadaver) to connect two adjacent vertebrae. This bridge will allow for new bone to grow and solidify the fusion. During spinal decompression therapy, a patient will be stretched in a few different positions, usually with a motorized table or device. This process creates negative pressure within the disc spaces of the spine, aiming to bring healing nutrients to sites of pain and inflammation. During an arthroplasty, incisions are made near the joint and then bone is usually cut away in order to improve mobility and function. Many times, synthetic joints are used to replace the bone that is causing pain. Tendons may also need to be lengthened to allow the synthetic joint to be successfully placed.

What are the risks and potential complications?

These types of procedures have the ability to yield complications associated with most surgeries such as infection and bleeding. Another, more specific, risk associated with these procedures include failed back surgery syndrome, which occurs when patients do not experience relief from pain symptoms.  This occurs in approximately 20% of back surgery patients. Other risks and complications include reaction to anesthesia or other drugs, formation of blood clots, recurrent disc herniation, and nerve damage.

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