Fusion

What is Spinal Fusion Surgery?

Spinal Fusion Surgery is a procedure used to permanently join two or more vertebrae so that they heal into a single, stable unit. It is commonly performed when abnormal movement between spinal bones causes pain, instability, deformity, or pressure on the spinal cord or nerve roots.

During fusion, bone graft is placed between the affected vertebrae. Screws, rods, plates, cages, or other implants may be used to hold the spine in the correct position while the bones gradually unite. The implants provide immediate stability, while the bone graft creates the long-term biological fusion.

Spinal fusion may be performed in the cervical, thoracic, or lumbar spine. It may also be combined with decompression, discectomy, or correction of spinal deformity.

Dr. Yadhu K Lokanath, Consultant Neurosurgeon and Spine Surgeon in Bangalore, recommends spinal fusion only after carefully evaluating the patient’s symptoms, spinal alignment, neurological condition, and imaging findings.

What Conditions Can Spinal Fusion Treat?

Spinal fusion may be considered for:

• Spinal instability
• Spondylolisthesis
• Degenerative disc disease
• Severe spinal stenosis with instability
• Recurrent disc herniation
• Cervical myelopathy
• Spinal fractures
• Spinal deformities
• Scoliosis
• Kyphosis
• Spinal tumours
• Spinal infections
• Failed previous spine surgery
• Severe facet joint degeneration
• Instability after spinal decompression

Fusion is generally recommended when preserving motion is less important than restoring stability and protecting the spinal nerves.

What is the Anatomy Involved?

The procedure may involve:

• Vertebral bodies
• Intervertebral discs
• Facet joints
• Pedicles
• Laminae
• Spinal canal
• Spinal cord
• Nerve roots
• Bone graft
• Screws, rods, plates, or cages

Depending on the condition, the surgeon may approach the spine from the front, back, side, or through a minimally invasive route.

What are the Symptoms?

Patients who may require spinal fusion can experience:

• Persistent neck or lower-back pain
• Pain radiating into the arm or leg
• Sciatica
• Numbness or tingling
• Muscle weakness
• Difficulty walking
• Loss of balance
• Pain caused by spinal movement
• Reduced spinal stability
• Progressive spinal deformity
• Difficulty standing upright
• Reduced ability to work or perform daily activities

Symptoms vary according to the spinal level and the cause of instability.

When Should I See a Spine Surgeon?

Consult a spine surgeon when pain or neurological symptoms persist despite medication, physiotherapy, rehabilitation, or spinal injections.

Seek urgent medical attention if you develop:

• Progressive weakness
• Loss of bladder or bowel control
• Numbness around the genital region
• Severe pain following trauma
• Increasing difficulty walking
• Frequent falls
• Loss of hand coordination
• Sudden spinal deformity

These symptoms may indicate severe instability, spinal cord compression, or nerve damage requiring prompt assessment.

How is the Condition Diagnosed?

Evaluation may include:

• Detailed medical history
• Physical examination
• Neurological examination
• MRI of the spine
• CT scan
• Standard X-rays
• Dynamic flexion-extension X-rays
• Full-length standing spine X-rays
• Bone-density testing when required
• EMG or nerve conduction studies in selected cases
• Blood tests if infection or inflammation is suspected

Dynamic X-rays are particularly useful for identifying abnormal movement between vertebrae.

Can It Be Managed Without Surgery?

Some spinal conditions can initially be treated with:

• Activity modification
• Physiotherapy
• Core-strengthening exercises
• Posture correction
• Weight management
• Anti-inflammatory medication
• Pain-relieving medication
• Neuropathic pain medication
• Spinal injections
• Temporary bracing when prescribed

Conservative treatment may reduce symptoms but cannot correct significant instability, progressive deformity, or severe structural damage.

When is Spinal Fusion Needed?

Fusion may be advised when:

• The spine is unstable
• Vertebrae move abnormally
• Severe pain persists despite conservative treatment
• Decompression would create instability
• A fracture requires stabilisation
• Spinal deformity is progressing
• Significant nerve or spinal cord compression is present
• Previous surgery has failed
• Infection or tumour has weakened the spine
• Daily activities are severely affected

The decision is based on symptoms, examination findings, imaging, and the expected benefits of surgery.

Types of Spinal Fusion Surgery

Posterior Lumbar Interbody Fusion

The spine is approached from the back. The damaged disc is removed, a cage and bone graft are inserted, and screws and rods provide stability.

Transforaminal Lumbar Interbody Fusion

The disc is accessed from one side through the back, reducing the need to retract the spinal nerves extensively.

Anterior Lumbar Interbody Fusion

The lumbar spine is approached from the front, allowing removal of the damaged disc and insertion of a large implant.

Lateral Lumbar Interbody Fusion

The spine is accessed from the side through a minimally invasive approach in selected patients.

Cervical Fusion

A damaged cervical disc may be removed and replaced with a cage or bone graft, followed by stabilisation with a plate, screws, or posterior instrumentation.

Posterolateral Fusion

Bone graft is placed along the back and sides of the vertebrae, often with screws and rods.

How is the Procedure Performed?

Spinal fusion is performed under general anaesthesia. The surgeon accesses the affected spinal level and removes any disc, bone, or ligament compressing the nerves when necessary.

Bone graft is placed between or around the vertebrae. Screws, rods, plates, or cages are then used to maintain alignment and stability. The bone graft may come from the patient, a donor source, or an approved bone-graft substitute.

Microscopic, tubular, navigated, or endoscopic techniques may be used in selected patients to reduce tissue disruption and improve accuracy.

Recovery and Possible Risks

Patients are usually encouraged to walk within a day after surgery. The length of hospital stay depends on the number of levels treated, surgical approach, and overall health.

Temporary restrictions may include avoiding heavy lifting, bending, twisting, and strenuous activity. Physiotherapy helps improve strength, posture, mobility, and safe movement.

Fusion develops gradually and may take several months.

Possible risks include:

• Infection
• Bleeding
• Nerve or spinal cord injury
• Spinal-fluid leakage
• Failure of fusion
• Implant loosening or breakage
• Persistent pain
• Blood clots
• Reduced spinal movement
• Adjacent-level degeneration
• Need for further surgery

Smoking, uncontrolled diabetes, poor bone quality, and inadequate nutrition may increase the risk of delayed or failed fusion.

Why Choose Dr. Yadhu K Lokanath?

Dr. Yadhu K Lokanath is a Consultant Neurosurgeon and Spine Surgeon in Bangalore with fellowship training in Minimally Invasive and Endoscopic Spine Surgery from Seoul St. Mary’s Hospital, South Korea.

His approach includes:

• Detailed neurological and spinal assessment
• Expertise in cervical and lumbar fusion
• Personalised surgical planning
• Minimally invasive techniques where appropriate
• Modern spinal instrumentation
• Evidence-based treatment recommendations
• Structured rehabilitation guidance
• Comprehensive postoperative follow-up

Frequently Asked Questions

Is spinal fusion a major surgery?

Yes. It is a significant spine procedure, although minimally invasive techniques may reduce tissue disruption in selected patients.

Will spinal fusion reduce movement?

Movement is lost at the fused levels, but most patients retain useful overall spinal mobility.

How long does the fusion take to heal?

Bone fusion usually develops over several months, although recovery begins much earlier.

Will I need screws and rods?

Most fusion procedures use implants to stabilise the spine while the bone graft heals.

Can spinal fusion fail?

Yes. Failure of fusion can occur, particularly in smokers or patients with poor bone quality or uncontrolled medical conditions.

When can I return to work?

Return to work depends on the type of surgery, number of levels fused, recovery progress, and physical demands of the job.

Book an Appointment

Persistent spinal pain, instability, deformity, weakness, or difficulty walking may indicate a condition that requires surgical stabilisation. When conservative treatment is no longer effective, Spinal Fusion Surgery may help restore stability, protect the nerves, and improve function.

Consult Dr. Yadhu K Lokanath, Consultant Neurosurgeon and Spine Surgeon in Bangalore, for expert evaluation and a personalised spinal fusion treatment plan.