Spinal fusion

Spinal fusion ( Wirbelkörperverblockung ) is an operation for stiffening of two or more vertebrae in the cervical, thoracic and lumbar spine. The surgery is designed to repair or prevention of spinal instability, such as those with unstable fractures ( fracture) or in spondylolisthesis ( spondylolisthesis ) is present due to a cleft in the vertebral arch.

To ensure strength, screws are inserted into the vertebral bodies, which are connected by rods or metal plates. Into the disc space while the bone chips are often incorporated in order to bring the bone connecting the vertebrae. Any special implants are additionally inserted into the intervertebral space, such as titanium cages ( Cage) who consider the distance of the vertebral bodies to each other until the bony healing has occurred.

A special feature of the X-ray imaging, spinal fusion is that in computed tomography by the metal implants many artifacts that can complicate the evaluability of the images. If steel implants used magnetic resonance imaging ( MRI) is not feasible. However, there are also titanium implants available with which an MRI scan is possible.

The figure shows a state after spinal fusion of the two lowest lumbar vertebra ( L5 and LWK4 ) to the first sacral vertebra ( SWK1 ) two years after the operation. The intervertebral space between the fourth and fifth lumbar vertebrae is already bony bridges ( ankylosed ); the transition from the fifth lumbar vertebra to the first sacral vertebra, these bony missing. If all interlocked vertebrae are stable bone connected to each other, the Spondylodesematerial can be removed.

The same patient in the MPR

The arrows indicate the bony LWK4 / 5 and the lack of Durchbauung LWK5/SWK1.

Example of a long segment spinal fusion with anterior and posterior fusion for severe scoliosis

As an alternative to reinforcement motion-preserving procedures are becoming increasingly important. In the flexible spinal stabilization eg is it a dynamic implant, including for use in spinal stenosis. Compared to stiffen this operation method neighboring segments protects against wear. Due to the lack of load transfer to adjacent vertebral segments occur back pain often.