Preparing for Spine Surgery

An Introduction

You are going to have spinal surgery (a spinal fusion). This is a decision reached by you and your doctor after careful consideration. This article provides a walk-through of typical post-operative expectations and procedures.

Your spine is made of 26 bones known as vertebrae (7 cervical, 12 thoracic, 5 lumbar, the sacrum and coccyx). Each vertebrae is separated (except the top two neck vertebrae) by a disc. Each disc has a soft, jelly-like center surrounded by a tough outer layer of fibers known as the annulus. Discs, bony structures, ligaments and strong muscles stabilize the spine. The muscles control movement. Inside the spine is the spinal cord.

The spinal cord is composed of nerves leading to and from the brain. It controls and transmits all muscle movement and sensation for the trunk, arms and legs. Nerve roots come from the spinal cord and carry electrical impulses to and from muscles, organs and other structures. These nerve roots can become pinched or irritated by abnormal conditions.

With some injuries you can have a compression injury to your back causing a disc to rupture. This can create spinal instability and/or nerve symptoms (numbness, tingling and changes in sensation). Spinal curvatures called scoliosis can be due to degenerative changes, instability, or an unknown cause. These conditions can also be corrected by a spinal fusion.

Your doctor will make an incision down the middle of your back, front midline, or use a translateral (side) approach. Then he/she will put in plates, rods or screws to stabilize the affected area. Your doctor will choose the best instrumentation and procedure for your individual needs. A bone graft, usually from the hip area, will also be used to stabilize the spine. Hip pain from the bone graft donor site is expected and will sometimes cause more discomfort than the surgical site itself.

After your surgery you will be asked to participate in clearing your lungs, turning frequently and to follow the activity limitations. These issues will be discussed in the next chapters.