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What
Are Spinal Instrumentation and Spinal Fusion?
By:
Susan Spinasanta
Staff Writer
Spinal
Instrumentation utilizes surgical procedures to implant
Titanium, Titanium-alloy, Stainless Steel, or non-metallic
devices into the spine. Instrumentation provides a permanent
solution to spinal instability. Medical implants are specially
designed to come in many shapes and sizes. Typically these
include rods, hooks, braided cable, plates, screws, and
more recently - threaded interbody cages.
Spinal
Fusion
is
a process using bone graft to cause two opposing bony surfaces
to grow together. In medical terminology, this is called
Arthrodesis. Bone graft can be taken from the patient's
pelvis (termed autogenous bone) during the primary surgical
procedure or harvested from other individuals (termed allograft
bone). In the future, another option may be bone morphogenetic
protein (BMP). This experimental compound stimulates the
body to make bone.
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| Examples
of Different Types of Spinal Instrumentation |
Instrumentation
and Fusion Working Together
Instrumentation
maintains spinal stability while facilitating the process
of fusion. These procedures are used to restore stability
to the spine, correct deformity (such as scoliosis), and
bridge space created by the removal of a spinal element
(e.g. intervertebral disc).
Both
procedures immobilize the involved spinal level(s). This
does not necessarily mean the patient is unable to move
(e.g. bend over). Many patients state they actually feel
more mobile because their pain has been reduced or eliminated.
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| Examples
of Different Types of Spinal Instrumentation |
An
Old Concept Made New
Spinal
instrumentation and fusion are not new surgical concepts.
Although the first spinal fusion was performed almost 90
years ago, Dr. Paul Harrington developed spinal instrumentation
in the late 1950's.
During
this time, many children stricken with polio developed spinal
deformities. In an attempt to treat these children, Dr.
Harrington developed the first spinal instrumentation system
(Harrington Instrumentation). Rods were secured to the spine
at two ends using hooks. The position of the spine was adjusted
using a tackling type of device. Through Dr. Harrington's
experience, fusion was discovered to be a necessary adjunct
to instrumentation. Today, fusion remains an integral part
of procedures utilizing instrumentation.
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| Examples
of Different Types of Spinal Instrumentation |
Technology
and Technique
Progress
During the 1960's instrumentation became more mainstream
as doctors, who saw the benefits to patients, found almost
50 ways to modify Harrington's original system. Bone screws
and threaded cabling were developed. In the 1970's, Dr.
Eduardo Luque was using smooth bendable rods and wire to
stabilize the spine. Moving into the 1980's instrumentation
evolved into a three-dimensional approach to spinal correction.
Rods, hooks, and screws were streamlined to meet individual
patient needs with less demand on the surgeon to customize
implants on the spot.
Today
and Tomorrow
During
the last 10 years, spinal instrumentation systems have been
consistently transformed to meet the demands of spine specialists
who are true visionaries in this specialized field of surgery.
This trend will most certainly continue to provide new and
innovative solutions for disorders involving the spine.
Cervical
Plates: Providing Neck Stability Using Spinal Instrumentation
Pedicle
Screws
Surgical
Technique for Anterior Thoracoscopic Correction of Idiopathic
Scoliosis
A
Patient's Guide to Video-Assisted Thoracoscopic Spinal Surgery(VATS)
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