Spinecare Topics

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Surgical Interventions
Surgical Interventions

There are different types of spinal Instrumentation. The main categories are listed below:

Lateral Mass Instrumentation:  This requires the use of screws, rods and/or plates to secure cervical vertebrae from the back (posterior).

Anterior Instrumentation:  This requires the placement of rods, a plate or other instrumentation along the front of the spine.

Cages:  A cage is a metal device that can be filled with any substance that can help form bone or a successful fusion between adjacent vertebrae. The cage
has many openings in it to help facilitate substance binding to adjacent bone. The cage is surgically placed into the disc space.

Vertebroplasty and Kyphoplasty:  These are new techniques used to treat and stabilize vertebral compression fractures. They are performed by injecting a
cement-like substance into the vertebral body. Either of these procedures may have to be performed to stabilize a region within an unstable area of the spine requiring other stabilizing approaches such as a bone graft or instrumentation.

Pedicle Screws and Rods:  Stabilization of a spinal segment may require the placement of metal screws through the back of a vertebrae.  The screws are then connected together through the placement of metal rods.

Post-operative recovery following a spinal fusion is more complicated and takes longer than other forms of spine surgery.  It also takes longer to return to normal active life style at this point of fusion when compared to other surgical procedures.  Substantial bone healing usually does not take place for 3 to 5 months after graft placement.  Immobilizing spinal braces are often utilized during the recovery period.  Most spine surgeries involving fusion are generally quite complicated.  Patients who have spinal fusion may require additional spinal operations within 5-10 years.  Sometimes a follow-up operation is required remove or replace instrumentation, which causes or contributes to progressive neurological signs or symptoms.  On occasion, a re-operation is required to address abnormalities that develop at adjacent spinal segments such as disc degeneration and herniation that has become painful and associated with neurological compromise. 

Problems may arise from vertebral segments adjacent to the level of a fusion because of increased physical stress placed upon them secondary to the loss of mobility at the fused level.  The determination as to whether a fusion is required or not depends to a great extent as to whether the surgeon believes that the individual will retain stability at the operative site.  There are a variety of different approaches which may be used to perform a fusion which include:

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