INTERVERTEBRAL FUSION CAGES

When doctors install the intervertebral fusion cage, it serves as a space holder between your affected vertebrae and allows the bone to grow through it — eventually becoming a part of your spine.

When necessary, the surgeons at the Southwest Scoliosis and Spine Institute use an intervertebral Fusion Case to help heal the body.

Intervertebral Fusion Cage

To clarify, the intervertebral fusion cage allows the spine surgeon to help bones grow during various back operations. For patients that require fusion surgery to treat degenerative disc disease, the intervertebral fusion cage provides an effective solution for several reasons.

Low complication rate
Minimized pain after surgery due to less trauma during surgery
Shorter hospital stay compared to other types of fusion methods
Quicker return to daily activities

In some patients who require posterior lumbar interbody fusion (PLIF) surgery, doctors may use minimally invasive PLIF techniques (MIS-PLIF). MIS-PLIF uses smaller incisions and less tissue dissection to achieve similar results to traditional, open surgery. These benefits include:

Smaller incisions: This leads to less scarring and a quicker recovery.
Less tissue dissection: Reduced tissue damage means minimized pain and a lower risk of complications post-surgery.

Patients can experience a quicker return to daily activities due to the less invasive nature of MIS-PLIF. For a more detailed understanding, consider exploring additional resources, including animations and detailed articles on posterior lumbar interbody fusion techniques.

However, the cage does not treat all types of spinal problems. If your pain comes from degenerative disc disease with segmental instability, the cage can provide a solution.

Surgical Devices

Surgeons installing the intervertebral fusion cage Upon examining the intervertebral fusion cage, it appears as a hollow cylinder — made from various materials including metal or carbon-graphite fiber. When used, doctors place bone inside the cylinder. Also, the holes in the cage keep the graft in contact with the bony surface of the vertebrae. Therefore, this ensures that the bone graft unites with the vertebrae, forming a solid fusion.

The cage helps in several ways. As an example, the solid cage separates and holds two vertebrae apart. Also, this makes the opening around the nerve roots bigger, relieving pressure on the nerves. As the vertebrae separate, the ligaments tighten up, reducing instability and mechanical pain. Thus, the cage replaces the problem disc while holding the two vertebrae in position until fusion occurs.

With over 10,000 procedures using intervertebral fusion cages, our doctors believe the cages effectively aid in healing patients. Similarly, the United States Food and Drug Administration (FDA) previously approved many of these devices.

In most cases, doctors treat lumbar scoliosis with a brace, but in cases where the patient’s curve has grown to the point that they are in pain, surgery may be necessary. Finally, surgeries to fix lower back scoliosis are complex, multi-step procedures, but Richard Hostin, MD, Devesh Ramnath, MD, Ishaq Syed, MD, Shyam Kishan, MD, and Kathryn Wiesman, MD are specially trained and have years of experience performing these types of complex spine surgeries.

Lumbar Scoliosis Surgery

To sum up, the most common type of surgery to address lower back scoliosis refers to spinal fusion surgery. This procedure involves inserting rods and screws into the vertebrae to prevent the spinal curve from growing.

QUESTIONS AND ANSWERS

How does intervertebral fusion with cages work, and why is it recommended for my condition?

Intervertebral fusion with cages refers to a surgical procedure used to stabilize the spine by fusing adjacent vertebrae. The cages, typically made of materials like titanium or plastic, are placed between the vertebrae to maintain the proper spacing and alignment. This procedure often becomes recommended for conditions such as degenerative disc disease, spinal instability, or certain types of fractures. The cages provide structural support during the fusion process, helping to alleviate pain and restore stability to the spine.

What are the potential risks and complications associated with intervertebral fusion using cages?

Like any surgical procedure, intervertebral fusion with cages carries some risks. Potential complications may include infection, bleeding, nerve damage, or issues related to the hardware, such as migration or breakage. It’s important for the patient to discuss their medical history and any concerns with the surgeon, and to follow pre- and post-operative care guidelines to minimize risks. The surgeon will provide detailed information about the specific risks associated with the procedure and steps taken to mitigate them.

What is the recovery process like, and when can I expect to return to normal activities?

The recovery process after intervertebral fusion with cages varies from patient to patient and depends on factors such as the extent of the surgery, overall health, and the specific condition being treated. Because there is a wide variety of surgical techniques for achieving vertebral fusion in the lumbar spine, there is also a variety in recovery times. For example, a minimally invasive LLIF recovery can occur much faster than a PLIF. Recovery times will differ both by procedure and by individual patient. Patients should discuss recovery expectations with their surgeon

Generally, patients may need to limit activities and movements that strain the spine during the initial recovery period. Doctors will recommend Physical therapy to aid in rehabilitation. Doctors will also tell their patients that the return to normal activities will occur gradually, with the surgeon guiding on when it’s safe to resume specific actions. Follow-up appointments will allow the healthcare team to monitor progress and address any concerns during the recovery process.

Procedure

Doctors install the cages from the front or back of the spine. Moreover, surgery from the back of the spine removes bone spurs or a herniated disc into the spinal canal. In these instances, durgeons can implant the cages from the back, without making an additional incision in the patient’s abdomen.

Most often, the cages get installed during surgery through the front of the spine by making a large incision in the abdomen. Furthermore, this procedure uses the laparoscope, a TV camera that allows the doctor to see inside the abdominal cavity while working on the spine. This method only requires a few small incisions, which seems to help patients heal and get moving faster after surgery. The use of a laparoscope for this procedure does not always exist.

Inserting the cage from the front

To see and work on the problem disc from the front, the surgeon first makes an incision in the abdomen. The size of the incision, however, depends on whether a laparoscope will assist the doctor during the procedure. Next, the surgeon moves organs and vessels to the side to gain a clear view of the spine. At this point, surgeons use another type of special instrument called a fluoroscope (a special X-ray machine that shows the images on a TV screen) to identify and locate the problem disc.

In most cases, two cages are placed side by side to replace one disc. Specifically, the surgeon drills two holes through the front of the disc. Before inserting one cage into each hole, the doctor prepares the cages by removing bone from the pelvis through a small incision on the side. Notably, a second incision may not be necessary if the surgeon opts to use a bone graft substitute instead.

Learn more about the use of bone grafts.

Comparing Lumbar Fusion Techniques: Recovery Times

When it comes to lumbar fusion surgery, the recovery period can vary significantly depending on the surgical technique used. It’s important to understand these differences to set realistic expectations for healing.

Minimally Invasive LLIF vs. Traditional PLIF

Minimally Invasive Lateral Lumbar Interbody Fusion (LLIF): This technique typically offers a shorter recovery time. Because the approach appears less intrusive, it generally results in less muscle and tissue damage.
Posterior Lumbar Interbody Fusion (PLIF): Being a more traditional and invasive method, PLIF often necessitates a longer recovery period, as muscles and tissues are more affected during surgery.

Factors Influencing Recovery

Type of Procedure: Recovery time appears closely tied to the specific technique used. Minimally invasive methods tend to expedite the healing process.
Individual Differences: Each patient’s recovery will differ based on factors like age, overall health, and adherence to post-operative care.

Discussing with Your Surgeon

Always discuss recovery expectations with your surgeon. They can provide personalized insights based on your specific situation and the surgical method chosen.

Understanding these variables helps you better prepare and manage your recovery journey, ensuring a smoother return to daily activities.

Surgical Options for Unrelieved Lower Back Pain

When persistent lower back pain or related leg pain doesn’t respond to conservative treatments, doctors can implement several surgical options. Here’s a detailed look:

Spinal Decompression

Spinal decompression is a surgical procedure focused on relieving pressure on the spinal cord or nerves. This method helps doctors when pain is caused by conditions like herniated discs or spinal stenosis. The goal is to remove the source of compression to alleviate discomfort and improve mobility.

Lumbar Fusion

Lumbar fusion aims to stabilize the spine by joining two or more vertebrae. This is particularly beneficial for patients experiencing pain due to degenerative disc disease, spondylolisthesis, or severe spinal instability. By fusing the vertebrae, the movement causing pain is eliminated, providing relief and improving function.

Combination Surgery

In some cases, a combination of spinal decompression and lumbar fusion may appear as the best approach. This dual method addresses multiple issues at once, such as decompressing a nerve root while simultaneously stabilizing the spine. This is often recommended for patients with complex spinal conditions.

Key Points to Consider

Pre-surgical Evaluation: A thorough assessment by a spine specialist is essential to determine the most appropriate surgical intervention.
Recovery Time: Each surgical option has a different recovery timeline, and patients should discuss this with their surgeon.
Potential Risks and Benefits: Understanding the potential risks and benefits of each procedure is crucial for making an informed decision.

By exploring these surgical options, patients not finding relief through conservative treatments have viable pathways to potentially alleviate their lower back pain.

Understanding the Different Types of Lumbar Fusion

Lumbar fusion is a specialized spinal surgery aimed at connecting two or more vertebrae in the lower back. The primary goal of this procedure, also referred to as arthrodesis, is to encourage the bones to grow together into a single, solid bone. This helps reduce motion between vertebrae, thereby alleviating pain from conditions like degenerative disc disease or spondylolisthesis.

There are several techniques used in lumbar fusion, which can be broadly categorized as follows:

Posterior and Posterolateral Fusion (PLF)

In these procedures, the surgeon approaches the spine from the back (posterior) or the side (posterolateral). Bone grafts are placed alongside the vertebrae to stimulate fusion, with the additional stability often provided by rods and screws. Surgeons use this technique frequently to treat a variety of spinal disorders and provides a robust and stable fusion environment.

Lumbar Interbody Fusion (LIF)

This category includes techniques where the intervertebral disc is removed and replaced with a bone graft or a spacer device, known as an intervertebral fusion cage. The use of these cages maintains disc height and spinal alignment while promoting bone growth. The types of LIF include:

Anterior Lumbar Interbody Fusion (ALIF): Access is gained through the front of the body. This approach allows doctors to place a larger implant, potentially offering better fusion rates and spinal alignment.
Posterior Lumbar Interbody Fusion (PLIF): The surgery is performed from the back. This method allows for the direct decompression of neural elements and the placement of bone grafts and cages in the intervertebral space.
Transforaminal Lumbar Interbody Fusion (TLIF): Approaches the spine from the side through a small incision. This technique minimizes disruption to the spinal muscles and provides access to the disc space for decompression and fusion.

Lumbar Corpectomy and Vertebral Body Replacement

In these procedures, the entire vertebral body and the adjacent intervertebral discs are removed. This is often done to treat fractures, tumors, or severe infections. The removed vertebra is then replaced with a cage or graft to provide stability. Intervertebral fusion cages in these cases help maintain the height and alignment of the spinal column, reduce the risk of further spinal deformity, and promote bone healing.

Conclusion

Understanding the different types of lumbar fusion is crucial for anyone considering this form of surgery. Each technique has its own unique approach and is chosen based on the specific medical condition and individual patient needs. Whether it’s PLF, LIF, or corpectomy, incorporating the use of intervertebral fusion cages can enhance healing and prevent complications. These cages support the spinal structure, maintain proper alignment, and facilitate the fusion process by providing a scaffold for bone growth. Discussing all available options with a healthcare provider can help patients determine the best route for pain relief and improved spinal health.

The Reasons why Patients Choose the Southwest Scoliosis and Spine Institute.

Expertise in the spine: The Southwest Scoliosis and Spine Institute’s team of specialists are recognized as spine experts. They specialize in the diagnosis and treatment of spinal conditions, ensuring the best possible care for their patients.
Cutting-edge technology: Our practice uses the latest technology and techniques to diagnose and treat a wide range of conditions. In addition, we use minimally invasive procedures that reduce pain and promote faster recovery.
Comprehensive care: Our practice offers a full range of services, from diagnostic imaging and physical therapy to surgery. We ensure that patients receive complete, seamless care for their spinal conditions.
Dedicated facilities: Southwest Scoliosis and Spine Institute is dedicated to providing patients with a safe and comfortable environment.

Finally, our board-certified physicians and fellowship-trained orthopedic surgeons use the full range of treatments to treat spine patients. Southwest Scoliosis and Spine Institute doctors and surgeons are experts with offices in Dallas, Plano, and Frisco, TX. They offer cutting-edge technology, comprehensive care, and dedicated facilities to ensure the best possible care for their patients. Call today to make an appointment.

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Medline: Intervertebral Fusion Cage

If you or a loved one suffers from spinal pain, you owe it to yourself to call Southwest Scoliosis and Spine Institute at 214-556-0555 to make an appointment.