Spinal fusion surgery is a neurosurgical that joins two or more vertebra. This procedure can be performed at any level in the spine (cervical, thoracic or lumbar) The Purpose of Instrumentation with rods and screws is to act as an 'internal cast' to stabilize the vertebra until the fusion or bony re-growth can occur.
The patient is positioned on the operating table in a prone position. The incision is made in the midline over the black at the site of pain. When indicated, soft tissue and bony decompression are performed to relive neurological compression For a degenerative case, a blunt probe is inserted through the pedicle and into the vertebral body. Once the pedicle canals are-prepared and the screw length determined, the pedicle screws are sequentially inserted. when required, a cage with bone graft may be placed between the vertebral. The screws are then connected to each other with rods. Once the construct has been assembled segmental distraction or compression may be carved out. This is followed by final tightening and closure of the incision in layers.
• Using plates, screws, cages, spacers- in anterior cervical spine surgery.
• Using rods and - screws- posterior approach for cervical, dorsal lumbar spine
• Using rods and - screws interbody cage- in posterior and lateral approaches to dorsal and lumbar spine surgery, especially if there is tumor or tuberculosis to spine
• Odontoid screw fixation in odontoid (part of C2 vertebrae) fractures
• fixation with wire and hooks
• percrutaneous fixation- minimally invasive techniqu
• cement augmented screws - in cases of severe osteoporosis
• Provides stability in case of fracture and dislocation
• Helps to achieve desired alignment of spine bone
• Helps to decompress the neural structures extensively and approaches without fear of creating instability
• Helps to forms a new stable spine in cases of tuberculosis and spine tumor
• Helps in early mobility and recovery from spine surgery
• It helps to maintain a good sagittal balance
• In expert hands and in a good hospital with all gadgets for spine surgery
• Mal-position of screws can cause neural (nerve or Spinal cord) injury
• Improper construct of implant may lead to chronic pain
• poor quality screws / rods may break in long term
• Minor complications are CSF leak/ infection/ adjacent level diseases