Minimally Invasive Spinal Fusion
What is minimally invasive spinal fusion?
Spinal fusion is a surgical procedure to join 2 or more bones (vertebrae) of your
spine together permanently. A minimally invasive spinal fusion uses a smaller cut
(incision) than a traditional spinal fusion surgery.
Your vertebrae are the small bones that make up your spinal column. These vertebrae
stack on top of each other. They are separated by intervertebral disks. These bones
protect your delicate spinal cord, which sends and receives information from your
brain to the rest of your body.
Various health conditions might cause your vertebrae to move against each other more
than they should. This can stretch your surrounding nerves, ligaments, and muscles,
causing pain. Spinal fusion may stop this pain by preventing 1 or more of your vertebrae
Depending on your problem, your surgeon might use different approaches to get to your
vertebrae. For instance, with direct lateral interbody fusion, your surgeon accesses
your vertebrae from your side. With transforaminal lumbar interbody fusion, your surgeon
approaches your spine through your back. Your surgeon then places a graft of some
sort (like bone) in the space between your vertebrae.
For minimally invasive spinal fusion, you’ll be given medicine (general anesthesia)
to put you asleep. One or more small incisions will be made to access your spine.
Your surgeon will gently push away the muscles of your back with a special tool. Your
surgeon will then remove the cushion (disk) between the vertebrae to fuse. They will
then weld together 2 or more of your vertebrae. They do this by placing bone or some
other material such as titanium in the space where the disk was. In some cases the
disks are left in place and the bone is fused on each side.
Minimally invasive spinal fusion uses smaller incisions than traditional surgery.
Because of this, it may lead to faster recovery times than traditional surgery. It
may also reduce the chance for certain problems.
Why might I need minimally invasive spinal fusion?
You might need spinal fusion for a variety of health conditions, such as:
Degenerative disc disease
Break (fracture) of your spinal column
Infection of your spinal column
Tumor in your spinal column
These conditions might be causing you major back pain. Your healthcare provider may
want to try other more conservative treatments first, such as pain medicines and physical
therapy. If these don’t work for you, minimally invasive spinal fusion may make sense.
But spinal fusion can’t help all types of back pain. Your provider will advise it
only if the procedure might work for you.
Talk with your healthcare provider about the risks and benefits of a minimally invasive
spinal fusion, instead of a traditional one.
What are the risks of minimally invasive spinal fusion?
Most people do very well with their minimally invasive spinal fusion. But as with
any surgery, the procedure does carry some risks. Possible risks include:
There is also a risk that your surgery will not effectively get rid of your pain.
Or the surgery might cause a different type of persistent pain at the graft site.
One side effect of all spinal fusion surgeries is decreased flexibility of your spine.
Usually, this limits motion only a small amount and isn’t a major problem in the short
term. But after many years, it may lead to more stress on the nearby parts of your
Your own risk for complications may vary based on your age, the surgical approach,
the anatomy of your back problem, and your other health conditions. Ask your healthcare
provider about the risks that most apply to you.
How do I get ready for minimally invasive spinal fusion?
Ask your healthcare provider how you should prepare for your surgery. Ask if you should
stop taking any medicines ahead of time, like blood thinners. If you are a smoker,
you should try to quit before your surgery. Follow any directions you are given for
not eating or drinking before your procedure. Your provider may order more imaging
tests of your spine before your surgery, such as an MRI.
Before surgery you will be asked to sign a document called an “informed consent.”
This form gives the doctor permission to do your surgery. Signing it means you understand
the risk and benefits of the surgery and know about other treatments options. It also
states that any questions you have were answered to your satisfaction. Read the form
carefully. Be sure all of your questions are answered before you sign it.
What happens during minimally invasive spinal fusion?
Your healthcare provider can help explain the details of your particular surgery.
They will depend on the nature of your injury and the surgical approach. An orthopedic
surgeon or neurosurgeon and a team of specialized nurses will do the surgery. The
whole surgery may take a couple of hours. In general, you can expect the following:
You will be given anesthesia so that you’ll sleep and won’t feel any pain or discomfort
during the surgery.
Your vital signs, like your heart rate and blood pressure, will be carefully watched
during the surgery. You may have a breathing tube inserted down your throat during
the surgery to help you breathe.
You may be given antibiotics during and after the procedure to help prevent infection.
Your surgeon will make a small incision, often on your side or back.
Using special tools, the surgeon will dilate your back muscles, pushing them out of
Your surgeon will remove the intervertebral disk between your affected vertebrae.
They will place some sort of material in the space between your vertebrae. This might
be bone or a synthetic bone-like material.
Your surgeon may use special screws or other material to anchor your bones in place.
Your surgeon will make other repairs, if needed.
The layers of skin around your incision will be surgically closed.
What happens after minimally invasive spinal fusion?
Talk with your healthcare provider about what you can expect after surgery. You may
have some pain around your incision after the procedure. But you can take pain medicines
to relieve it. You should be able to resume your normal diet and activities fairly
quickly. You may have some sort of imaging procedures, like X-ray, done to see how
your surgery went. Depending on the extent of your injury and your other health conditions,
you might be able to go home within the next couple of days.
Your original symptoms may greatly decrease right after your surgery. Or they might
go away more slowly.
Follow all your healthcare provider’s instructions carefully. They might not want
you to take certain over-the-counter medicines for pain. Some of these can interfere
with bone healing. Your provider may advise you to eat a diet high in calcium and
vitamin D as your bone heals.
You might have a little drainage from your incision. This is normal. Let your healthcare
provider know right away if you notice an increase in redness, swelling, or draining
from your incision. You should also let them know if you have high fever, incision
drainage that has a bad odor, or severe pain that is not improving. Make sure to keep
all of your follow-up appointments. You may need to have your stitches removed a week
or so after your surgery.
While you heal, it’s important to keep your spine in correct alignment. A healthcare
provider will show you the correct way to move. At first, you’ll likely need to only
do light activity, like walking. As you heal, you’ll be able to slowly increase your
Before you agree to the test or the procedure make sure you know:
The name of the test or procedure
The reason you are having the test or procedure
What results to expect and what they mean
The risks and benefits of the test or procedure
What the possible side effects or complications are
When and where you are to have the test or procedure
Who will do the test or procedure and what that person’s qualifications are
What would happen if you did not have the test or procedure
Any alternative tests or procedures to think about
When and how will you get the results
Who to call after the test or procedure if you have questions or problems
How much will you have to pay for the test or procedure