Spinal Fusion Surgery Cost in India

About Spinal Fusion

Spinal fusion is a surgical procedure that is used to rectify problems with the small bones in the spine (vertebrae). Spinal fusion could facilitate relieve symptoms of the many back issues, including:

1. Degenerative disk disease
2. Spondylolisthesis: A spinal disorder during which a bone (vertebra) slips forward onto the bone below it.
3. Spinal Stenosis (narrowing of the spinal canal)
4. Scoliosis: A sideways curvature of the spine.
5. Fractured vertebra
6. Herniated disk (slipped disc )
7. Tumor

INDICATIONS

• When your doctor can pinpoint the source of your pain.
• If medicines, physical therapy, and other treatments (like steroid injections) haven't alleviated back pain.

BEFORE SURGERY  

• Imaging tests such as X-Rays, Computerized Tomography (CT) scans and Magnetic Resonance Imaging (MRI) scans are vital pre-requisites to know the actual status of the spine for confirming the diagnosis and for recommending surgery.
• Complete blood count, Urine tests, Fasting blood sugar and other routine tests are advised before the surgery.

SURGERY

• Spinal fusion surgery puts halt to motion between vertebrae. It also stops the stretching of nerves, surrounding structures such as ligaments and muscles.
• Lumbar and Cervical (both names of vertebrae, vertebrae are small bones which constitute your backbone) spinal fusion has been performed for decades.

A stepwise approach to this surgery is as follows

1.  INCISION (Cut)

It can be given via three approaches and is chosen depending on specific case requirements.

• Anterior approach spine may be approached from the front.

In the case of Lumbar Fusion, if an anterior approach is adopted, an incision is given in the lower abdomen (lower part of the stomach).

In cases of Cervical Fusion, an incision is given in front of the neck.

• Posterior approach: If the spine is approached from the back this is known as a posterior approach.
• Lateral approach: Incision’s approach is from the side.

In Minimally invasive techniques these fusions are performed with smaller incisions to minimise the wound size. The right procedure and approach vary from case to case.

        2. BONE GRAFTING

All spinal fusions use some variety of bone material, called a bone graft, to help promote the fusion. Generally; small pieces of bone are placed into the space between the vertebrae to be fused.

One of the functions of the bone graft is to create a scaffold (a niche for cellular migration) and other is it promotes bone healing.

When the graft is taken from the patient itself, that type of graft is known as an autograft. The pelvic bone is the most common bone/area to harvest autograft from.      

       3. IMMOBILISATION

After bone grafting, Plates, screws, and rods are used to help hold the vertebrae together to help the fusion progress.

Wearing a brace (belt around the waist) may also be advised.

AFTER SURGERY

•  A patient will feel some pain, it is normal and natural healing process.
• Some patient will get pain medications via tube within the back this is known as epidural.
• A catheter (tube to pass urine) is attached to a patient’s body for the first few days to avoid the mobility and promote healing and fusion of the spine.
• The patient should undergo physiotherapy appointments to fully understand what precautions to be taken, how to get up and how to walk again.
• Sutures are usually removed in 10 day period and Xrays are done again to check to heal.
• A follow up scheduled at different time intervals such as  4 to 6 weeks, 6 months, 12 months and 24 months.
• It takes  6 months to 1 year for complete fusion and healing of the spine.
• Opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), and local anaesthetics and opioids are prescribed to the patients to relieve pain.