The spine consists of a column of stacked bones called vertebrae, and the column stretches from the neck all the way down to the tailbone. There are five segments: cervical 7 bones , thoracic 12 bones , lumbar 5 bones , sacrum 5 fused bones , and coccyx the 4 fused bones that make up the tailbone. Their purpose is to provide structure for the body and to protect the big bundle of nerves that threads through the middle of the column called the spinal cord. Between each vertebra, we have intervertebral discs, which cushion the vertebrae as we move and absorb s hock. While the terminology spinal column likely brings to mind a stick-straight structure, the spinal column is not straight.
Occasionally, a blood clot will travel through the bloodstream and may settle in the lungs. Your surgeon may suggest that you wear a brace. Make an Appointment. At Fuded level of the spine, there is a disc space in the front and paired facet joints in the back. I would edit that for spine surgery and write that fusion is the last resort of the incompetent spine surgeon.
Light green polo uniform shirts. Lumbar Spinal Fusion
It is a complex structure that Bottom disk fused to spine the weight of the body and, with the facet joints, permits a significant range of motion. Watch: Spine Anatomy Overview Video. Disc degeneration and the accompanying changes in soft tissues and bone can result in increased instability eg, spondylolisthesis in some people, and decreased motion in others. A Model of the brady bunch house incidence has been noted in the African-American population. Last Reviewed September Sign up for our newsletter. Bottom disk fused to spine latter causation is the subject of the remainder of this essay. They sit atop the sacrum, which is formed by five vertebrae fused together into a solid unit. Lumbar spinal fusion surgery for low back pain caused by degenerative disc disease is usually considered an option for patients who:. Pedicles act as the lateral side walls of the bony spinal canal that protects the spinal cord and cauda equina, or nerve roots, in the lumbar region. In Bottom disk fused to spine case of organic spinal fusion, this occurrence happens naturally and is not the result of surgical intervention, such as in the spondylodesis procedure detailed above.
Degenerative disc disease DDD affects the discs that separate the spine bones.
- In spondylolisthesis, one of the bones in your spine — called a vertebra — slips forward and out of place.
- A spine fusion is a surgery performed to link together individual segments, or vertebrae, within the spine.
- A lumbar spine fusion is a type of back surgery designed to treat low back pain from degenerative disc disease.
A lumbar spine fusion is a type of back surgery designed to treat low back pain from degenerative disc disease. The spine is not actually fused at the time of the surgery. Instead, the surgery creates the conditions for the spine to be able to fuse and the fusion is a process that will set up over a 3 to 6 month and up to 18 month period of time following the spinal fusion surgery.
Lumbar spinal fusion surgery for low back pain caused by degenerative disc disease is usually considered an option for patients who:. It is important to stress that the decision to undergo a fusion procedure for low back pain is entirely the patient's decision and he or she needs to carefully weigh the risks and possible complications along with the potential benefits of surgery, as well as consider the full range of alternatives to a spine fusion surgery. The decision to have a spine fusion procedure to treat low back pain from degenerative disc disease is a very personal one.
Lumbar Spinal Fusion Surgery. Deciding on Surgery for Degenerative Disc Disease. Postoperative Care for Spinal Fusion Surgery. What Is Degenerative Disc Disease? Treatment for Degenerative Disc Disease Video. Surgery for Lumbar Degenerative Disc Disease.
Peer Reviewed. The fusion is designed to eliminate motion in that fused segment of the spine , thereby decreasing or eliminating the back pain created by the motion. Lumbar Disc Disease Video. Editor's Top Picks. Health Information Sponsored.
Degenerative Spondylolisthesis As we age, general wear and tear causes changes in the spine. In this x-ray taken from the side, vertebrae in the low back have slipped out of place due to degenerative spondylolisthesis. It must be noted that although this case profile of disc degeneration is severe, the process of disc desiccation is completely normal and universal. Nonsurgical Treatment Although nonsurgical treatments will not repair the slippage, many patients report that these methods do help relieve symptoms. Follow Us. The muscles and ligaments in the spine work to hold the spine upright, and to allow forward bending flexion and backward bending extension , as well as rotation from side to side and combinations of those activities. The sacrum connects the spine to the pelvis and the lower half of the skeleton.
Bottom disk fused to spine. Naturally Fused Vertebrae Explained
This can occur due to degeneration of the spinal disc or acute traumatic injury. Naturally fused vertebrae can occur virtually anywhere in the spine, with the exception of the sacrum and the coccyx, which already demonstrate organic fusion of the vertebral bones by natural design in a typical anatomy. Natural fusions may occur in the neck and are often found in combination with disc degeneration, severe osteoarthritis and possible compression fractures of vertebral bones.
Natural fusions in the thoracic spine statistically have the least chance of being diagnosed, since this area is not called upon to move in the same manner as the other regions of the vertebral column. Once again, the changes are often seen in combination with marked disc desiccation, osteoarthritis. When the final vertebral bone in the lumbar spine is fused to the sacrum, this is called a sacralized vertebra. This is just a name for a particular location of natural fusion in the lower spine and is not different than any other variety of organic bone joining.
Risk factors for acquiring a natural vertebral fusion include unusually high levels of spinal degeneration, such as those often demonstrated by some types of athletes and those with genetic predisposition to unusual degrees of disc and bone deterioration.
In virtually all cases of compression fractures leading to natural fusions, the patient is usually either very old, morbidly obese or both. The effects of naturally fused vertebrae range greatly, depending on particular patient criteria and location of the joining.
Single level natural fusions are virtually never problematic, regardless of where they exist in the spine, as long as the central and neuroforaminal canals remain patent during the formation of the fusion. Multiple levels of fusion might become problems, since they exert increased force against the remainder of the spine, especially affecting nearby vertebral levels above and below.
Spinal or foraminal stenosis is likely to occur with multiple levels of organic fusion, although this is not a rule. Multilevel fusions might reshape the spinal anatomy, causing scoliosis or creating lordotic or kyphotic changes to the immediate area or the entire backbone length. Some organic fusions might increase the incidence of suffering fracture at the fused locations or nearby. Natural fusions that occur in people with porous bones or osteomalacia are especially dangerous and often break repeatedly, causing pain and possible spinal instability.
Multiple level natural spinal fusions may increase force in the spine and enhance any trauma suffered, since there will be less flex from level to level and less shock absorption capability to the entire backbone structure. For a complete description of a diagnosed natural spinal fusion condition, be sure to undergo a variety of specialized imaging techniques and then consult with a neurologist and orthopedist for accurate prognostic evaluation.
A numb arm can occur due to a pinched nerve or other spinal pathology, such as central canal stenosis. Learn about many causes of numbness in the arms. Lateral recess stenosis, also called subarticular stenosis, is a common condition that can compress a single nerve root usually in the neck or lower back.
Recovering from lower back pain may seem like an impossible objective for so many patients to achieve. Many patients get worse with time and treatment. You Can Help! Follow Us. Subscribe to our Free Newsletter Email.
I am at least 16 years of age. People with back problems that get better within a few weeks usually have a strained muscle a pulled muscle or other soft tissue damage. However, many back problems that don't get better within a few months are caused by some type of problem with a spinal disc or nerve.
Spinal discs are located in between each of the vertebral bodies along the back bone and may also be referred to as an intervertebral disc, spinal disc, or disk.
Each disc is named according to which two vertebral bodies it lies between. For instance:. The disc and vertebra above and below the disc comprise one segment of the spine - usually called a spinal level or spinal segment. The L4 vertebra and L5 vertebra, along with the disc in between them, make up the L4-L5 segment.
Discs are always labeled for the vertebrae that they lie between, and this is consistent throughout the length of the spine - for the cervical, thoracic and lumbar spine. For example, the C1-C2 disc in the neck lies between the first and second vertebrae in the cervical spine, and the T1-T2 disc lies between the first and second vertebrae in the thoracic spine. However, the same is not true of how the spinal nerves are labeled, and back problems are often described by both the spinal segment and the nerve root that is affected.
Multilevel Spinal Fusion for Low Back Pain
While multilevel spinal fusions are a common and necessary procedure to treat many types of spinal pathology, such as scoliosis or other types of deformity, for treatment of low back pain from lumbar degenerative disc pathology this type of procedure remains controversial.
Figure 1: X-ray of two-level and three-level spine fusions, from the lateral view. Representation modeled after x-ray data. This article examines the potential risks and benefits of multilevel fusion for patients with low back pain from degenerative disc problems. The lumbar spine low back has six mobile spinal levels, also known as motion segments, surrounding and in between the five lumbar vertebrae. A spinal level carries the name of the disc at that level, named by the vertebra above and below the disc.
For example, the disc space or motion segment between the L4 and L5 vertebrae is known as the L disc or the L level. The lowest spinal segment, between the L5 vertebra and the sacrum bone of the pelvis, is known as the L5-S1 level.
At each spinal level, motion is controlled by the disc, located between the vertebral bodies, and the paired left and right facet joints , in the back of the spine, which allow flexion and extension motion in the lumbar spine and block rotation motion. Fusion of only one motion segment of the spine e. L5-S1 is referred to as a single level fusion. L3-L4 and L4-L5 fusions. Multilevel spinal fusion for treatment of low back pain is a controversial topic.
In general, lumbar spine fusion has a relatively poor success rate for treatment of multi-level disc degeneration seen on MRI scans 1. A two-level fusion may be considered for patients with severe, disabling pain that occurs at two levels of the spine e.
L4-L5 and L5-S1 after extensive non-surgical and pain management approaches have been tried. However, three-level fusions for treatment of low back pain from lumbar degenerated discs are rarely advisable for three main reasons:. In addition to treatment for severe low back pain, there are many different reasons that surgeons perform multilevel spinal fusions.
One common indication is for the treatment of spinal deformity, including scoliosis side curvature of the spine , kyphosis forward bending of the spine , and spondylolisthesis forward slippage of one vertebra on another. In addition, multilevel spinal fusions are often performed in the treatment of the less commonly seen fractures, tumors, and infections of the spine. Postoperative Care for Spinal Fusion Surgery. Multi-level Spinal Fusion Video. Lumbar Spinal Fusion Surgery. Spine Fusion Surgery Video.
By Jeffrey Spivak, MD. Peer Reviewed. Editor's Top Picks. Health Information Sponsored.