Spinal Fusion
Spinal fusion is the joining together of vertebrae in the spine with bone so that they effectively become one bone, and is used to help with symptoms of severe pain affecting the lower back.
The Operation
How long does the surgery take?
The operation usually takes about two hours but will be somewhat longer if two levels are being fused.
Where is the incision made?
At L5/S1 (the lowest level of the spine) the operation will be done through the lower part of the abdomen. The incision, which can be as little as 5-6 cm in a slim patient, is usually a little above the pubic hair line. The rectus muscles at the front (the 'six-pack muscles') will be moved apart but not damaged. For levels above this the incision will be on the left side, usually just above the top part of the pelvis. Again, this is usually about 5-6 cm. The flank muscles are separated but not cut or damaged.
What happens during the procedure?
After separating the muscles, the peritoneal sack, containing the abdominal organs, is carefully moved to one side. A marker is placed on the disc and an x-ray obtained to confirm the level where the fusion is to be undertaken. The large blood vessels in front of the spine are then carefully moved to give the necessary access to the disc.
The outer and central parts of the disc are then removed, and the vertebrae spread apart to allow access to the very back of the disc. This must be carefully cleared away to ensure removal of the painful posterior tears, which are so often a cause of back pain. This also ensures good placement of the cage.
The appropriate size of STALIF cage is then determined using trials and x-ray control. The cage is prepared and packed with bone graft or a bone graft alternative. Additional graft material is packed at the back of the disc space before the cage is inserted. Placement is meticulously checked as the STALIF cage is inserted. The cage is then fixed very firmly in place using the screws which pass through the cage and into the vertebral bodies. Additional bone graft is also packed to either side of the cage.
Local anaesthetic is infiltrated around the wound to help with your post-operative pain control. The wound is then closed, and small clips are used to close the skin edges.
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In memory of Nick Boeree
Following the sudden death of Nick Boeree we have set up a tribute page to allow you to share your memories, thoughts, and feelings. Click here.
I had keyhole surgery by Mr Boeree in June 2006 and it was completely successful. I was no longer in any pain what so ever!! I’m really delighted that I went ahead with the surgery and want to thank Nick Boeree and his staff for everything that they have done for me!!
Elena Baltacha
