Understanding Interbody Fusion Surgery

If two or more bones in the spine (called vertebrae) deteriorate and cause pain, especially when you walk, run, or go about other daily activities, a type of surgery called interbody fusion may provide relief. Occasionally the bones are unstable and causing problems, and sometimes restoration of height and alignment is required to take pressure off of the nerves. 

What Happens During Transforaminal/Anterior Interbody Fusion Surgery?

Spinal fusion surgery is designed to make the spine more stable. In the surgery, deteriorating vertebrae are fused together so that they heal into a single, solid bone, which can eliminate pain.

Interbody fusion involves removing the damaged disc, the soft padding between vertebrae that acts as a shock absorber for the spine. For an anterior lumbar interbody fusion, the incision is made from the front of your body, in the abdomen. For a transforaminal interbody fusion, the incision is made in the back. Then, the surgeon places an implant and/or bone graft between the adjoining damaged vertebrae where the disc once was. The graft acts as a kind of glue.

The bone graft is placed inside a spacer device called a cage, which helps the bone grow together. Over time, the bone graft and nearby bone will grow into a solid unit.

To help keep your spine stable as the bone graft fuses with the vertebrae, the surgeon may use a metal plate or screws and rods to hold the cage in place while it heals. These supports will stay in place permanently. The supports may need to be introduced in your body through a separate incision.

What to Expect After Surgery

After transforaminal/anterior interbody fusion surgery, you’ll stay in the hospital until you recover enough to go home. How long you’ll stay depends on how well you’re healing. Your IV line will remain in place for most of your hospital stay. You may have tubes in your incision and a catheter (thin tube) in your bladder for a few days.

Soon after surgery, you’ll be encouraged to get up and walk. Light physical activity helps prevent blood clots and keeps fluid from building up in your lungs. You may wear a brace to support your spine.

Before going home, you may meet with a physical therapist. The physical therapist will teach you ways to protect your spine during activities. You may also be given a basic exercise program to do at home. This can speed your recovery and help you get back on your feet faster.

While you’re recovering at home, follow all the instructions you’re given, including:

• Avoid bending, twisting, or lifting anything heavy until your doctor tells you it’s safe to do so.
• Use reachers and graspers to access out-of-the-way items.
• Take your pain medication as prescribed.
• Move around a little each day. Don’t sit for long stretches.

Take a Team Approach

Transforaminal/anterior interbody fusion surgery can help ease spine-related pain, but whether to have the surgery is up to you. Before making that decision, know your options and get your questions answered by your doctor. Be clear about the results you can expect and what surgery can and can’t do for you.

Like all surgery, spinal fusion surgery has risks. You should weigh them against the benefit of potentially living pain-free or with less pain. The risks of transforaminal/anterior interbody fusion surgery can include infection, blood clots, damage to nearby nerves, or the bone graft shifting out of place.

If you have spinal fusion surgery, keep your follow-up appointments in the weeks and months afterward. That way your doctor can monitor how well you’re healing and the improvements in your back pain.