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Everything you need to know
Spinal fusion is a surgical procedure used to join two or more vertebrae (the interlocking bones that make up the spine) together. This fusion of the vertebrae creates a single, solid bone structure, which prevents movement between the connected bones.
People who undergo a spinal fusion may have been experiencing severe pain in their spine as well as postural issues, such as a curve, numbness and/or muscle weakness. A spinal fusion can be undertaken to:
- Stabilise the spine: Too much motion between two or more vertebrae can make the spine unstable. This is a common effect of severe arthritis in the spine. A spinal fusion may also be undertaken when a damaged disc is removed from the spine, to reduce the risk of nerve compression.
- Reshape the spine: Spinal fusion can correct issues with the way the spine is formed, such as scoliosis – a condition characterised by a curvature of the spine.
A spinal fusion may be recommended if:
- Pain medicines are no longer working for your persistent pain
- You suffer from severe arthritis
- Other surgical procedures have failed
- Your spine is no longer in proper alignment
- You have a congenital spine condition (one you were born with)
- You have spinal stenosis (where a section of the spinal canal has narrowed and compressed nerves.
If you have surgery for spinal decompression or a slipped disc, your surgeon may also recommend having a fusion as part of your treatment.
Before surgery
Firstly, you will have an appointment with one of our spinal consultants. If you don’t already have a confirmed diagnosis, they will take a history, conduct a physical exam, and refer you for X Rays an MRI scan, and sometimes also a CT scan of your spine. You may need to have some blood tests as well.
If spinal fusion surgery is recommended, your doctor will walk you through the potential risks and details of the procedure.
If you decide to go ahead with surgery, we will help you prepare, but you should also try to eat healthily in the run up and stop smoking if you can.
We will conduct some pre-operative tests, which will include an MRSA test. We will give you some specific antibacterial soap and lotions to use in the run up to the procedure, which will help reduce your risk of contracting MRSA.
If you take any blood thinners—for example, Warfarin, Rivaroxaban, or Aspirin, tell your doctor straight away, as you may need to stop taking these or modify your intake a week or so before surgery. Your doctor or pre assessment clinic will give you specific instructions if this is the case. You should also tell your doctor if you take nonsteroidal anti-inflammatory drugs, such as ibuprofen or Naproxen.
From midnight on the day of your surgery, do not eat or drink anything. This includes water, chewing gum and hard candies. Brush your teeth with toothpaste only on the morning of surgery. If you take any prescriptions medications, bring them to hospital with you. Your doctor will let you know if you can take these with a sip of water before your surgery or if you should wait until after.
On surgery day, it’s a good idea to wear loose, comfortable clothing and bring a small bag with things you might need during your stay. Items to remember include a toothbrush and toothpaste, your phone and a charger, a book, any prescription medications and a change of clothes. Once you have arrived and are settled in your room, a nurse will help prepare you for surgery by monitoring vital signs and running through your medical history, medications and emergency contacts.
Your doctor will then run you through the procedure once again and ask you to sign a consent form for surgery.
During surgery
Firstly, you’ll have an intravenous (IV) line fitted into a vein. This is usually on an arm or hand. Through this, your surgical team can quickly give you medications and fluids. The surgical team will also place monitors on you so you can stay safe throughout the surgery.
After some final safety checks, surgery can start, and you’ll be given general anaesthesia. This means you will be asleep throughout the procedure. The surgeon will then make an incision over the affected area of the spine.
There are several different techniques that may be used to fuse the spine. There are also different “approaches” your surgeon can take to reach your spine. Your surgeon may approach your spine from the front. This is called an anterior approach and requires an incision in the lower abdomen for a lumbar (lower back) fusion, or in the front of the neck for a cervical (neck region) fusion.
A posterior approach is done from the back. A lateral approach is approached from the side. Minimally invasive techniques have also been developed, which allow fusions to be performed with smaller incisions.
Your specific procedure will depend on the nature and location of your spinal issue.
To finish, the surgeon will close the incision using stitches or staples. You will then be taken to our recovery area, where specialist staff will monitor your vital signs, including blood pressure, heart rate and oxygen levels, as you wake up from anaesthesia.
After surgery
Once we’re happy you’re doing well, we will take you to your private room where you can start your recovery. We’ll encourage you to start moving the day after your operation, so one of our physiotherapists will guide you through some exercises and an occupational therapist will take you through an assessment as well. Depending on your specific situation, your stay in hospital could range from one night to a few days.
For the first few weeks after your procedure, we will ask you to attend regular physical therapy. We have an excellent therapies department based on-site in our hospital. This will help you achieve an optimal recovery, so you can get back to enjoying life quickly. You may find that you feel generally sore and tired for a few weeks after surgery, and this can take up to six weeks to pass.
When you get home, it’s important to take things easy at first, and gradual increase your level of activity every day. Some help at home is usually needed for at least the first week after surgery.
Make sure you stick to the exercise programme recommended by your physiotherapist and try not to sit or stand in the same position for more than 15-20 minutes at a time, as this will make you feel stiff and sore.
For a faster recovery, it’s important to follow the advice of your surgeon. This includes:
- Keeping an eye on your incision for infection.
- Being kind to yourself post-surgery: it takes time for your body to return to its usual state.
- Being consistent with your physiotherapy exercises
- Staying as active as possible.
Recovery from fusion surgery is a gradual process. You’ll be able to slowly get back to light exercise and activities over the first few weeks. Depending on your job, you may be able to return in a few weeks to a few months. Full recovery should be expected, but you may notice you have some reduced flexibility and movement because the fused vertebrae in your back no longer move like they did before.
Stitches
Deep stitches beneath the skin will dissolve and don’t need to be removed. Non-dissolvable stitches or staples will need to be removed five to 10 days after your operation. Before you leave hospital, you’ll be given an appointment to have them removed.
Your stitches will be covered by a simple adhesive dressing, like a large plaster. Be careful not to get this wet when you wash. After having your stitches removed, you won’t need a dressing and will be able to bath and shower as normal.
Hospital Fee Guaranteed
£15,695
The price shown includes all costs associated with your treatment, from admission to discharge.
Doesn’t include surgeon or anaesthetist fee.
Our hospital fee is guaranteed at the price quoted and valid for one month from the date issued, subject to pre-assessment.
How to pay for your treatment
If you’re… paying for yourself
Did you know you don’t need private medical insurance to come to St John & St Elizabeth Hospital? As a self-pay patient, you can access safe, outstanding quality health care at times to suit you.
For scans and tests, as well as to see most consultants, you’ll still need to be referred by a medical professional like your GP, but as a self-pay patient, the process is more straightforward. You won’t need authorisation from an insurance provider, and you’ll have greater choice of consultant and appointment times.
If you’re… insured
St John & St Elizabeth Hospital is approved by all major medical insurance companies. If you have a personal private health insurance policy, or your company provide it for you, you can use it to pay for your care from your initial consultation through to treatment, surgery and aftercare such as physiotherapy. Not all private health insurance plans cover the same things. It’s very important to check exactly what you are covered for with your insurance provider.