Interbody Fusion of Spondylolisthesis & Instability

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Interbody Fusion of Spondylolisthesis & Instability

Restoring Stability and Function to the Spine

The goal of the surgical treatment known as interbody fusion for spondylolisthesis and instability is to stabilize the spine by merging several vertebrae. Spondylolisthesis, in which a vertebra slips out of place, as well as spinal instability caused by degeneration, trauma, or other diseases, sometimes necessitate this procedure. The injured disc between the vertebrae is removed, and a bone graft or implant is inserted to encourage fusion during the treatment. It helps reduce pain and improve movement by putting the spine back in place, easing pressure on nerves, and giving long-term stability.

What is Spondylolisthesis?

Spondylolisthesis is a deformity of the spine in which a vertebra slips forward over its neighbouring vertebra. Leg weakening, back pain, and nerve compression are all symptoms of this imbalance. Age, birth defect, trauma, or stress fracture can cause lumbar spine diseases. Stabilization and symptom relief can be achieved by a variety of treatment methods. It includes physical therapy, pain management, and bracing. In extreme circumstances, surgical treatments such as spinal fusion is needed.

  • Grade 1: Mild slippage (less than 25%)
  • Grade 2: Moderate slippage (25-50%)
  • Grade 3: Severe slippage (50-75%)
  • Grade 4: Very severe slippage (75-100%)
  • Grade 5 (Spondyloptosis): Complete dislocation of the vertebra.

When is Interbody Fusion Recommended?

Interbody fusion surgery for spondylolisthesis and spinal instability is typically recommended when:

  • Non-surgical treatments (like physical therapy, medications, or injections) fail to relieve pain and symptoms.
  • Severe pain is caused by nerve compression due to vertebral slippage.
  • Spinal instability leads to difficulty in movement and physical activities.
  • The condition is progressive, causing worsening symptoms or deformity.
  • Neurological symptoms, such as numbness, weakness, or loss of coordination, occur due to nerve compression.

Goals of Interbody Fusion Surgery

  • Restore Spinal Stability: By fusing the affected vertebrae, the spine becomes more stable and less prone to further slippage.
  • Alleviate Pain: Reduce or eliminate pain caused by nerve compression or abnormal motion in the affected vertebrae.
  • Prevent Further Degeneration: Prevent the worsening of the condition and any additional damage to surrounding spinal structures.
  • Improve Mobility: Regain normal spinal function, allowing for a better quality of life and improved range of motion.

How is Interbody Fusion Performed?

Interbody fusion surgery involves the removal of the damaged intervertebral disc between the affected vertebrae, followed by the insertion of a bone graft or implant to promote fusion. The procedure typically follows these steps:

  1. Disc Removal: The damaged or degenerated disc between the affected vertebrae is removed.
  2. Bone Grafting: A bone graft (either from the patient or a donor) or an artificial implant is placed in the space where the disc was removed. This promotes the fusion of the two vertebrae.
  3. Stabilization: Screws, rods, or other fixation devices are used to stabilize the spine while the fusion occurs. These devices are typically placed through the front, back, or side of the spine, depending on the surgical approach.

Surgical Approaches for Interbody Fusion

  • Anterior Approach (ALIF – Anterior Lumbar Interbody Fusion): The surgeon approaches the spine from the front (abdomen) to remove the damaged disc and place the bone graft or implant.
  • Posterior Approach (PLIF – Posterior Lumbar Interbody Fusion): The surgeon approaches the spine from the back to remove the disc and insert the graft or implant.
  • Lateral Approach (XLIF – Extreme Lateral Interbody Fusion): This approach is performed from the side, offering less disruption to the muscles and tissues around the spine.

What to Expect During Surgery

  1. Pre-Surgical Assessment: Imaging tests (X-rays, MRI, CT scans) and physical exams help determine the extent of the slippage and the most appropriate surgical approach.
  2. Procedure: Interbody fusion surgery is performed under general anesthesia. The type of approach (anterior, posterior, or lateral) will depend on the patient’s condition and surgeon’s recommendation.
  3. Post-Surgery Care: After surgery, patients are monitored for complications, and a rehabilitation program is developed to ensure a smooth recovery.

Recovery and Rehabilitation

  • Hospital Stay: Recovery in the hospital can last from a few days to a week, depending on the complexity of the surgery.
  • Physical Therapy: A key part of recovery, physical therapy helps strengthen muscles, improve mobility, and ensure proper spinal alignment.
  • Bracing: Some patients may be required to wear a brace to support the spine during healing.
  • Pain Management: Medications will help manage post-surgery discomfort, and ice or heat therapy may also be used.
  • Follow-Up Care: Regular follow-up visits will be needed to monitor the progress of the fusion and ensure that the spine is healing properly.

Why Choose Interbody Fusion for Spondylolisthesis and Instability?

  • Effective Pain Relief: Alleviates chronic pain caused by vertebral slippage and nerve compression.
  • Restores Spinal Stability: Prevents further degeneration of the spine and restores proper alignment.
  • Improved Quality of Life: With successful fusion, patients can expect improved mobility, reduced pain, and a return to normal activities.

Interbody fusion surgery offers a reliable solution for spondylolisthesis and spinal instability, helping patients regain stability and function in their spine.

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Dr. B. Leela Prasad is one of the country’s most renowned orthopedic doctors, with over 15 years of experience in the field. After earning his medical degree from Andhra Medical College, Visakhapatnam, he pursued post-graduation in Orthopedics at Guntur Medical College.

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