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Spinal fusion, also called spondylodesis or spondylosyndesis, is a surgery performed by orthopaedic surgeons or neurosurgeons that joins two or more vertebrae. [1] This procedure can be performed at any level in the spine (cervical, thoracic, lumbar, or sacral) and prevents any movement between the fused vertebrae.
X-ray of interbody fusion cage in cervical vertebrae, Juliet system. X-ray of interbody fusion cage in L5S1 vertebrae. An interbody fusion cage (colloquially known as a "spine cage") is a prosthesis used in spinal fusion procedures to maintain foraminal height and decompression. They are cylindrical or square-shaped devices, and usually threaded.
It involves fusion of two or more levels utilizing screws, rods, and an interbody graft. It has a theoretical advantage over instrumented posterolateral fusion (iPLF) in that it provides better support for the vertebra along with several potential neurological benefits, but as of 2011 evidence demonstrating actual improved clinical outcomes was ...
Flatback syndrome is a problem that develops in some patients treated with Harrington rod instrumentation, where the rod extends down into lower part of the lumbar spine. Because the Harrington cannot follow the natural lordosis of the lower back (i.e. the backwaist curve), the spine is straightened out into an unnatural position. At first, the ...
Bertolotti's syndrome is characterized by sacralization of the lowest lumbar vertebral body and lumbarization of the uppermost sacral segment. It involves a total or partial unilateral or bilateral fusion of the transverse process of the lowest lumbar vertebra to the sacrum, leading to the formation of a transitional 5th lumbar vertebra.
Sacralization of the L5 vertebra is seen at the lower right of the image. Sacralization of the fifth lumbar vertebra (or sacralization) is a congenital anomaly, in which the transverse process of the last lumbar vertebra (L5) fuses to the sacrum on one side or both, or to ilium, or both.
Degenerative spondylolisthesis at L5-S1. (A) CT sagittal view of a low grade slip. (B) Lateral radiograph pre-operative intervention. (C) Surgically treated with L5–S1 decompression, instrumented fusion and placement of an interbody graft between L5 and S1. Both minimally invasive and open surgical techniques are used to treat anterolisthesis ...
These cannot be determined by plain films, as the x-ray passes through the soft tissue. A study by Giles et al., stated that sixteen of the thirty patients (53%) had retrolisthesis of L5 on S1 ranging from 2–9 mm; these patients had either intervertebral disc bulging or protrusion on CT examination ranging from 3–7 mm into the spinal canal.