A spinal fusion procedure is designed to help limit movement in an area of your spine by fusing two spinal vertebrae together. Although plates, screws and other surgical instrumentation are used, what eventually holds the section in place is the growth and union of a bone graft in the area.
Unfortunately, this bone graft doesn’t always heal as expected and can lead to a non-union of the two vertebral sections, bringing with it a host of potential symptoms and complications. Below, we explain why a non-union can occur after a spinal fusion, and how the issue is treated.
Why A Non-Union Can Occur After Spinal Fusion
A non-union, also known as pseudarthosis, can occur after a spinal fusion procedure for a variety of reasons, only some of which are modifiable by the patient. This means that while you can have some control over whether or not your spinal fusion procedure succeeds, sometimes you can do everything right and still end up with a non-union. Here’s a look at some of the reasons and factors that can contribute to a non-union after a spinal fusion procedure.
- Older age
- Diabetes
- Infection onset
- Poor diet
- Medications
- Anemia
- Smoking or tobacco use
- Surgical skill
As you can see by looking at some of the above factors, you’ll notice a common theme among them. Issues that inhibit healthy blood flow or that contribute to a sub-optimal healing environment for the fusion site are the main reasons why a fusion site will fail to union. You can try to improve your diet, cut out tobacco and manage your diabetes, but you can’t make yourself younger or prevent against certain infections, so there’s only so much you can do to prevent against a failed union.
It takes a long time for your fusion to successfully connect the two vertebral portions after a surgical procedure, but if you’re experiencing pain nine months after your fusion operation, there’s a chance you’re dealing with a non-union. It’s worth noting that some non-unions can still provide enough area support such that the condition is asymptomatic, but for other patients, they’ll deal with pain, numbness and tingling sensations at the site of their operation.
Diagnosing and Treating Spinal Fusion Non-Union
If a non-union after spinal fusion is suspected, the doctor will talk with the patient about their symptoms, perform a physical exam and order some imaging tests. An X-ray can help to determine the extent of the bone grant and whether or not it successfully connected the adjacent vertebrae. A CT scan can also help with this determination. Blood tests may also be ordered to check for anemia or the possible presence of an infection.
Treatment of a non-union can be done using conservative or operative techniques, depending on the patient’s wishes and needs. If the surgeon believes a conservative approach may be best, they may use what’s known as a bone stimulator to help speed up the healing process. A bone stimulator uses ultrasonic or pulsed electromagnetic waves to stimulate healing in the area. Eventually, this can help to connect the fusion site.
If more hands-on care is required, a secondary surgery may be in order. Another surgery to add bone graft to the area can help give it the boost it needs to eventually union. It’s not ideal to undergo a secondary surgery, but it’s an unfortunate reality for a very small percentage of patients after a spinal fusion procedure. However, these secondary operations oftentimes produce encouraging results.
For more information about the spinal fusion procedure or the union of the fusion site, reach out to Dr. Chang’s office today.