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Patients with spinal instability or chronic back pain may require spinal fusion surgery. This surgery is done to stabilize and strengthen the spine and to alleviate severe, chronic back pain. Spinal fusion surgery is a common treatment for such spinal disorders as spondylolisthesis, scoliosis, severe disc degeneration or spinal fractures. Fusion surgery is usually considered only after non-operative therapies have failed.
What is fusion?
Spinal fusion is the joining or fusing of two or more vertebrae. Bone graft is traditionally used to facilitate fusion. This involves small amounts of bone being taken from the patient’s pelvis (autograft), or from a donor (allograft), and then packed between the vertebrae in order to "fuse" them together.
Specially designed implants (including cages, rods, hooks and screws) are also often used in a fusion surgery. The implants are used to ensure correct alignment between vertebrae and to help successful fusion to take place. In addition, these implants add strength and stability to the spine while healing progresses.
A fusion is not always achieved after surgery. Fusion rates vary depending on such factors such as whether or not the patient smokes, number of previous procedures, and the underlying pathology. However, there has recently been a breakthrough relating to fusions. Surgeons are now able to use bone substitutes such as bone morphogenetic proteins (BMPs) during surgery to facilitate fusion. BMP is a "substance" that causes bone growth. The use of BMP in fusion surgery is already improving fusion rates.
PLIF and ALIF
The two most common interbody fusion techniques used to treat chronic low back pain are PLIF and ALIF.
PLIF stands for Posterior Lumbar Interbody Fusion. It is a fusion technique done from the back (posterior) of the lumbar spine. The PLIF procedure involves three basic steps:
ALIF, which stands for Anterior Lumbar Interbody Fusion, is similar to PLIF. However, it is done from the front (anterior) of the body.
About Dr. Goldstein
Minimally Invasive Surgery
Cervical Degenerative Disc
Cervical Herniated Discs
Lumbar Degenerative Disc
Lumbar Disc Herniation
Dr. Goldstein is recognized as one of the leading spine surgeons in New York. His expertise is sought by television, media, and magazines. His practice is focused on surgical treatment:About Dr. Goldstein »
Dr. Goldstein serves as Director of the Spine Service at NYU Langone Medical Center Hospital for Joint Diseases.
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