Spinal fusion in Iran is a surgical procedure used to correct problems with the small bones in the spine (vertebrae). It is essentially a "welding" process. The basic idea is to fuse together two or more vertebrae so that they heal into a single, solid bone. This is done to eliminate painful motion or to restore stability to the spine.
Spine surgery in Iran is usually recommended only when your doctor can pinpoint the source of your pain. To do this, your doctor may use imaging tests, such as x-rays, computerized tomography (CT) scans, and magnetic resonance imaging (MRI) scans.
Spinal fusion in Iran permanently connects two or more vertebrae in your spine to improve stability, correct a deformity or reduce pain.
The surgery can take several hours.
Spinal fusion in Iran will be performed to treat:
. Deformities of the spine. Spinal fusion can help correct spinal deformities, such as a sideways curvature of the spine (scoliosis).
. Spinal weakness or instability. Your spine may become unstable if there's abnormal or excessive motion between two vertebrae. This is a common side effect of severe arthritis in the spine. Spinal fusion can be used to restore spinal stability in such cases.
. Herniated disk. Spinal fusion may be used to stabilize the spine after removal of a damaged (herniated) disk.
Spinal fusion may also help relieve symptoms of many back problems, including:
. Degenerative disk disease (the space between disks narrows; sometimes they rub together spaces).
. Spondylolisthesis (forward shifting of a spinal disk)
. Spinal stenosis (narrowing of the spinal canal)
. Fractured vertebra (broken spinal bone)
. Spine Infection
As with any surgery, there are risks associated with spinal fusion. Your doctor will discuss each of the risks with you before your procedure and will take specific measures to help avoid potential complications.
Potential risks and complication of spinal fusion include:
. Infection. Antibiotics are regularly given to the patient before, during, and often after surgery to lessen the risk of infections.
. Bleeding. A certain amount of bleeding is expected, but this is not typically significant. It is not usually necessary to donate blood before spinal fusion.
. Pain at graft site. A small percentage of patients will experience persistent pain at the bone graft site.
. Recurring symptoms. Some patients may experience a recurrence of their original symptoms. There are various causes for this. If your original symptoms recur, inform your doctor so that he or she can determine what is causing your symptoms.
. Pseudarthrosis. This is a condition in which there is not enough bone formation. Patients who smoke are more likely to develop a pseudarthrosis. Other causes include diabetes and older age. Moving too soon—before the bone is able to start fusing—may also result in a pseudarthrosis. If this occurs, a second surgery may be needed in order to obtain a solid fusion.
. Nerve damage. It is possible that nerves or blood vessels may be injured during these operations. These complications are very rare.
. Blood clots. Another uncommon complication is the formation of blood clots in the legs. These pose significant danger if they break off and travel to the lungs.
. Donor bone graft complications like infection or tissue rejection.
Preparation before surgery may involve trimming hair over the surgical site and cleaning the area with a special soap or antiseptic. Additionally, the surgical team may order monitoring of any unhealthy bacteria in your nose by taking a swab sample. Tell your doctor about any medications you are taking. You may be asked to stop taking some medications before the surgery.
Surgeons perform spinal fusion while you're under general anesthesia so you're unconscious during the procedure. Surgeons have developed a variety of techniques for performing spinal fusion surgery. The technique your surgeon uses depends on the location of the vertebrae to be fused, the reason for the spinal fusion, and in some instances, your general health and body shape.
Generally, the procedure involves the following:
. Incision. To gain access to the vertebrae being fused, the surgeon makes an incision in one of three locations: in your neck or back directly over your spine, on either side of your spine, or in your abdomen or throat so that your surgeon can access the spine from the front.
. Bone graft preparation. The bone grafts that actually fuse two vertebrae together may come from a bone bank or from your own body, usually from your pelvis or hip. If your own bone is used, the surgeon makes an incision above your pelvic bone, removes a small portion of it and then closes the incision. Bone from another person is called a donor graft.
. Fusion. To fuse the vertebrae together permanently, the surgeon places the bone graft material between the vertebrae. Metal plates, screws or rods may be used to help hold the vertebrae together while the bone graft heals.
In selected cases, some surgeons use a synthetic substance instead of bone grafts. These synthetic substances help promote bone growth and speed the fusion of the vertebrae.
A hospital stay of two to three days is usually required following spinal fusion. Depending on the location and extent of your surgery, you may experience some pain and discomfort but the pain can usually be controlled well with medications.
After you go home, contact your doctor if you exhibit signs of infection, such as:
. Redness, tenderness or swelling
. Wound drainage
. Shaking chills
. Fever higher than 100.4 F (38 C)
It may take several months for the affected bones in your spine to heal and fuse together. Your doctor may recommend that you wear a brace for a time to keep your spine aligned correctly. Physical therapy can teach you how to move, sit, stand and walk in a manner that keeps your spine properly aligned.
After surgery, you will feel some pain. This is a natural part of the healing process. Your doctor and nurses will work to reduce your pain, which can help you recover from surgery faster.
Medications are often prescribed for short-term pain relief after surgery. Many types of medicines are available to help manage pain, including opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), and local anesthetics. Your doctor may use a combination of these medications to improve pain relief, as well as minimizing the need for opioids.
The fusion process takes time. It may be several months before the bone is solid, although your comfort level will often improve much faster. During this healing time, the fused spine must be kept in proper alignment. You will be taught how to move properly, reposition, sit, stand, and walk.
Your symptoms will gradually improve, as will your activity level. Right after your operation, your doctor may recommend only light activity, like walking. As you regain strength, you will be able to slowly increase your activity level. Physical therapy is typically started from 6 weeks to 3 months after surgery. Your surgeon will talk with you about whether physical therapy is needed in your situation.
Maintaining a healthy lifestyle and following your doctor's instructions will greatly increase your chances for a successful outcome.