Spinal fusion surgery in India: a guide before you decide

What is spinal fusion?

The bones of the spine are called vertebrae. In fusion the surgeon places bone graft between or over the vertebrae so that they grow together. MedlinePlus describes three graft sources: your own bone, usually from near the pelvis; donor bone from a bone bank; or an artificial substitute. Rods, screws, plates or cages often hold the bones still while the graft heals.

The operation is done under general anaesthetic. Depending on the level, the surgeon may work from the back, the side or the front of the neck. Fusion is often combined with another procedure such as a discectomy or laminectomy.

Who may be considered for spinal fusion?

MedlinePlus lists reasons for fusion:

• alongside other operations for spinal stenosis, or after a neck discectomy
• injuries or fractures of the spinal bones
• a weak or unstable spine caused by infection or tumours
• spondylolisthesis, where one vertebra slips forward on another
• abnormal curves such as scoliosis or kyphosis
• arthritis in the spine

MedlinePlus is frank that surgery does not always improve pain and can sometimes make it worse. It notes that fusion is unlikely to take away all symptoms of long-term back pain. Ask your surgeon what the operation aims to achieve for you, and consider a second opinion before agreeing to fusion for back pain alone.

Which reports does a spine surgeon usually ask for?

Ask the hospital whether it needs:

• an MRI of the relevant part of the spine with the images
• standing X-rays, including bending views if available
• a CT scan if one has been done
• nerve conduction studies, if done
• a clear account of leg or arm symptoms, numbness, weakness and bladder or bowel changes
• treatments already tried, such as physiotherapy or injections

How do I plan a spinal fusion trip?

MedlinePlus describes a hospital stay of a few days and teaching on log-rolling to get out of bed without twisting the spine. You may need a brace when you leave. Plan for remote review, a plan and estimate, visas, arrival and checks, surgery, a hospital stay, and a period near the hospital until your surgeon is satisfied you can manage a long flight.

MedlinePlus advises reducing or stopping smoking, because it slows healing. Tell the team about any blood thinners well before travel. Bring an attendant for the whole trip. Ask for wheelchair help and seating that lets you stand and move during the flight, as your surgeon advises. Arrange physiotherapy and a spine doctor at home.

What should I ask the hospital before booking?

• What exactly is causing my symptoms on the scans?
• What do you expect fusion to change and what will it not change?
• How many levels will be fused and which graft will you use?
• Will I need a brace and for how long?
• What restrictions apply on sitting, lifting and flying?
• Who will review my follow-up X-rays at home?