Spinal fusion procedures have become increasingly common. Among the patients who have undergone this procedure are athletes with spinal injuries, including Peyton Manning and Tiger Woods. This has allowed them to extend careers that would have ended without modern surgical techniques.
The human spine consists of a system of nerves, bones, cartilage and ligaments divided into the cervical, thoracic and lumbar segments. The cervical segment is the uppermost segment and the lumbar is the lowest.
The vertebrae are bones that surround and protect the spinal cord and nerve roots. Cartilage provides cushioning between the vertebrae. Ligaments that allow the spinal segment to bend and twist hold the vertebrae and cartilage together.
Spinal injuries typically result in extreme amounts of pain given the intimate association with nerves. These injuries include fractures of bone and cartilage, as well as displacement of the cartilaginous discs that can impinge on the nerve roots. Repetitive trauma to the spinal elements can result in arthritis that will narrow the passages through which the nerve roots exit.
Often surgery is required to alleviate these conditions. Multiple surgeries will eventually alter the complex mechanics involved in coordinating spinal movement.
Spinal fusion involves joining bony vertebrae together with the use of metal plates and screws as well as bony fragments that eventually form a solid body of one or more levels. This will result in diminished flexibility and range of motion at those levels.
“With modern surgical techniques, many athletes of all levels can return to sports after one or two level lumbar (low back) and cervical (neck) fusions. Prior to return to sport it must be confirmed that the bone has successfully healed, which can take up to one year from the time of surgery” said Dr. Isaac Moss, assistant professor of orthopaedic and neurosurgery at UConn. “The most significant determinants of return to sport are usually the patient’s preoperative level of function and the extent of surgery required to fix the problem. I recommend that patients be upfront with their surgeon prior to surgery and discuss their functional goals once they have recovered to make sure that the optimal surgical procedure is selected and their post-op expectations are realistic.”
Spinal fusion does not have to be a game-ending condition.
Dr. Alessi is a neurologist in Norwich and serves as an on-air contributor for ESPN. He is director of UConn NeuroSport and can be reached at firstname.lastname@example.org