How Are Implants Used In Spinal Surgery?
With rapidly advancing medical technology, spinal implants have become more advanced and widely used in recent years. Implants can facilitate and improve the outcomes of spinal procedures by providing support and stabilization.
Spinal implants are used in many different types of surgery to alleviate back pain. Here, we’ll go over the applications of spinal implants to enhance the results of spine surgery.
Which Types of Spinal Surgery Use Implants?
Surgeons may opt to use spinal implants in several different surgical procedures. These types of surgery fall into 2 main categories: spinal decompression and interbody fusion.
Implants may be used in several different spinal procedures. For one, implants are often used after spinal decompression, which encompasses the following procedures:
- Laminectomy and laminotomy
Laminectomy and laminotomy are forms of spinal decompression that involve removing some or all of the lamina. The lamina is a section of bone that covers and protects the back side of the spinal cord.
In laminectomy, the entire lamina of the affected vertebra is removed. In laminotomy, only a small section of the lamina is removed.
Foraminotomy is a decompression procedure that involves expanding the area through which a nerve root leaves the spinal canal. This form of spinal surgery is most commonly used to treat nerve compression caused by spinal stenosis.
In discectomy, the injured portion of a spinal disc is removed. Discectomy is widely used to treat herniated discs that cause nerve compression. This procedure can alleviate back pain and sciatica symptoms.
Corpectomy involves removing some or all of a vertebral body, which is the primary part of a vertebra, and an intervertebral disc. The goal of this surgical procedure is to release pressure on the adjacent spinal nerves.
Interbody fusions also involve the use of spinal implants. An interbody fusion involves removing part or all of the damaged spinal disc. The surgeon may then either perform spinal fusion or use a non-fusion spinal implant.
There are several approaches to interbody fusion, including:
ALIF is short for anterior lumbar interbody fusion. This approach involves accessing the spine with an anterior approach, meaning that the incision is positioned in the abdomen. ALIF leaves the large back muscles and nerves undisrupted.
PLIF stands for posterior lumbar interbody fusion. It’s the most widely-used approach to interbody fusion and is generally performed on the lumbar spine.
With PLIF, the spine is accessed from the back. Laminectomy is then performed to create access to the nerve roots. Then, the nerves can be moved aside, the disc material can be removed, and, in the case of spinal fusion, the bone graft material can be positioned.
TLIF is an acronym for transforaminal lumbar interbody fusion. This method involves fusing both the front and back spinal columns by accessing the spine through the back. TLIF is considered a contemporary method of interbody fusion and can facilitate the fusion process.
XLIF stands for extreme lateral interbody fusion. It’s a minimally-invasive method that involves a small incision located in the patient’s flank. XLIF results in less pain, blood loss, and recovery time than conventional interbody fusion.
Fusion and Non-Fusion Spinal Implants
Implants for spinal surgery can be separated into two key categories: fusion and non-fusion. Spinal fusion is a procedure that’s commonly done alongside decompression and other types of spine surgery.
During fusion, the surgeon places bone graft material in between two vertebrae (typically after removing a portion of damaged tissue). Over time, the bone graft material will stimulate new bone development and permanently fuse the affected vertebrae.
- Fusion implants
Implants that are used with spinal fusion typically include rods, plates, and/or cages. These implants are designed to stabilize the vertebrae so that the bone graft material can be positioned and kept in place. Pedicle screws and hooks are commonly used to secure these implants to the vertebrae.
- Non-fusion implants
Non-fusion implants are used as an alternative to conventional spinal fusion. These implants work by supporting and stabilizing the spine without permanently fusing the vertebrae. This preserves the movement of the spine so that patients can still have a regular range of motion after spinal surgery.
Comparing Fusion and Non-Fusion Surgery
Spinal fusion is widely used to prevent spinal instability in surgery for spinal stenosis, spondylolisthesis, slipped disc, degenerative disc disease, vertebral fractures, and scoliosis. Fusion can prevent instability and reduce the patient’s risk of injury.
Unfortunately, there are several downsides to spinal fusion. These include:
- Hospital time
Patients generally need a hospital stay of two to four days after spinal fusion. In contrast, some non-fusion spinal implants allow for an outpatient procedure.
- Recovery period
Patients may need 6 months to a year to recover fully from spinal fusion. It may take as long as 4 to 6 weeks to return to an office job, and 3 months to return to light physical activity. Additionally, since spinal fusion involves comprehensive bone work, it can cause significant back pain during the recovery period.
- Lost spinal flexibility
Many patients experience a loss of spinal mobility after spinal fusion. They may struggle to bend over, rotate, and perform various spinal stretches. Additionally, reduced flexibility from spinal fusion can reduce your ability to partake in sports and other physical activities.
- Potential medical complications
A lumbar motion spine surgery implant can stabilize the spine while preventing lost range of motion in the lower back. Whether used in lumbar laminectomy, slipped disc surgery, spondylolisthesis surgery, or related spinal surgeries, spine devices can serve as excellent spinal fusion alternatives.
Spinal implants are medical devices that are broadly used to facilitate spine surgery. With recently developed technology, spinal implants can reduce the need for fusion and decrease the risk of complications from surgical treatment.