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Spine Surgery : Spine Fusion, Posterior
Posterior fusion is done by placing bone on the posterior parts of the vertebras. This however makes it difficult to operate again at the same level should the need arise. Posterior fusion can also lead to overgrowth of bone that eventually could pinch the nerve roots. This technique is rarely used today.
More recently, posterolateral fusion has been used. The bone graft is placed along the sides of the vertebras.
The rate of fusion improves markedly if some stabilizing system is used besides a back brace. Those systems are referred as instrumentation, i.e., a combination of rods, screws and hooks made of stainless steel or nonmagnetic titanium that are placed on the spine and rigidly connected together.
Although it is better than purely posterior fusion, the posterolateral technique necessitates a great deal of dissection of the surrounding muscles and ligaments and it is believed that this contributes to postoperative pain. This is the main reason why the current trend favors interbody fusion.
Sometimes, the posterior fusion can be strengthened by fusing the vertebral bodies as well. This is called a 360 degree fusion as it is done both in the front and back of the vertebral body.
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