Historically, spinal fusion has been performed with a bone graft without implants. However, the fusion rate with this technique is notoriously low, in the 50% range. The clinical result of spinal fusion without implants is also not very good. In addition, patients treated in this manner are often immobilized with prolonged bracing and/or bed rest for weeks or months. Modern techniques utilizing pedicle screw fixation with plates or rods in combination with devices replacing the disc have resulted in fusion rates of well more than 95% and associated increases in clinical results to around 70%. Thus, the use of implants is not necessary, but certainly an advantage in terms of rapid rehabilitation to the patient and better clinical results with higher fusion rates.
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Spinal instrumentation has improved the outcomes of spinal fusions a great deal in modern spinal surgery. Your spine surgeons will use those techniques that will likely lead to the most favorable outcome.
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Implants can significantly help with reducing pain and improving fusion rates or increasing stability in the spine. A number of different implants are available. Each implant is best suited for a specific spinal condition or conditions. Most experienced spinal surgeons can recommend the best implant to help maximize the benefits and minimize the risks of surgery.
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For some problems, spinal fusion can be performed without instrumentation. For most forms of spinal fusion operation, instrumentation is used to supplement the bony bridging. The bone bridging takes a period of time to grow across the space between the bones and the instrumentation provides immediate stability until the bones grow together. Also any slight motion between bones is known to reduce the chances of the bones effectively growing together. The instrumentation immobilizes the bones, reducing the chance of failure of fusion.
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Instrumentation serves as an internal splint or a cast to allow a bony fusion to occur. It has been shown in multiple studies that the use of this internal splint clearly increases the chance of getting a solid fusion the first time around so that the patient can avoid further surgery.
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The use of implants traditionally increases fusion rates and therefore increases the reliability of the outcome of the surgery. Today, most surgeons use titanium cages for a one level.
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Spinal implants, such as screws and rods, have been widely used by spine surgeons for many years. While they are not necessary in every spinal operation, they are often helpful in promoting a successful fusion, correcting deformity and/or controlling instability.
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Before implants were invented, braces were used postoperatively to keep the stability of the spine until the spine healed. The benefit of using an implant is that you don't need to wear a brace for that long of a period of time and you can go back to your activities sooner without worrying about the spine becoming unstable. If for whatever reason my patient does not want an implant, then we can go back to the older methods of spine surgery and do the surgery without an implant. But most of the time the patient does much better with an implant.
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The use of implants which may consist of screws and rods or plates or even a cage are sometimes helpful to hold the spine still while your body heals the bone across the segments. The specific instance when implants are needed is really a judgment call by the surgeon. They are almost always needed for fractures and correction of deformities and may be helpful for more routine degenerative problems as well.
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This question cannot be answered without the specific information of the case. Clearly, before spinal instrumentation, spinal fusion was accomplished. However, spinal instrumentation does improve the success of spinal fusion and allows a quicker recovery and return to normal activities. After successful spinal fusion, spinal instrumentation can be removed safely with no consequence, and is even recommended by many spinal surgeons.
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I believe instrumentation is always necessary because it increases the success rate by diminishing the likelihood of the vertebrae not fusing; a condition known as "psuedoarthrosis." The other main advantage to using screws and rods is that in most cases, the patients do not need a brace after surgery because the plate acts as an internal splint. In general, plates used today are titanium which do not set off metal detectors and are MRI compatible.
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Well there are a lot of spinal implants out there and they are made from materials that are very biocompatible. That means that your body will not reject them. They've been studied extensively and they are very safe. The reason why he will use those implants is that they will increase the success of that surgery.
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Most spine surgeons prefer to use implants in the spine. Implants provide immediate stability and allow for early rehabilitation. External fixation of the spine like casts and braces do not provide rigid fixation and are associated with less successful fusion rates as well as increased pain in the period around the time of the operation (the perioperative period).
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Implants are used during spinal fusion procedures for several reasons. They allow for correction of deformities, help hold the spine in proper alignment, allow restoration of collapsed disc spaces and stabilize the spine, increasing the chance of a solid fusion.
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Titanium screws and rods to help augment a spinal fusion have been used successfully for years. The chances of a fusion successfully healing go up when there is an internal brace added to the spine. The rods and screws serve both to move the spine into a better position and to hold it there while it heals.
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The spinal instrumentation serves two purposes. First, it allows the surgeon to restore the alignment and balance of your spine. Second, the instrumentation acts as an internal brace, stabilizing the spine while the bone fusion grows.
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Well some sort of implant is always necessary to get adequate fusion if you are going to do a fusion. In order to create a fusion, you have to put bone where the disc was, so that is an implant even if it is your own bone. Then to be able to achieve an adequate fusion, really the success rate is much higher if you put in screws and rods to help with stability. So by and large, it is necessary and there is really no way to get around some form of implant if we are going to be doing a fusion.
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In the 1920s surgeons started performing fusions. These were called in-site fusions, where all you did was weld the vertebral bodies together. If you want to correct the deformity, you need spinal implants in order to improve the spinal alignment. So implants are important, not only in achieving higher rates of fusion, but also even more importantly in correcting any type of deformity. In order to increase the swayback in order to increase the lordosis, in order to increase the disc height, implants are very important in that regard.
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The answer to this question depends on the specific condition being treated. Some only require decompression. In this situation, implants are not required. However, other conditions, such as spinal instability, scoliosis, trauma or degenerative disease, may require fusion. Spinal implants have dramatically improved the success rate of spinal fusions. The implants act as an internal splint to stabilize the spine while the fusion occurs. Use of these implants leads to improved fusion rates, less time spent in a brace, and better patient outcomes.
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The use of screws and rods in the spine, for the purpose of spinal fusion, have proven to be a great benefit to the patient and spinal surgeon alike. This instrumentation allows us to secure the individual vertebrae, which need to be fused. This dramatically increases the rate of fusion and allows patients to mobilize and perform activities more freely, while the fusion process is occurring after surgery. With earlier and increased mobility after surgery, the patient can return more quickly to normal activities. The use of spinal instrumentation also allows the surgeon to correct conditions of instability and deformity, which would not be possible without these implants. Indeed, the use of spinal instrumentation has become the accepted standard in spinal fusion surgery.
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Spinal instrumentation has improved the outcomes of spinal fusions a great deal in modern spinal surgery. The instrumentation acts as an "internal brace". Your spine surgeon will use those techniques that will likely lead to the most favorable outcome. These implants are generally permanent and usually do not need to be removed.
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The success of spinal surgery has progressed light years over the last 2 decades, in large part because of improvements in spinal instrumentation and how it is used. To forego the latest in technology is the same as requesting a 1950s surgical result. No one would want that.
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When a spinal fusion is performed, bone is grafted from a donor site to the part of the spine that is generating the pain. The inflammation is associated with motion and elimination of the motion reduces the inflammation and therefore the pain. The bone graft becomes a living, permanent stabilizer of the painful motion segment but only after it has undergone a complex metamorphosis involving the in-growth of blood vessels and the laying down of new bone over the graft. Research has shown that restricting spinal motion during this process improves the success rate. Bracing has a limited ability to limit spinal motion while internal fixation with rods and screws allows immediate stabilization without restricting the rest of the back. Titanium has been shown to be well tolerated by the body compared to other metals. In addition titanium has less effect on MRI or CT images if follow-up studies are required. Newer techniques allow for stabilization of the spine with implants placed within the disc space between adjacent vertebral bodies. In many cases this can be performed without the need for supplemental fixation using metallic rods and screws. There is a growing trend to use bone implants in place of metal, allowing adequate stabilization without the use of any metal at all. It is the responsibility of the spinal surgeon to decide what is the best instrumentation choice for the patient's proposed surgery.
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On most occurrences that calls for a fusion.
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The use of implants raises the success rate for a spinal fusion and, as such, is for the most part recommended.
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Fusion rates have been improved with the use of implants in the lumbar spine. Implants stabilize the spine and allow fusion to occur. An example is the LT-CAGE® Lumbar Tapered Fusion Device.
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Instrumentation increases the chance that a fusion will occur. Especially in instances of a high risk of pseudarthrosis (non-union), instrumentation is very necessary.
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Yes; for a spinal fusion; because he would be removing disc-foramen at laminectomy and has to stabilize the spine.
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