Spine Surgery

Keyhole Spinal
Fusion Surgery

Keyhole Spinal Fusion Surgery

Keyhole Spinal Fusion Surgery

What is spinal fusion surgery?

  • This is a procedure where one or more spinal levels are fixed with screws and rods to permanently stop them from moving
  • It usually requires placing some fresh bone in the disc space and may require the insertion of a plastic or metal ‘cage’ for added stability
  • The bones on either side of the disc space knit together over a period of 6 months to 1 year
  • Here the fresh bone is like a slow setting concrete and the screws and rod are like the scaffolding that holds the concrete
Keyhole Spinal Fusion Surgery

What are the indications for spinal fusion surgery?

  • Spinal fusion is usually done when the spinal segment has excessive mobility which is called ‘instability’
  • Instability can be the cause of leg pain because the nerves between the bones can be pinched
  • Instability can also cause back pain by damaging the jelly between the bones
  • Spinal fusion surgery treats the above 2 issues by abolishing the movement at the spinal level
  • Other indications for spinal fusion or stabilization would be when there is a fracture of the spine or there is a tumour of the spine
Keyhole Spinal Fusion Surgery
Keyhole Spinal Fusion Surgery

How is Spinal fusion surgery done?

  • This involves the exposure of the relevant bony parts by stripping the muscle covering them
  • Some of the bone is then removed to allow access to the disc in between the bones
  • The disc is then removed as much as possible
  • The space left behind is filled with fresh bone. Sometimes a plastic or titanium cage is also placed inside the disc space
  • 2 screws are placed in each bone, 1 on each side of the midline
  • These screws are then connected with rods which are tightened up so the spinal level is held rigidly
Keyhole Spinal Fusion Surgery

What is ‘Keyhole Spinal Fusion Surgery’?

  • Spinal fusion can be done through smaller incisions that do not require the muscles to be completely stripped off the bone
  • The screws and rods can be placed under Xray control or with computer aided navigation
  • The removal of the disc and the placement of the cage is under microscope visualization
Keyhole Spinal Fusion Surgery

What are the advantages of ‘Keyhole Spinal Fusion Surgery’?

  • Because of minimal muscle stripping, there is less bleeding and less pain after the surgery
  • Less pain medication is usually required
  • The return to function is quicker and the hospital stay is shorter
  • There is less damage to the structures adjacent to the level that is being operated on
Keyhole Spinal Fusion Surgery

Are there any disadvantages to ‘Keyhole Spinal Fusion Surgery’?

  • It usually requires that your surgeon be trained in these techniques
  • The costs can be higher due to the use of specialized instruments
  • The surgery may take longer
  • Sometime, we may need to convert to normal open surgery for reasons of safety and if keyhole surgery is insufficient

Will my spine feel stiff after fusion surgery?

  • While spinal fusion takes away movement at the level/s that are fused, the other levels are usually able to make up for this
  • Because fusion surgery can improve your pain, your back movement may actually be better after fusion surgery

Do the screws need to be removed after some time?

  • Usually there is no need to remove any of the screws after fusion surgery
  • These screws may not trigger metal detectors at the airports, but you will still be provided with an official card to explain this if it happens


Keyhole Spinal Fusion Surgery