Lumbar Interbody Fusion Holds Up over Time
Since the Genome project, spinal fusion has changed dramatically. New understanding of how bone grows is changing the way doctors treat chronic low back pain. This report reviews those changes in detail. The history of spinal fusion is reviewed from 50 years ago to today.

During this transition time, we are moving from using bone chips and metal screws and plates on the outside of the spine to fusion from the inside out. This new way to fuse the spine is called interbody fusion.

In interbody fusion, special bone growth cells are placed on a sponge the size of a thumbnail. The sponge is put inside a titanium cage. The cage is then inserted between two vertebral bones in place of the disc. The cage restores the normal disc height while new bone cells grow inside the cage. Over time new bone forms around the outside of the cage, forming a solid fusion.

The authors say doctors won't give up other ways to fuse the spine. Each method has its own benefits and drawbacks. The key is to find out what each patient needs and match the fusion to those needs. For example, when three or more levels are affected, interbody fusion is not the best choice. The patient is more likely to need metal plates, rods, and screws.

Today's surgeon must be able to use many different methods of fusion. At the same time, new ways to repair and restore the spine are being developed rapidly. This report suggests that interbody fusion, artificial discs, and vertebral bone replacement are all part of the future for the spinal surgeon.
Praveen V. Mummaneni, MD, et al. Lumbar Interbody Fusion: State-of-the-Art Technical Advances. In Journal of Neurosurgery: Spine. July 2004. Vol. 1. No. 1. Pp. 24-30.