... for spondylolisthesis (slipped vertebra), advanced degeneration or instabilities!!

L5/S1 spondylolisthesis before surgery.	Spondylolisthesis in the frontal view before surgery
Situation after the operation side. The vertebral bodies are back on top	Post operative image in the frontal view
A spondylodesis (fusion or stiffening surgery) should always be considered as a last resort, as it is an irreversible surgical intervention. Screws are fixed in the vertebral bodies and then interconnected with a bar. The aim is to obtain a complete immobilization of the affected spine section (stiffening). An additional insertion of “cages” (placeholders made out of titanium, carbon or organic polymer thermoplastics like polyetheretherketones PEEK) for a ventral support is nowadays considered as state-of-the art. The quoted success rates of those stiffening surgeries differ considerably in scientific literature. An estimated average is 85%.

Spondylodesis for scoliosis

A scoliosis surgery is a considerable and irreversible intervention. The distorted segment of the spine will be aligned and stiffened (fusion, spondylodesis) simultaneously. The intervention is done either from the front (ventral access) or from the back (dorsal access) – in rare cases both access points will be used concomitantly. After such a stiffening surgery other surgical or conservative treatment options are no longer available. It must hence always be regarded as a last resort if all other non-surgical therapeutic methods have failed and if there is no hope that with conservative care there will be any success.

How is surgery carried out?

The insertion of the screws and bars is done through an incision at the centre line of the back at the level of the affected spine section. If no additional ventral fusion is planned, eventually bone grafts from the iliac crest will be taken and placed at the rear part of the spine. This will further support osseous stiffening.

If an additional ventral support and fusion is planned, the point of entrance will be an incision at the left abdomen. The spinal disk will be removed and replaced by a cage (placeholder made of bone graft, titanium or organic polymer thermoplastics like polyetheretherketones PEEK).

The intervention is done under general anesthesia and takes about two hours. You will be able to walk by yourself already two hours after surgery and you may go back home again after three days.

What post-operative care is necessary?

About six weeks you will have to carry a specially fitted corset and then it is recommended to start an individually targeted and professionally supervised physiotherapy.

When may I resume my sports activities?

After about 12 weeks you should be able to go swimming or to ride your bicycle. You may gradually resume your usual sports activities after 6 to 9 months.

When can I go back to work?

After six weeks you can resume simple office work and slight physical work. You shouldn’t do any hard physical work during the first 8 weeks and then only gradually increase.

What is the success rate?

In the international scientific literature success rates of more than 80% are quoted.