Complex spinal disorders include those that involve degeneration or instability of the spine with or without compression of the spinal cord or nerve roots and can result in neck and back pain, in addition to arm and leg pain. This includes instability due to degenerative arthritis, fractures, tumors, infection, scoliosis and spondylolisthesis. Patients often require surgical fusion of the spine for stabilization.

Spinal fusion is an operation that creates a solid union between two or more vertebrae. This procedure may assist in strengthening and stabilizing the spine and may thereby help to alleviate severe neck or back pain and prevent neurological injury.

Almost all of the surgical treatment options for fusing the spine involve placement of cage or spacer between the vertebrae. Spacers are often supplemented with bone from the hip or from another bone in the same patient (autograft) or from a bone bank (allograft). Bone graft extenders and bone morphogenetic proteins (hormones that cause bone to grow inside the body) can also be used to reduce or eliminate the need for bone grafts.


Fusion may or may not involve use of supplemental hardware (instrumentation) such as plates, screws, and cages. This fusing of the bone graft with the bones of the spine will provide a permanent union between those bones. Once that occurs, the hardware is no longer needed, but the hardware is generally left in place rather than go through another surgery to remove it.

Fusion can often be performed via smaller incisions through minimally invasive surgical (MIS) techniques. The use of advanced fluoroscopy, CT guided stereotactic navigation, and endoscopy has improved the accuracy of incisions and hardware placement, minimizing tissue trauma while enabling an MIS approach. The doctors at the Neurosurgical Group of Texas are experts that specialize in these minimally invasive techniques.

Minimally Invasive Lumbar Fusion Procedures

Minimally Invasive Lateral Interbody Fusion (XLIF)
Minimally Invasive Posterior Lumbar Interbody Fusion (PLIF)
Minimally Invasive Transforaminal Lumbar Interbody Fusion (TLIF)
Minimally Invasive Lumbar Vertebrectomy
Minimally Invasive Posterior Thoracic Fusion and/or Vertebral Replacement


Procedures Approach Typical Incision Size(s) Surgery Duration
XLIF Side 4cm 1 to 1 1/2 hours
PLIF Back two 2.5cm 3 to 3 1/2 hours
TLIF Back two 2cm - 3cm 3 hours

Cervical Fusion Procedures

Anterior Cervical Discectomy and Fusion (ACDF)
Cervical Vertebrectomy
Posterior Cervical Fusion
Occipitocervical Fusion
Atlantoaxial Fusion

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