Spinal Fusion

Many surgeries and procedures utilize spinal fusion to strengthen and stabilize your spine. Spinal fusion uses a bone graft between different vertebrae to remove damaged spinal material while providing additional stability to the spinal region. These procedures use bone grafts that are often held in places with screws, rods, and plates to ensure that the bone fusion is successful while limiting complications.

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Why It’s Done

Spinal fusion can be effective for numerous ailments and spinal issues that may rise. Spinal fusion may be a good option for you if you have any spine deformities or need corrective action taken to help straighten out your spine’s curvature. This procedure can also be highly useful in stabilizing the spine after removing a herniated disc. Additionally, if you experience arthritis or have abnormal motion between vertebrae, a spinal fusion procedure may be ideal to help you increase stability while reducing overall pain.

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“Posterior lumbar fusion may help ease low back and leg pain. Two or more vertebrae in the low back are fused. This is done through an incision in your low back (posterior). The graft may be put between the transverse processes, in the disk space, or both.”

(Krames, 2017, p 10)

“Spinal fusion surgery makes the spine more stable. It is done to help ease symptoms of back and neck problems. During the surgery, a substance called bone graft is put between two or more vertebrae. Over time, bone graft and nearby bone fuse (grow into a solid unit).”

(Krames, 2017, p 5)


There are some associated risks with a spinal fusion procedure which can include:

  • Infection
  • Bleeding
  • Blood clots
  • Poor wound healing
  • Injury to bloods vessels or nerves (in region around surgery)
  • Pain from bone graft site

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What To Expect?

During A Spinal Fusion


  1. In preparation for the procedure, you are positioned and anesthetized.
  2. The surgeon makes an incision in your skin. The tissues are gently moved aside to create a path to your spine.
  3. If your fusion is being performed as part of the procedure to relieve pressure on your spinal nerves, your spine may need to be modified.
  4. Your surgeon may remove part or all of the lamina from one or more vertebrae.
  5. If bony growths are pressing against your nerves, your surgeon removes these as well.
  6. To create the fusion, your surgeon uses bone graft. This graft can be taken from your own body or it can also come from a donor.
  7. The surgeon removed some bones from the surface of your vertebrae to create a bed where this graft can grow.
  8. The surgeon stabilizes your spine. This involves implanting hardware to lock the vertebrae together. Many devices are available. Your surgeon may use screws and rods, plates, or other devices.
  9. Finally, the graft is placed against your vertebrae.

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After Spinal Fusion


  1. When the procedure is complete, the incision is closed.
  2. You may be placed in a brace to support your spine.
  3. In the weeks after this surgery, new bone grows and attaches securely to the spine.
  4. This creates a permanent fusion.
  5. You may benefit from physical therapy as you heal

Medical Source

Types of Spinal Fusion

“Your doctor will determine which vertebrae to fuse. Fusing vertebrae in the neck is called cervical fusion. Fusing vertebrae in the low back is called lumbar fusion. Fusion can be done from the front of the spin (anterior fusion) or the back of the spine (posterior fusion). In some cases, both approaches are used. Your surgeon will recommend the best approach for you.”

(Krames, 2017, p 5)

Bone Graft

“Bone graft is what allows the vertebrae to grow together. Bone graft may be small pieces of bone taken from your own body. It may be from a human donor who has died. Or, it may be artificial bone substitute. Your surgeon will choose the type of graft that’s best for you.

  • If bone from a donor is used: Bone from donors is collected and stored by a bone back. Donated bone is screened carefully to ensure it is healthy and carries no disease.
  • If bone from your own body is used: This may be dbone removed from your spine or taken from your pelvic bone. Bone from your own body may work better than donor or bone substitute.”

(Krames, 2017, p 5)

Anterior Lumbar Fusion

“Anterior lumbar fusion may help ease low back and leg pain. Two or more vertebrae in the low back are fused. This is done though an incision in the front (anterior) of the body.

  • An incision is made in the abdomen to reach the spine.
  • Most of the disk is removed from inside of the vertebrae.
  • Bone graft is placed. It is usually put inside a device called a cage. The cage is filled with bone graft is placed in the space between the vertebrae.
  • To hold the spine steady as the bone graft fuses with the vertebrae, a metal plate and screws may be added. These typically stay in place and are not removed.
  • The incision is closed with sutures, staples, or surgical glue.”

(Krames, 2017, p 6)

Cervical Fusion

“To help ease neck and arm pain, two or more vertebrae in the neck are fused. This may be done through an incision in the front (anterior) of the neck or the back (posteriori) of the neck.

  • For an anterior fusion: An incision is mode on the front of the neck to reach the spine. Most of the disk is removed between the vertebrae. Then, bone graft is placed. It is often put inside a device called a cage. The cage is placed between the vertebrae.
  • For posterior fusion: An incision is made on the back of the neck. Bone graft is then placed on the back of the spine between the transverse processes. In either case, a metal plate or rod and screws may be added. These hold the spine steady as the bone graft fuses with the vertebrae. The supports typically stay in place and are not removed.
  • The incision is closed with sutures, staples, or surgical glue.”

(Krames, 2017, p 7)


Christopher P Demers neurosurgeon

Christopher Demers


Dante F. Vacca, MD, FAANS

Dante F. Vacca


Jay K. Morgan, MD, FAANS

Jay K. Morgan


Marshall Tolbert, MD, PhD, FAANS

Marshall Tolbert


Michael Moore neurosurgeon

Michael Moore


Frequently Asked Questions

What is Neurosurgery?

Most people think of neurosurgeons as brain surgeons, and this is true! However, neurosurgeons are more broadly defined as highly trained medical specialists who diagnose and treat disorders of the entire nervous system – including our brain, spinal cord, skull and the spine (bony vertebral column). Of course, they operate on the brain, but they actually spend more of their time helping patients with spine and peripheral nerve disorders.

Do I need surgery if I am being referred to a neurosurgeon?

Not necessarily. Your referring physician most likely believes that you have a disease or disorder which would benefit from diagnoses, testing and treatment by a neurosurgeon. The decision whether or not to recommend surgery is a complex one, best handled by your neurosurgeon and his/her team.

What is the difference between an orthopedic surgeon and a neurosurgeon?

Each of these surgical specialists has their own areas of expertise however, their skill and expertise overlap in the area of spinal surgery. Both specialties require 5-7 years of residency training, followed in some cases by additional time in fellowship training. Neurosurgeons perform spinal operations dealing with the cervical discs, nerves, and the bony spine, while orthopedic surgeons handle surgeries limited to the bony spine, such as spinal fusion.

How do I make an appointment with Sierra Neurosurgery Group?

Call us today at (775) 323-2080 or toll free (888) 323-2080.  We have 5 locations to serve you: Carson City, Elko, Fallon, Reno and Sparks.  If your health insurance plan requires a referral, contact your primary care or emergency room physician and request a referral to Sierra Neurosurgery Group.

What is the difference between a neurologist and a neurosurgeon?

A neurologist and a neurosurgeon are similar to a cardiologist and a cardiac surgeon: the neurosurgeon can offer a surgical solution to neurologic disorders, while the neurologist identifies neurological disorders through diagnostic testing and uses non-surgical treatment options.

Do you offer X-rays and MRI’s?

Sierra Neurosurgery offers comprehensive imaging services at our Reno office on Kietzke Lane, including X-Ray services and MRI scans with & without contrast.  This provides a quick, easy and no-hassle way to complete necessary imaging as part of your treatment plan.

What to Expect From Your Visit

Sierra Neurosurgery Group is focused on providing the highest quality surgeries with the best possible patient care. We focus on creating a unique experience for each of our patients to show them we understand their current situation and to do our best to help them get back to living the life they want. We provide the best care to our patients because we have assembled a team of professionals with extensive surgical experience consisting of neurosurgeons, physician assistants, nurse practitioners, and interventional pain specialists. Our personnel, focus on patients, and quality of care allows Sierra Neurosurgery Group to be highly effective in creating the best results and outcomes for our patients.