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Spinal Instrumentation // Pic from @medschool_life Sometimes patients with severe Degenerative Disk Disease or other conditions which impact the integrity of the spine may need spinal fusion surgery. Various instrumentation (medical devices) are utilized to improve the rate of successful spinal fusion. Instrumentation can facilitate spinal fusion by limiting the amount of movement the spine is exposed to. There are three primary types of medical devices utilized when performing spinal fusion surgery: pedicle screws, anterior interbody cages, and posterior lumbar cages. Pedicle screws themselves are embedded into separate spinal segments and provide a firm anchor point for rods which then connect separate spinal components together, arresting their motion. Screws are places in 2-3 consecutive spine segments (e.g. Lumbar 4/5). A short rod can then connect the sets of screws and segments 4/5 now act as one segment, and the reduced movement can make their fusion more probable. As recently as 1996, surgeons have also used anterior interbody cages to aid in bone fusion. In this procedure, a porous titanium cylinder is placed within the disc space between two segments of spine. The holes within the cylinder allow the bone graft (material which induces bone growth) to grow from one vertebral body to another while passing through the cylinder. This procedure has diminished morbidity and improved fixation, all while allowing less overall instrumentation to be needed by the patient. Finally, posterior lumbar cages can be used when managing spinal issues in the lumbar region. A small incision is made and the laminae of the spine can be removed from one or two segments. This procedure will reduce the amount of pressure on nerve roots by placing metallic cages within the disc space. Bone graft is placed within the cages to aid in fusion. Sometimes this procedure is used in complex with pedicle screws and rod placement to further aid in remediation. Imaged above is a spine that has undergone screw pedicle installation along with rod fixation.

A photo posted by High Definition Neurology (@brainpage) on Mar 7, 2016 at 1:05pm PST