What is Laparoscopic Spinal Fusion?

Patients with degenerative spinal disease may require spinal fusion surgery to stabilize the vertebrae and alleviate severe, chronic back pain. Traditionally, spinal fusion was performed as open surgery, and while it has been associated with a low complication rate and pain relief for 90% of patients, many patients experienced back pain and fatigue as a result of muscle loss from the operation.
In 1993, Dr. Thomas Zdeblick from the Division of Orthopedic Surgery and Dr. David Mahvi of the Division of General Surgery began developing a minimally invasive way to perform spinal fusion surgery. The procedure, laparoscopic spinal fusion, was performed for the first time in the world in September 1993. Since then, Drs. Mahvi and Zdeblick have become world leaders in the field of minimally invasive spine surgery.

By using special instrumentation and scopes, laparoscopic spinal fusion requires only a small incision in the back. There are numerous benefits to this approach, the most significant being patients' reduced hospital stay and recuperation time. Patients undergoing laparoscopic surgery are hospitalized for just under 2 days, versus the 4 to 6 days required for patients undergoing open surgery. Return-to-work time ranges from 3 to 8 weeks (depending on the physical requirements of patients' jobs), compared to the 3 to 6 months associated with open surgery.

New Research in Spinal Fusion
Clinical research efforts continue with spinal fusion surgery. Dr. Zdeblick was one of the first surgeons who investigated the first combination of a bone graft substitute in a cage fusion procedure.

During this procedure, a metal cage is inserted between the vertebrae that need to be fused. Implanted inside the cage is a laboratory-made bone substitute called bone morphogenetic protein (BMP). This protein is the same substance that the body uses to form bone after a fracture.

Bone substitutes potentially will eliminate the need to harvest bone grafts from the patient, theoretically reducing the postoperative pain and possibly speeding recovery time.

Preliminary success rates associated with this procedure are encouraging. Of the 11 patients who participated in the pilot study, 100% fused, compared with the 85 to 90% typical success rate with other spinal fusion procedures. Dr. Zdeblick is currently following patients the second phase of this study.

For more information, contact:

UW Division of Orthopedic Surgery
F4/312 Clinical Science Center
600 Highland Avenue
Madison, WI 53792-3228

Material provided by the University of Wisconsin, Department of Surgery.  You may visit their website at www.surgery.wisc.edu.