Spinal Fusion

  1. General information
    1. Fusion of spinous processes with bone graft from iliac crest to provide stabilization of spine
    2. Performed in conjunction with laminectomy
  2. Nursing interventions
    1. Provide pre-op care as for laminectomy.
    2. In addition to post-op care for laminectomy
      1. Position client correctly.
        1. lumbar spinal fusion: keep bed flat for first 12 hours, then may elevate head of bed 20°-30°, keep off back for first 48 hours.
        2. cervical spinal fusion: elevate head of bed slightly.
      2. Assist with ambulation.
        1. time varies with surgeon and extent of fusion.
        2. usually out of bed 3-4 days post-op.
        3. apply brace before getting client out of bed.
        4. apply special cervical collar for cervical spinal fusion.
      3. Promote comfort: client may experience considerable pain from graft site.
    3. In addition to client teaching and discharge planning for laminectomy, advise client that
      1. Brace will be needed for 4 months and lighter corset for 1 year after surgery.
      2. It takes 1 year until graft becomes stable.
      3. No bending, lifting, stooping, or sitting for prolonged periods for 4 months.
      4. Walking without excessive tiring is healthful exercise.
      5. Diet modification will help prevent weight gain resulting from decreased activity.