Spinal fusion with rods and screws

With several approaches to spinal fusion, your physician can determine the one that best suits your individual needs.  

Not everybody with low back pain will require surgery. But if your condition is one that requires surgery, rest assured that spinal fusion has a long history as a treatment option.

A spinal fusion is the permanent joining of two or more vertebrae so that there is no movement between them. Over time they heal into a single, solid bone. The procedure involves roughening the bone between two adjacent vertebrae and then placing bone graft between them. In some cases, disc material may be replaced with autogenous bone graft and/or allograft material, or in the case of degenerative disc disease with or without Grade 1 spondylolisthesis, plastic or metal spacers may be used instead. Rods and screws are then placed to create an "internal cast" that support the vertebrae, holding it together until the fusion, or bony regrowth, can occur.


Spine surgery involves creating a single incision and stripping the muscles from the spine. In comparison to a minimally invasive technique, the “open” method offers key benefits that include:

  • Increased access to the spine to remove the damaged bone or intervertebral discs with less likelihood of leaving compressive elements behind

  • Greater visibility to the surgeon in order to place the rods, screws, and bone graft materials needed to stabilize the spinal bone

When surgeons replace disc material with either bone, plastic, or metal spacers, they may approach the disc space in different ways:

  • Anterior lumbar interbody fusion (ALIF): An incision is made in the abdomen
  • Posterior lumbar interbody fusion (PLIF): An incision is made in the back
  • Transforaminal lumbar interbody fusion (TLIF): An incision is made in the back next to the spine to access the vertebra at an angle
  • Direct lateral interbody fusion (DLIF): An incision is made on the side of the abdomen
  • Oblique Lateral Interbody Fusion (OLIF): An incision is made between your belly button and hip.

All these procedures can also be done using a minimally invasive technique, and all involve joining different parts of two or more vertebrae together. Your surgeon will decide on the best approach after considering various factors, including the spinal condition to be treated, its location in the spinal column, and your overall health.


Potential risks to any surgical procedure include unforeseeable complications caused by anesthesia, blood clots, undiagnosed medical problems such as silent heart disease, and rare allergic reactions. Complications of spinal surgery can include neurological damage, damage to the surrounding soft tissue and, where used, instrument malfunction. Most of these complications can be treated once they are detected, but sometimes they require a longer period of hospitalization or recovery, additional medications, and sometimes even additional surgery. Depending upon the type of surgery you are having, these risks will be explained by the primary surgeon. Other risks associated with implants used include device migration, loss of spinal curvature, correction, height, and/or reduction. As a patient, it is important to understand and follow your doctor’s advice so that the best possible outcome can be achieved. Surgery is not for everyone. Please consult your physician.

Information on this site should not be used as a substitute for talking with your doctor. Always talk with your doctor about diagnosis and treatment information.