Spinal Surgery Spinal Surgery

The Woolworth Building
233 Broadway, Ste 640
New York, NY 10279
(212)­ 513-7711

333 East 38th Street
6th Floor
New York, NY 10016
(212)­ 513-7711


The Woolworth Building
233 Broadway, Ste 640
New York, NY 10279
(212)­ 513-7711

Spinal Fusion with Instrumentation

Patients with spinal instability or chronic back pain may require spinal fusion surgery. This surgery is done to stabilize and strengthen the spine and to alleviate severe, chronic back pain. Spinal fusion surgery is a common treatment for such spinal disorders as spondylolisthesis, scoliosis, severe disc degeneration or spinal fractures. Fusion surgery is usually considered only after non-operative therapies have failed.

What is fusion?
Spinal fusion is the joining or fusing of two or more vertebrae. Bone graft is traditionally used to facilitate fusion. This involves small amounts of bone being taken from the patient’s pelvis (autograft), or from a donor (allograft), and then packed between the vertebrae in order to "fuse" them together.

Specially designed implants (including cages, rods, hooks and screws) are also often used in a fusion surgery. The implants are used to ensure correct alignment between vertebrae and to help successful fusion to take place. In addition, these implants add strength and stability to the spine while healing progresses.

A fusion is not always achieved after surgery. Fusion rates vary depending on such factors such as whether or not the patient smokes, number of previous procedures, and the underlying pathology. However, there has recently been a breakthrough relating to fusions. Surgeons are now able to use bone substitutes such as bone morphogenetic proteins (BMPs) during surgery to facilitate fusion. BMP is a "substance" that causes bone growth. The use of BMP in fusion surgery is already improving fusion rates.

PLIF and ALIF
The two most common interbody fusion techniques used to treat chronic low back pain are PLIF and ALIF.

PLIF stands for Posterior Lumbar Interbody Fusion. It is a fusion technique done from the back (posterior) of the lumbar spine. The PLIF procedure involves three basic steps:

  1. Pre-operative planning and templating. Before the surgery, the surgeon will use MRI and CT scans to determine what size implant(s) the patient will need.
  2. Preparing the disc space. An incision is made and back muscles are retracted to allow access to the vertebral disc. The surgeon then carefully removes the affected disc and surrounding tissue.
  3. Implants Inserted. Once the disc space is prepared, bone graft, or BMP with a cage, is inserted to promote fusion between the vertebrae. Additional implants may also be used at this time to further stabilize the spine.

ALIF, which stands for Anterior Lumbar Interbody Fusion, is similar to PLIF. However, it is done from the front (anterior) of the body.

Spinal Expertise

Dr. Goldstein is recognized as one of the leading spine surgeons in New York. His expertise is sought by television, media, and magazines. His practice is focused on surgical treatment:

2017 New York Magazine Best DoctorsDr. Jeffrey Goldstein was recognized again in 2017 as one of America's Top Doctors .

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Spine Surgery in New York

Dr. Goldstein serves as Director of the Spine Service at NYU Langone Medical Center Hospital for Joint Diseases.
Hospital for Joint DiseaseHospital for Joint Disease

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