Effective Compression Fracture Spine Treatments

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Effective Compression Fracture Spine Treatments Compression  Compression fractures of the spine can cause significant pain and affect daily life. Fortunately, there are various effective treatment options available to alleviate pain, promote healing, and restore function. Whether through non-surgical approaches or surgical interventions, the goal is always to provide optimal care tailored to each individual’s needs.

Rehabilitation and physical therapy are also vital components of recovery for spinal compression fractures. We will delve into the importance of these interventions and explore various exercises and techniques that can enhance healing and promote strength and mobility.

Moreover, we will highlight innovative approaches offered by Acibadem Healthcare Group, a renowned provider known for its state-of-the-art facilities and specialized services in the treatment of compression fractures of the spine. Their advanced technologies and comprehensive care contribute to improved outcomes for patients.


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A multidisciplinary approach involving orthopedic surgeons, physical therapists, and pain management specialists is crucial in managing spinal fractures effectively. By collaborating across specialties, healthcare professionals can provide holistic care and optimize patient outcomes.

We will also address the psychological impact of spinal compression fractures and the need for emotional support during the recovery process. It is essential to address not only the physical aspects but also the emotional well-being of patients to ensure a more comprehensive and successful recovery.

Lastly, this article will provide insights into strategies that can optimize recovery and enhance the overall quality of life for individuals with spinal compression fractures. From nutrition and lifestyle modifications to ongoing care, these strategies can make a significant difference.


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ACIBADEM Health Point, we are dedicated to providing exceptional healthcare services to our patients. With a team of highly skilled medical professionals and state-of-the-art facilities, we strive to deliver the highest standard of care to improve the health and well-being of our patients. What sets ACIBADEM Health Point apart is our patient-centered approach. We prioritize your comfort, safety, and satisfaction throughout your healthcare journey. Our compassionate staff ensures that you receive personalized care tailored to your unique needs, making your experience with us as seamless and comfortable as possible.

Throughout this article, you will find real-life success stories from individuals who have overcome spinal compression fractures and returned to active, fulfilling lives. These stories serve as inspiration and highlight the possibility of recovery.

Early diagnosis and timely treatment are crucial in the management of compression fractures of the spine. By seeking medical attention promptly, individuals can avoid potential complications and improve their chances of a successful recovery.

Join us as we explore the various aspects of effective compression fracture spine treatments and empower individuals to take proactive steps towards improved well-being. Let’s embark on a journey towards pain relief, healing, and a better quality of life.

Understanding Compression Fractures of the Spine

A compression fracture of the spine is a common injury that occurs when one of the vertebrae in the spine collapses or fractures due to excessive force or pressure. These fractures typically happen in the thoracic (mid-back) or lumbar (lower back) regions of the spine.

Causes

Compression fractures of the spine can be caused by various factors, including:

  • Osteoporosis: A condition characterized by weakened bones, making them more susceptible to fractures.
  • Trauma: Severe impact or injury to the spine, such as a fall or car accident.
  • Repetitive stress: Activities that put repetitive stress on the spine, such as heavy lifting or sports.

Symptoms

The symptoms of a compression fracture of the spine can vary depending on the severity of the fracture. Common symptoms include:

  • Back pain: Persistent or sudden onset of localized back pain, often aggravated by movement.
  • Loss of height: Gradual loss of height over time due to vertebral compression.
  • Decreased mobility: Difficulty bending, walking, or performing daily activities due to pain and stiffness.

Risk Factors

Several factors can increase the risk of developing a compression fracture of the spine, including:

  • Age: The risk of fractures increases with age, particularly in postmenopausal women.
  • Gender: Women are more likely to develop osteoporosis and, consequently, compression fractures of the spine.
  • Family history: A family history of osteoporosis or fractures may increase the risk.
  • Lifestyle factors: Lack of exercise, smoking, excessive alcohol consumption, and poor nutrition can contribute to bone loss and increase the risk of fractures.

Importance of Timely Treatment

Timely treatment is crucial for individuals with compression fractures of the spine to prevent further complications and promote healing. Without appropriate treatment, these fractures can lead to chronic pain, loss of mobility, and even permanent disability.

There are various treatment options available, including non-surgical approaches such as spinal compression fracture therapy and surgical interventions. The choice of treatment depends on factors such as the severity of the fracture, overall health, and patient’s goals.

Treatment Options Description
Pain Management Medications and interventional pain procedures to alleviate pain and improve quality of life.
Bracing Applying a brace to provide support and stability to the spine, facilitating healing.
Physical Therapy Exercises and stretches to improve strength, flexibility, and mobility of the spine.
Vertebroplasty A minimally invasive procedure where cement is injected into the collapsed vertebra to stabilize it.
Kyphoplasty A minimally invasive procedure that uses a balloon to restore height and shape to the collapsed vertebra before injecting cement.
Spinal Fusion A surgical procedure that joins two or more vertebrae together to stabilize the spine.

Non-surgical Treatment Options for Spinal Compression Fractures

When it comes to treating spinal compression fractures, non-surgical options can provide effective relief and help patients regain function without the need for invasive procedures. These non-surgical treatments focus on managing pain, promoting healing, and improving overall mobility. Let’s explore some of the non-surgical treatment options for spinal compression fractures:

Pain Management

Pain management techniques play a crucial role in alleviating discomfort caused by spinal compression fractures. Nonsteroidal anti-inflammatory drugs (NSAIDs) and pain medications can help reduce pain and inflammation, allowing patients to resume their daily activities with greater ease.

Bracing

Bracing is another non-surgical treatment option commonly used for spinal compression fractures. By providing external support, braces help stabilize the spine, relieve pain, and promote healing. Orthopedic specialists work closely with patients to determine the most appropriate type of brace and ensure a proper fit.

Physical Therapy

Physical therapy plays an essential role in the recovery process for spinal compression fractures. Through targeted exercises and techniques, physical therapists help improve strength, flexibility, and range of motion. This therapy focuses on strengthening the muscles surrounding the spine and teaches proper body mechanics to prevent further injury.

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Structured Exercise Programs

Structured exercise programs, tailored to the specific needs of each patient, can be highly beneficial in speeding up recovery and improving overall function. These programs often include a combination of stretching, strengthening, and cardiovascular exercises to promote healing and enhance mobility.

Individualized Care Plans

Every patient’s journey to recovery from spinal compression fractures is unique. Therefore, it’s crucial to develop individualized care plans that address each person’s specific needs. Orthopedic specialists and rehabilitation experts collaborate to create personalized treatment strategies that optimize outcomes and enhance overall well-being.

Non-surgical treatment options for spinal compression fractures offer a holistic approach to recovery, focusing on pain management, functional improvement, and overall quality of life. By combining these therapies and tailoring them to individual needs, patients can achieve optimal outcomes without the need for surgery.

Surgical Treatment Options for Spinal Compression Fractures

When non-surgical treatments fail to provide sufficient relief or if the spinal compression fracture is severe, surgical intervention may be recommended. Surgical options for spinal compression fractures include:

1. Vertebroplasty

Vertebroplasty is a minimally invasive procedure that involves injecting a special bone cement into the fractured vertebra. This cement hardens, stabilizing the fractured bone and relieving pain. Vertebroplasty typically takes about an hour and can be performed on an outpatient basis.

2. Kyphoplasty

Kyphoplasty is a similar procedure to vertebroplasty but involves the additional step of using a balloon-like device to create space in the vertebra before injecting the bone cement. This helps restore the height of the collapsed vertebra and correct spinal deformities caused by the compression fracture.

3. Spinal Fusion

In cases where the compression fracture has led to significant instability or spinal deformity, spinal fusion may be recommended. During this procedure, the surgeon will permanently connect two or more vertebrae together using bone grafts and metal screws, rods, or plates. Spinal fusion aims to stabilize the spine, reduce pain, and improve overall spinal alignment.

These surgical options for spinal compression fractures offer several benefits. They can provide immediate pain relief, restore vertebral height and spinal alignment, and improve overall quality of life. However, it’s important to note that surgery also carries certain risks and considerations, such as infection, bleeding, and complications related to anesthesia. Additionally, each patient’s condition is unique, and the choice of surgical treatment will depend on various factors, including the severity of the fracture, the patient’s overall health, and the surgeon’s expertise.

Surgical Treatment Procedure Benefits Considerations
Vertebroplasty Injection of bone cement into the fractured vertebra Immediate pain relief, stabilization of the fractured bone Risks of infection, bleeding, complications related to anesthesia
Kyphoplasty Creation of space in the vertebra using a balloon-like device, followed by injection of bone cement Restoration of vertebral height, correction of spinal deformities Risks of infection, bleeding, complications related to anesthesia
Spinal Fusion Connection of two or more vertebrae using bone grafts and metal hardware Stabilization of the spine, reduction of pain, improvement of spinal alignment Risks of infection, bleeding, complications related to anesthesia

Rehabilitation and Physical Therapy for Spine Fracture Recovery

Rehabilitation and physical therapy play a crucial role in the recovery process for spinal compression fractures. By incorporating various exercises and techniques, these treatments not only promote healing but also restore strength and mobility to individuals.

The Importance of Rehabilitation

Spine fracture rehabilitation aims to reduce pain, improve function, and enhance overall quality of life. It involves a comprehensive approach that addresses the specific needs and challenges of each patient.

Dedicated rehabilitation programs are tailored to the severity of the fracture and the individual’s unique circumstances. These programs may include exercises to improve flexibility, strength, and range of motion, as well as strategies to help manage pain and discomfort.

In addition to physical benefits, rehabilitation also supports emotional well-being by providing a supportive environment where individuals can share their experiences, challenges, and successes with others going through similar journeys.

Rehabilitation Methods for Spinal Fractures

There are various rehabilitation methods used in the treatment of spinal fractures, each serving a specific purpose in the recovery process:

  • Physical Therapy: Physical therapists employ exercises and techniques to improve strength, flexibility, and balance. They may also use modalities such as heat or ice to manage pain and inflammation.
  • Occupational Therapy: Occupational therapists assist patients in regaining independence in their daily activities, such as dressing, bathing, and cooking. They focus on improving fine motor skills and functional abilities.
  • Pain Management: Specialists in pain management utilize various techniques to help patients cope with pain and discomfort. These can include medication, nerve blocks, or alternative therapies like acupuncture or meditation.
  • Psychological Support: Psychological support plays a crucial role in the recovery process. Therapists or counselors can help individuals cope with emotional challenges and develop strategies for maintaining a positive mindset.

Benefits of Spinal Compression Fracture Physical Therapy

Physical therapy for spinal compression fractures offers numerous benefits, such as:

  • Improved pain management
  • Enhanced mobility and functionality
  • Reduced risk of complications
  • Quicker return to daily activities
  • Increased strength and flexibility
  • Better overall quality of life

The specific exercises and techniques used in physical therapy are tailored to the individual’s condition, taking into account factors such as age, overall health, and severity of the fracture.

It is important for individuals recovering from spinal compression fractures to work closely with their healthcare team to develop a customized rehabilitation plan that meets their specific needs and goals. By doing so, they can optimize their recovery and regain independence.

Innovative Approaches in Compression Fracture Spine Treatment

When it comes to the treatment of compression fractures of the spine, the Acibadem Healthcare Group stands at the forefront of innovation and technology. With a commitment to providing comprehensive and effective care, they have developed innovative approaches that prioritize patient well-being and recovery.

At Acibadem Healthcare Group, state-of-the-art facilities and specialized services are combined to deliver exceptional outcomes for patients with compression fractures of the spine. Their team of experienced physicians and medical professionals utilizes cutting-edge techniques and advanced technologies to ensure the best possible results.

Minimally Invasive Procedures

Acibadem Healthcare Group is renowned for its expertise in performing minimally invasive procedures for compression fractures of the spine. These procedures, such as vertebroplasty and kyphoplasty, involve the injection of bone cement into the fractured vertebrae to stabilize and strengthen the spine.

By employing these minimally invasive techniques, Acibadem Healthcare Group minimizes patient discomfort, reduces hospitalization time, and accelerates the recovery process. This approach allows patients to regain mobility and independence faster, enhancing their overall quality of life.

Advanced Imaging Technologies

Accurate diagnosis is crucial for effective treatment of compression fractures of the spine. At Acibadem Healthcare Group, advanced imaging technologies such as MRI, CT scans, and X-rays are used to precisely assess the extent of the injury and identify the most appropriate treatment approach.

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These state-of-the-art imaging technologies allow Acibadem Healthcare Group’s specialists to develop personalized treatment plans that address patients’ unique needs. By utilizing the latest advancements, they can ensure the best possible outcomes for every individual.

Collaborative Approach

Collaboration is a core principle at Acibadem Healthcare Group. Their multidisciplinary team of healthcare professionals, including orthopedic surgeons, neurosurgeons, and physical therapists, works together to provide comprehensive care for patients with compression fractures of the spine.

Through a collaborative approach, Acibadem Healthcare Group ensures that every aspect of a patient’s condition is addressed comprehensively. From diagnosis to treatment and rehabilitation, their team is dedicated to supporting patients throughout the entire healing process.

Patient-Centered Care

Acibadem Healthcare Group places the patient at the center of their treatment philosophy. They prioritize open communication, patient education, and individualized care plans to empower patients to actively participate in their recovery.

By involving patients in their treatment decisions, Acibadem Healthcare Group ensures that their unique needs and preferences are considered. This patient-centered approach results in better outcomes and improved patient satisfaction.

With their commitment to innovation, advanced technologies, collaborative care, and patient-centered approach, Acibadem Healthcare Group remains a leading provider of compression fracture spine treatment. Their unwavering dedication to excellence sets them apart as a trusted and reliable healthcare partner.

Multidisciplinary Management of Spinal Fractures

 

When it comes to spinal fracture management, a multidisciplinary approach plays a crucial role in ensuring optimal patient outcomes. The collaborative efforts of various healthcare professionals, including orthopedic surgeons, physical therapists, and pain management specialists, contribute to comprehensive and effective treatment plans.

Orthopedic Surgeons:

Orthopedic surgeons are at the forefront of spinal fracture management. They specialize in diagnosing and surgically treating various types of fractures, including those affecting the spine. These experts utilize advanced imaging techniques, such as X-rays and MRIs, to accurately assess the severity and location of the fracture. Based on their evaluation, orthopedic surgeons determine the most appropriate surgical intervention, ensuring proper alignment, stability, and restoration of the spine.

Physical Therapists:

Physical therapists play a vital role in the overall recovery process of spinal fracture patients. They design customized rehabilitation programs that focus on improving strength, flexibility, and mobility. Through a combination of targeted exercises, manual therapy techniques, and assistive devices, physical therapists help patients gradually regain function and independence. They closely monitor progress, making necessary adjustments to the program, and provide ongoing support for a successful recovery.

Pain Management Specialists:

Spinal fractures often cause significant pain and discomfort, requiring specialized pain management interventions. Pain management specialists, such as anesthesiologists or physiatrists, work closely with patients to alleviate pain and improve their quality of life. They employ a range of techniques, including medications, nerve blocks, physical modalities, and minimally invasive procedures, to effectively manage pain. By addressing pain comprehensively, these specialists contribute to enhanced patient comfort and overall well-being.

The multidisciplinary management of spinal fractures ensures that patients receive comprehensive care from a team of experts with diverse skill sets. This collaborative approach maximizes treatment effectiveness and addresses the unique needs of each patient, promoting successful recovery and improved quality of life.

Psychological Support for Spine Fracture Patients

The recovery process for individuals with spinal compression fractures not only involves physical healing but also requires attention to the psychological impact of the injury. Dealing with the pain, limitations, and potential changes in lifestyle can be overwhelming for patients, making psychological support a crucial aspect of their recovery journey.

Providing emotional support to spine fracture patients helps them navigate the challenges they may face, improves their mental well-being, and enhances their overall recovery experience. It is important for healthcare professionals to acknowledge the emotional toll of spinal compression fractures and offer appropriate resources and coping strategies.

Patients can benefit from various psychological support options tailored to their individual needs, such as:

  • Individual counseling: One-on-one sessions with a licensed mental health professional can help patients process their emotions, fears, and anxieties related to the fracture. It provides a safe space to express concerns and develop strategies to cope with the psychological aspects of the injury.
  • Support groups: Joining support groups composed of individuals who have experienced or are currently going through spine fractures can be highly beneficial. Sharing experiences, advice, and tips for managing daily challenges can provide comfort and a sense of belonging. Support groups also offer a platform for patients to gain insights into others’ recovery journeys.
  • Family and friends: The support of loved ones plays a crucial role in the psychological well-being of spine fracture patients. Their presence, understanding, and encouragement are invaluable during the recovery process. Healthcare professionals can involve family members and friends in counseling sessions to ensure a holistic approach to support.

Additionally, educational resources, such as brochures, websites, and online forums, can provide valuable information about the psychological aspects of spine fracture recovery and offer tips for coping. By equipping patients with knowledge and strategies, healthcare professionals empower them to actively participate in their emotional healing process.

Case Study: John’s Journey to Emotional Healing

To illustrate the importance of psychological support for spine fracture patients, let’s consider John, a 45-year-old man who suffered a compression fracture in his lower back due to a fall. The physical pain was accompanied by feelings of anger, frustration, and fear about his ability to return to his normal life.

Fortunately, John’s healthcare team recognized the need for psychological support. He was connected with a licensed therapist who provided him with individual counseling sessions, allowing him to express his emotions and fears openly. Through therapy, John developed coping strategies, including deep breathing exercises and visualization techniques, to manage anxiety and discomfort.

In addition to individual counseling, John also joined a support group for spine fracture patients. Hearing others’ stories, sharing his own experiences, and receiving encouragement from individuals who understood his journey were transformative for John. The support group became a safe space for him to express his concerns and seek advice from those who had overcome similar challenges.

With the combined support of his therapist, support group, and family members, John was able to navigate the psychological impact of his spine fracture. Not only did he regain physical strength, but he also emerged emotionally stronger, more resilient, and equipped with coping strategies that will serve him well in the future.

Optimizing Recovery and Enhancing Quality of Life

When it comes to recovering from spinal compression fractures, there are various strategies that can optimize your recovery and enhance your overall quality of life. From focusing on nutrition to making lifestyle modifications and seeking ongoing care, these spine fracture recovery options can help you regain your strength and improve your well-being.

1. Nutrition

Proper nutrition plays a crucial role in healing and recovery. Consuming a well-balanced diet rich in essential nutrients can support bone health and aid in the healing process. Include foods that are high in calcium and vitamin D, such as dairy products, leafy greens, and fatty fish, to promote bone strength and repair. Additionally, focusing on an anti-inflammatory diet, which includes fruits, vegetables, whole grains, and lean proteins, can help reduce inflammation and support overall healing.

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2. Lifestyle Modifications

Adjusting your lifestyle to accommodate your spinal fracture recovery is essential. Avoid activities that may put additional stress on your spine, such as lifting heavy objects or participating in high-impact exercises. Instead, engage in low-impact activities like swimming, walking, or gentle yoga that can promote flexibility, strength, and overall well-being. It’s also important to maintain a healthy weight and quit smoking, as these factors can impact bone health and impede the healing process.

3. Ongoing Care

Recovering from a spinal compression fracture may require ongoing care and monitoring. This can involve regular check-ups with your healthcare provider, physical therapy sessions, and following a prescribed treatment plan. Physical therapy can help improve flexibility, strength, and range of motion in the affected area, aiding in a faster and more complete recovery. Your healthcare provider may also recommend specific exercises and stretches to target the affected area and prevent further injury.

Spine Fracture Recovery Options: Description:
Nutrition Incorporate a well-balanced diet rich in essential nutrients to support bone health and promote healing.
Lifestyle Modifications Make necessary adjustments to your lifestyle to avoid additional stress on your spine and promote overall well-being.
Ongoing Care Follow up with healthcare providers, undergo physical therapy, and adhere to prescribed treatment plans for comprehensive healing.

 It’s important to consult with your healthcare provider to develop a personalized plan that best suits your specific needs and goals. With dedication and perseverance, you can regain your strength and get back to living a fulfilling life.

Real-life Success Stories from Spinal Fracture Patients

Recovering from spinal compression fractures can be a daunting journey, but many individuals have defied the odds and regained their strength and mobility. Their inspiring stories serve as a beacon of hope for others facing similar challenges.

1. Lisa’s Remarkable Road to Recovery

After a devastating spine fracture, Lisa was uncertain about her future. However, with the guidance of her medical team and unwavering determination, she embarked on a comprehensive recovery program that included physical therapy, pain management, and personalized care. Lisa’s commitment to her rehabilitation paid off, allowing her to regain her independence and improve her quality of life.

2. Mark’s Path to Resilience

Mark encountered a severe spinal compression fracture that left him paralyzed from the waist down. Despite the physical and emotional hurdles, he refused to let his injury define him. With the help of an exceptional rehabilitation team, Mark underwent a rigorous rehabilitation regimen consisting of targeted exercises, advanced spinal treatments, and adaptive technologies. Through perseverance and mental fortitude, Mark not only overcame his injury but also became an advocate for spinal fracture recovery, inspiring others to never give up.

3. Sarah’s Journey of Strength and Support

When Sarah experienced a traumatic spinal fracture, she faced significant physical and emotional obstacles. However, Sarah’s unwavering determination and the support of her loved ones helped her navigate through the ups and downs of recovery. Sarah’s multidisciplinary rehabilitation program, which included physical therapy, counseling, and nutrition guidance, played a crucial role in her healing journey.

Success Story Key Takeaways
Lisa Focused rehabilitation, personalized care, and support lead to remarkable recovery.
Mark Perseverance, advanced treatments, and adaptive technologies can help overcome paralysis.
Sarah Comprehensive rehabilitation, emotional support, and nutrition contribute to a successful recovery.

These remarkable success stories highlight the incredible resilience and determination of individuals who have triumphed over spinal compression fractures. They demonstrate the transformative impact of embracing comprehensive recovery options and underpin the importance of early intervention, personalized care, and multidisciplinary support in achieving optimal outcomes.

Importance of Early Diagnosis and Treatment

When it comes to spinal compression fractures, early diagnosis and timely treatment are of utmost importance. Delaying treatment can lead to further complications and hinder the recovery process.

Without timely intervention, spinal compression fractures can cause significant pain and discomfort, limiting mobility and impacting daily activities. Prompt diagnosis allows healthcare professionals to accurately assess the severity of the fracture and determine the most suitable treatment plan.

Early diagnosis and treatment also help prevent potential complications associated with untreated spinal compression fractures. Complications may include chronic pain, spinal deformities, decreased lung function, and reduced quality of life. By addressing the fracture promptly, patients can avoid these long-term consequences and improve their prognosis.

Advantages of Early Diagnosis and Treatment

  • Faster Recovery: Early treatment helps expedite the healing process, leading to a faster recovery and a quicker return to normal activities.
  • Reduced Pain: Prompt intervention can help alleviate pain associated with spinal compression fractures, improving the overall quality of life.
  • Improved Functionality: Timely treatment can restore spinal stability and functionality, allowing patients to regain their independence and mobility.
  • Prevention of Complications: By addressing the fracture early on, potential complications can be avoided, reducing the need for more extensive and invasive interventions in the future.

In summary, early diagnosis and treatment play a vital role in the management of spinal compression fractures. Seeking medical attention promptly ensures timely initiation of spinal compression fracture therapy, leading to improved outcomes, reduced pain, and enhanced overall well-being.

Conclusion

In conclusion, effective compression fracture spine treatment is crucial for individuals experiencing spinal compression injuries. By understanding the causes, symptoms, and risk factors of compression fractures of the spine, individuals can take proactive steps towards timely diagnosis and treatment.

Non-surgical treatment options such as pain management, bracing, and physical therapy can provide relief and help patients regain function. Surgical options like vertebroplasty, kyphoplasty, and spinal fusion may be considered in more severe cases.

Rehabilitation and physical therapy play a significant role in the recovery process, promoting healing and restoring strength and mobility. Additionally, a multidisciplinary approach involving orthopedic surgeons, physical therapists, and pain management specialists ensures comprehensive and holistic care.

It is important to recognize the psychological impact of spinal compression fractures and provide emotional support to patients throughout their recovery. Optimizing overall well-being and quality of life can be achieved through nutrition, lifestyle modifications, and ongoing care.

FAQ

What is a compression fracture of the spine?

A compression fracture of the spine is a type of fracture that occurs when the vertebrae of the spine collapse or become compressed. It is usually caused by osteoporosis, trauma, or certain medical conditions.

What are the symptoms of a compression fracture of the spine?

Common symptoms of a compression fracture of the spine include sudden onset back pain, limited mobility, loss of height, and changes in posture. Some individuals may also experience nerve compression symptoms, such as numbness, tingling, or weakness in the extremities.

What are the treatment options for a compression fracture of the spine?

Treatment options for a compression fracture of the spine depend on the severity of the fracture as well as the patient's overall health. Non-surgical treatments may include pain management, bracing, or physical therapy, while surgical options can include vertebroplasty, kyphoplasty, or spinal fusion.


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