I’ve had a discectomy with a laminectomy two years ago but still have back pain and numbness down my leg. My surgeon is advising a spinal fusion. How can they do that when the bone was removed?

There are a variety of ways to do a spinal fusion. Your surgeon will take into consideration the fact that you’ve had a laminectomy. Bone graft can be used to fill in around the unstable portion of the spine. Since the lamina or posterior part of the vertebral ring has been removed, bone can be taken from your pelvic bone (iliac crest) instead.

A titanium cage can be placed between the two vertebral bodies. The cage is filled with bone graft usually obtained from the patient’s pelvic bone. Plates and screws may also be used to help stabilize the spinal segment until fusion occurs.

If there is some reason why you can’t donate bone to yourself, then a donor graft from a bone bank may be an acceptable option. There is one other product to ask about. Artificial bone substitute can be mixed in with bone to form a solid fusion site. A recent study showed that a 50:50 mix of bone-to-bone substitute worked as well as 100 per cent bone for spinal fusions.