What is posterior spinal fusion?
Posterior spinal fusion is a surgical procedure performed through an incision in the back to stabilize one or more spinal segments using pedicle screws, connecting rods, and bone graft material. It is the most common approach to spinal fusion and the foundation of virtually all deformity correction surgery.
Pedicle screws are placed through the pedicles — the bony bridges connecting the vertebral body to the posterior elements — at each level to be fused. Titanium rods connect the screws on each side, holding the vertebrae in the corrected position while bone graft material slowly grows across the treated segment over six to twelve months. When fusion is complete, the treated levels form a single solid bone structure.
Dr. Enguidanos performs posterior spinal fusion for a wide range of conditions including scoliosis, spondylolisthesis, degenerative instability, revision surgery, and complex deformity correction. He operates at HCA Florida Twin Cities Hospital in Niceville, Florida, serving patients throughout the Florida Panhandle and Gulf Coast. His fellowship training at the University of Colorado Spine Center under Dr. Thomas Lowe — former president of the Scoliosis Research Society — gives him one of the deepest fusion and deformity backgrounds in the region.
The procedure.
Positioning and Incision
The patient is positioned prone on the operating table. A midline incision is made over the levels to be fused and the paraspinal musculature is carefully retracted to expose the posterior spine.
Pedicle Screw Placement
Pedicle screws are placed bilaterally at each level under fluoroscopic or navigation guidance. Accuracy is confirmed before proceeding. The screw trajectory follows the pedicle — the strongest bone in the vertebra.
Deformity Correction
For scoliosis and deformity cases, correction maneuvers are applied through the instrumentation — compression, distraction, rotation, and in-situ bending — to correct curve and restore normal spinal alignment.
Interbody Fusion When Indicated
At appropriate levels, a posterior interbody cage is placed in the disc space through the same posterior approach to improve fusion rates and provide additional height restoration and indirect decompression.
Bone Graft and Closure
Autograft, allograft, or biologic bone graft is applied to the decorticated posterior elements to stimulate fusion. The wound is irrigated and closed in layers over a drain.