text:
United Nations Security Council veto power
From Wikipedia, the free encyclopedia
Jump to: navigation, search
[hide]This article has multiple issues. Please help improve it or discuss these issues on the talk page. (Learn how and when to remove these template messages)
The factual accuracy of parts of this article (those related to article) may be compromised due to out-of-date information. Please update this article to reflect recent events or newly available information. (March 2013)
This article needs additional citations for verification. Please help improve this article by adding citations to reliable sources. Unsourced material may be challenged and removed. (February 2010) (Learn how and when to remove this template message)
(Learn how and when to remove this template message)
Room of the United Nations Security Council
The United Nations Security Council "veto power" refers to the power of the permanent members of the United Nations Security Council to veto any "substantive" resolution. A permanent member's abstention or absence does not prevent a draft resolution from being adopted. However, the veto power does not apply to "procedural" votes, as determined by the permanent members themselves. A permanent member can also block the selection of a Secretary-General, although a formal veto is unnecessary since the vote is taken behind closed doors.
The unconditional veto possessed by the five governments has been seen by critics as the most undemocratic character of the UN.[1] Critics also claim that veto power is the main cause for international inaction on war crimes and crimes against humanity.[2] However, the United States refused to join the United Nations in 1945 unless it was given a veto.[1] The absence of the United States from the League of Nations contributed to its ineffectiveness. Supporters of the veto power regard it as a promoter of international stability,[3] a check against military interventions,[4] and a critical safeguard against U.S. domination.[5]
Contents
[hide]
1 Article 27
2 Origins of the veto provision
3 Use of the veto power
3.1 Selection of a Secretary-General
4 Most common users
5 Most recent veto per country
6 Analysis by country
6.1 China (ROC/PRC)
6.2 Soviet Union/Russia
6.3 France
6.4 United Kingdom
6.5 United States
7 Criticism
8 Veto power reform
9 Notes
10 Further reading
11 External links
12 See also
Article 27[edit]
Article 27 of the United Nations Charter states:
Each member of the Security Council shall have a vote.
Decisions of the Security Council on procedural matters shall be made by an affirmative vote of nine members.
Decisions of the Security Council on all other matters shall be made by an affirmative vote of nine members including the concurring votes of the permanent members; provided that, in decisions under Chapter VI, and under paragraph 3 of Article 52, a party to a dispute shall abstain from voting.[6]
Although the "power of veto" is not explicitly mentioned in the UN Charter, the fact that "substantive" decisions by the UNSC require "the concurring votes of the permanent members", means that any of those permanent members can prevent the adoption, by the Council, of any draft resolutions on "substantive" matters. For this reason, the "power of veto" is also referred to as the principle of "great power unanimity" and the veto itself is sometimes referred to as the "great power veto".[7]
Origins of the veto provision[edit]
The idea of states having a veto over the actions of international organizations was not new in 1945. From the foundation of the League of Nations in 1920, each member of the League Council, whether permanent or non-permanent, had a veto on any non-procedural issue.[8] From 1920 there were 4 permanent and 4 non-permanent members, but by 1936 the number of non-permanent members had increased to 11. Thus there were in effect 15 vetoes. This was one of several defects of the League that made action on many issues impossible.
The UN Charter provision for unanimity among the Permanent Members of the Security Council (the veto) was the result of extensive discussion, including at Dumbarton Oaks (August–October 1944) and Yalta (February 1945).[9] The evidence is that the UK, US, USSR, and France all favoured the principle of unanimity, and that they were motivated in this not only by a belief in the desirability of the major powers acting together, but also by a concern to protect their own sovereign rights and national interest.[10] Truman, who became President of the US in April 1945, went so far as to write in his memoirs: "All our experts, civil and military, favored it, and without such a veto no arrangement would have passed the Senate."[11]
The veto was forced on all other governments by the (soon to be) five veto holders. In the negotiations building up to the creation of the UN, the veto power was resented by many small countries, and in fact was forced on them by the veto nations - US, UK, China, France and the Soviet Union - through a threat that without the veto there would be no UN. Francis O. Wilcox, an adviser to US delegation to the 1945 conference described it: "At San Francisco, the issue was made crystal clear by the leaders of the Big Five: it was either the Charter with the veto or no Charter at all. Senator Connally [from the US delegation] dramatically tore up a copy of the Charter during one of his speeches and reminded the small states that they would be guilty of that same if they opposed the unanimity principle. "You may, if you wish," he said, "go home from this Conference and say that you have defeated the veto. But what will be your answer when you are asked: 'Where is the Charter'?"[1]
The United Nations Security Council veto system was established in order to prohibit the UN from taking any future action directly against its principal founding members. One of the lessons of the League of Nations (1919–46) had been that an international organization cannot work if all the major powers are not members. The expulsion of the Soviet Union from the League of Nations in December 1939, following its November 1939 attack on Finland soon after the outbreak of World War II, was just one of many events in the League's long history of incomplete membership.
It had already been decided at the UN's founding conference in 1944, that United Kingdom, China, the Soviet Union, the United States and, "in due course" France, should be the permanent members of any newly formed Council. France had been defeated and occupied by Germany (1940–44), but its role as a permanent member of the League of Nations, its status as a colonial power and the activities of the Free French forces on the allied side allowed it a place at the table with the other four.[citation needed]
Use of the veto power[edit]
The actual use of the veto, and the constant possibility of its use, have been central features of the functioning of the Security Council throughout the UN's history. In the period from 1945 to the end of 2009, 215 resolutions on substantive issues were vetoed, sometimes by more than one of the P5. The average number of vetoes cast each year to 1989 was over five: since then the average annual number has been just above one.[citation needed]
The figures reflect the fact that a Permanent Member of the Security Council can avoid casting a veto if the proposal in question does not in any event obtain the requisite majority. In the first two decades of the UN, the Western states were frequently able to defeat resolutions without actually using the veto; and the Soviet Union was in this position in the 1970s and 1980s. Use of the veto has reflected a degree of diplomatic isolation of the vetoing state(s) on the particular issue. Because of the use or threat of the veto, the Security Council could at best have a limited role in certain wars and interventions in which its Permanent Members were involved – for example in Algeria (1954–62); Suez (1956), Hungary (1956), Vietnam (1946–75), the Sino-Vietnamese war (1979), Afghanistan (1979–88), Panama (1989), Iraq (2003), and Georgia (2008).[citation needed]
Not all cases of UN inaction in crises have been due to actual use of the veto. For example, re the Iran–Iraq war of 1980–88 there was no use of the veto, but the UN role was minimal except in its concluding phase. Likewise the limited involvement of the UN in the crisis in the Darfur region of Sudan from 2003 onwards was not due to any actual use of the veto. A general lack of willingness to act was the main problem.[citation needed]
Since 1990 the veto has been used sparingly. The period from 31 May 1990 to 11 May 1993 was the longest without use of the veto in the history of the UN. Up until the end of 1989 the number of resolutions passed by the Security Council had been 646 – an average of about 15 per annum. The figures for the years since then show a peak of Security Council activism in 1993, followed by a modest degree of retrenchment.[12]
In 1950 the Soviet Union missed one important opportunity to exercise its veto power. The Soviet government had adopted an "empty chair" policy at the Security Council from January 1950, owing to its discontent over the UN's refusal to recognize the People's Republic of China's representatives as the legitimate representatives of China,[13] and with the hope of preventing any future decisions by the Council on substantive matters. Despite the wording of the Charter (which makes no provisions for passing resolutions with the abstention or absence of a veto-bearing member), this was treated as a non-blocking abstention. This had in fact already become Council practice by that time, the Council having already adopted numerous draft resolutions despite the lack of an affirmative vote by each of its permanent members. The result of the Soviet Union's absence from the Security Council was that it was not in a position to veto the UN Security Council resolutions 83 (27 June 1950) and 84 (7 July 1950) authorising the US-led military coalition in Korea that assisted South Korea in repelling the North Korean attack.[14]
Selection of a Secretary-General[edit]
Main article: United Nations Secretary-General selection
The veto power can also be used to block the selection of a Secretary-General.[15] However, this is not counted as a veto of a Security Council Resolution, because the Security Council is only issuing a "recommendation" to the General Assembly. Since 1981, no Secretary-General has been formally vetoed, because the Security Council does not vote until they have already agreed on a Secretary-General in a series of straw polls. A vote by a permanent member to "discourage" a candidate is considered equivalent to a veto, and the candidate will withdraw from the race without forcing a formal veto. The formal recommendation of a Secretary-General is approved unanimously by acclamation.
Every permanent member has vetoed at least one candidate for Secretary-General. The United States circumvented the Soviet veto in 1950 by asking the General Assembly to vote on Trygve Lie's reappointment without a recommendation from the Security Council.[16] However, every Secretary-General since 1953 has been recommended by a unanimous vote of the permanent members of the Security Council. Vetoes have not been recorded publicly since 1981, because the straw poll is taken by secret ballot. However, countries may announce their votes to encourage the rotating members to vote for another candidate.
Most common users[edit]
Number of resolutions vetoed by each of the five permanent members of the Security Council between 1946 and 2016.[17]
In the history of the Security Council, almost half the vetoes were cast by the Soviet Union, with the vast majority of those being before 1965.[18]
Since 1966, out of the total 153 vetoes cast, 119 were issued by one of the council's three NATO members: the US, the UK and France.[19]
From 1946 to 2016, vetoes were issued on 258 occasions. For that period, usage breaks down as follows:
The United States has used the veto on 79 occasions between 1946 and 2016; and since 1972, it has used its veto power more than any other permanent member.[19]
Russia and the Soviet Union have used the veto on 122 occasions, more than any other of the five permanent members of the Security Council.[20]
Most recent veto per country[edit]
See also: List of Vetoed United Nation Security Council Resolutions
The following list describes the most recent veto from each of the five permanent members of the United Nations Security Council. France and the United Kingdom have not vetoed any resolutions since 1989. However, China, Russia and the United States have all exercised their veto power in 2017.
December 17, 2017: The United States vetoed a draft resolution calling on countries to avoid establishing embassies in Jerusalem. (14-1-0)[21]
November 17, 2017: Russia vetoed a 30-day renewal of a commission investigating chemical weapons attacks in Syria. (11-2-2)[22]
February 28, 2017: China and Russia vetoed UN sanctions over chemical weapons in Syria. (9-3-3)[23]
December 23, 1989: France, the United Kingdom and the United States vetoed a draft resolution condemning the United States invasion of Panama. (10-4-1)[24]
Analysis by country[edit]
China (ROC/PRC)[edit]
See also: China and the United Nations
Between 1946 and 1971, the Chinese seat on the Security Council was the government of the Republic of China (that retreated to Taiwan in 1949) during which time its representative used the veto only once, to block Mongolia's application for membership in 1955, because the ROC considered the country to be a part of China. This postponed the admission of Mongolia until 1961, when the Soviet Union announced that unless Mongolia was admitted, it would block the admission of all of the newly independent African states. Faced with this pressure, the ROC relented under protest.
After the Republic of China's expulsion from the United Nations in 1971, the first veto cast by the present occupant, the People's Republic of China, was issued on 25 August 1972 over Bangladesh's admission to the United Nations. As of February 2017, the People's Republic of China has used its veto eleven times.[25] Observers have noted a preference for China to abstain rather than veto on resolutions not directly related to Chinese interests.[17]
Soviet Union/Russia[edit]
See also: Soviet Union and the United Nations and Russia and the United Nations
In the early days of the United Nations, the Soviet Union commissar and later minister for foreign affairs, Vyacheslav Molotov, vetoed resolutions so many times that he was known as "Mr. Veto". In fact, the Soviet Union was responsible for nearly half of all vetoes ever cast—79 vetoes were used in the first 10 years. Molotov regularly rejected bids for new membership because of the US's refusal to admit all of the Soviet republics. Following the dissolution of the Soviet Union, Russia used its veto power sparingly. However, its use of the veto increased in the late 2000s and 2010s, due to a number of resolutions on conflicts that it was involved militarily in, including Georgia, Syria and Ukraine.[26]
France[edit]
See also: France and the United Nations
France uses its veto power sparingly. The last time it unilaterally vetoed a draft was in 1976 to block a Resolution on the question of the Comoros independence, which was done to keep the island of Mayotte as a French overseas territory.[27] It also vetoed, along with U.K, a resolution calling on the immediate cessation of military action by the Israeli army against Egypt in 1956 during the Suez Crisis.[27] The last time France used its veto power was in December 1989 concerning the situation in Panama.[27] In 2003, the threat of a French veto of resolution on the impending invasion of Iraq caused friction between France and the United States.
United Kingdom[edit]
See also: United Kingdom and the United Nations
The United Kingdom has used its Security Council veto power on 32 occasions.[28] The first occurrence was in October 1956 when the United Kingdom and France vetoed a letter from the USA to the President of the Security Council concerning Palestine. The most recent was in December 1989 when the United Kingdom, France and the United States vetoed a draft resolution condemning the United States invasion of Panama.[29]
The United Kingdom used its veto power, along with France, to veto a draft resolution aimed at resolving the Suez Canal crisis (in which France and UK were militarily involved) in 1956. The UK and France eventually withdrew from Egypt after the U.S. instigated an 'emergency special session' of the General Assembly, under the terms of the "Uniting for Peace" resolution, which led to the establishment of the United Nations Emergency Force I (UNEF I), by the adoption of Assembly resolution 1001.[30] The UK also used its veto seven times in relation to Rhodesia from 1963 to 1973, five of these occasions were unilateral; the only occasions on which the UK has used its veto power unilaterally.[29]
United States[edit]
See also: United States and the United Nations
Ambassador Charles W. Yost cast the first U.S. veto in 1970, regarding a crisis in Rhodesia, and the U.S. cast a lone veto in 1972 to block a resolution that condemned Israel for war against Syria and Lebanon. Since that time it has become the most frequent user of veto power, mainly on resolutions criticizing and condemning Israel and almost always unilaterally for war and human rights violations; since 2002, the Negroponte doctrine has been applied for the use of a veto on resolutions relating to the ongoing Israel-Palestinian conflict. This has been a constant cause of friction between the General Assembly and the Security Council. On 18 February 2011, the Obama administration vetoed resolutions condemning Israeli settlements. On December 23, 2016, the Obama administration allowed a resolution calling for an end to Israeli settlements to pass.[31]
Criticism[edit]
The veto power has brought criticism to the Security Council. As it stands, a veto from any of the permanent members can halt any possible action the Council may take. One country's objection, rather than the opinions of a majority of countries, may cripple any possible UN armed or diplomatic response to a crisis. For instance, John J. Mearsheimer claimed that "since 1982, the US has vetoed 32 Security Council resolutions critical of Israel, more than the total number of vetoes cast by all the other Security Council members."[32] Since candidates for the Security Council are proposed by regional blocs, the Arab League and its allies are usually included but Israel, which joined the UN in 1949, has never been elected to the Security Council. The Council has repeatedly condemned Israel. On the other hand, critics contend that, while Israel has the United States to rely on to veto any pertinent legislation against it, the Palestinians lack any such power.
Apart from the US, several resolutions have been vetoed by Russia, notably attempts to impose sanctions on Syria during the Syrian Civil War and to condemn Russia's own annexation of Crimea in 2014. In the case of the latter, Russia's lone veto overruled the thirteen other votes in favor of the condemnation.[33] As part of the Soviet Union, Russia also vetoed a UN resolution condemning the USSR's shooting down of Korean Air Lines Flight 007 in 1983. The veto has been singled out as a threat to human rights, with Amnesty International claiming that the five permanent members had used their veto to "promote their political self interest or geopolitical interest above the interest of protecting civilians." As of 2015, Amnesty International has suggested that a solution would involve the five permanent members surrendering their veto on issues of genocide.[34]
Some see the fact that veto power exclusive to the permanent five as being anachronistic, unjust, or counterproductive. Peter Nadin writes that "The veto is an anachronism ... In the twenty-first century, the veto has come to be almost universally seen as a disproportionate power and an impediment to credible international action to crises."[35] The "enormous influence of the veto power" has been cited as a cause of the UN's ineffectiveness in preventing and responding to genocide, violence, and human rights violations.[36] In an address to the UN General Assembly on the Russian annexation of Crimea, Ukrainian President Petro Poroshenko said: "In every democratic country, if someone has stolen your property, an independent court will restore justice, in order to protect your rights, and punish the offender. However, we must recognize that in the 21st century our organization lacks an effective instrument to bring to justice an aggressor country that has stolen the territory of another sovereign state.”[37] Various countries outside the P5, such as the Non-Align Movement and African Union have proposed limitations on the veto power.[38]
Because of this situation, it has been denounced that the Security Council is only effective when it comes to safeguarding the interests of its permanent members, and is unable to act against them. Consequently, resolutions authorizing intervention in the internal affairs of other countries have been few. The interests of the permanent members have come to rest on the concept of non-interference, at the expense of the "keep the peace and security" mandate with which the Security Council was created. Perhaps because, while the "responsibility to protect" is not binding, state sovereignty remains a priority and, as the specialist in international relations Philippe Moreau-Desfarges points out, "even if the rights of their populations are violated, only the Security Council can decide whether peace is threatened and take measures to protect that peace". Thus, the Security Council has not taken forceful measures to punish governments considered as authoritarian, neglecting the "responsibility to defend civilian populations", recognized by the UN General Assembly in 2005.[39]
Veto power reform[edit]
See also: Reform of the United Nations Security Council
Various discussions have taken place in recent years over the suitability of the Security Council veto power in today's world. Key arguments include that the five permanent members no longer represent the most stable and responsible member states in the United Nations, and that their veto power slows down and even prevents important decisions being made on matters of international peace and security. Due to the global changes that have taken place politically and economically since the formation of the UN in 1945, widespread debate has been apparent over whether the five permanent members of the UN Security Council remain the best member states to hold veto power. While the permanent members are still typically regarded as great powers, there is debate over their suitability to retain exclusive veto power.[40]
A second argument against retaining the UNSC veto power is that it is detrimental to balanced political decisions, as any draft text needs to be approved of by each permanent member before any draft resolution can possibly be adopted. Indeed, several proposed draft resolutions are never formally presented to the Council for a vote owing to the knowledge that a permanent member would vote against their adoption (the so-called "pocket veto"). Debate also exists over the potential use of the veto power to provide "diplomatic cover" to a permanent member's allies[citation needed]. The United States has used its veto power more than any other permanent member since 1972, particularly on resolutions condemning the actions or policies of Israel.
Advocates of the veto power believe that it is just as necessary in the current geo-political landscape, and that without the veto power, the Security Council would be open to making democratic "majority rules" decisions on matters that have implications at a global level[41]—decisions that may well go directly against the interests of a permanent member.
Discussions on improving the UN's effectiveness and responsiveness to international security threats often include reform of the UNSC veto. Proposals include: limiting the use of the veto to vital national security issues; requiring agreement from multiple states before exercising the veto; and abolishing the veto entirely. However, any reform of the veto will be very difficult, if not impossible. In fact, Articles 108 and 109 of the United Nations Charter grant the P5 veto over any amendments to the Charter, requiring them to approve of any modifications to the UNSC veto power that they themselves hold: it is highly unlikely that any of the P5 would accept a reform of the UN Charter that would be detrimental to their own national interests.
Nonetheless, it has been argued that with the adoption of the "Uniting for Peace" resolution by the General Assembly, and given the interpretations of the Assembly's powers that became customary international law as a result, that the Security Council "power of veto" problem could be surmounted.[42] By adopting A/RES/377 A, on 3 November 1950, over two-thirds of UN Member states declared that, according to the UN Charter, the permanent members of the UNSC cannot and should not prevent the UNGA from taking any and all action necessary to restore international peace and security, in cases where the UNSC has failed to exercise its "primary responsibility" for maintaining peace. Such an interpretation sees the UNGA as being awarded "final responsibility"—rather than "secondary responsibility"—for matters of international peace and security, by the UN Charter. Various official and semi-official UN reports make explicit reference to the Uniting for Peace resolution as providing a mechanism for the UNGA to overrule any UNSC vetoes;[43][44][45][46] thus rendering them little more than delays in UN action, should two-thirds of the Assembly subsequently agree that action is necessary.
The threat of the use of the veto by the P5 has led the UN Security Council to adopt what some commentators have described as unlawful resolutions that violated the UN Charter. For example, UNSC resolution 1422 of 2002, renewed once through resolution 1487 of 2003, aimed at exempting peace-keepers and other military personnel conducting operations authorized by the Security Council from the jurisdiction of the International Criminal Court (ICC) for a period of 12 months. Resolution 1422 was adopted as a consequence to the US veto on 30 June 2002 to the renewal of the Peace-keeping operation in Bosnia and Herzegovina, a State Party to the Rome Statute of the ICC.[47]
Notes[edit]
^ Jump up to: a b c II. The Yalta Voting Formula, Author(s): Francis O. Wilcox, Source: The American Political Science Review, Vol. 39, No. 5 (Oct., 1945), pp. 943-956, Stable URL: https://www.jstor.org/stable/1950035, Accessed: 05-05-2015 17:13 UTC
Jump up ^ Oliphant, Roland (4 October 2016). "'End Security Council veto' to halt Syria violence, UN human rights chief says amid deadlock". The Telegraph.
Jump up ^ Putin, Vladimir V. (11 September 2013). "What Putin Has to Say to Americans About Syria". The New York Times. The United Nations’ founders understood that decisions affecting war and peace should happen only by consensus, and with America’s consent the veto by Security Council permanent members was enshrined in the United Nations Charter. The profound wisdom of this has underpinned the stability of international relations for decades.
Jump up ^ "Wang Yi: China Is Participant, Facilitator and Contributor of International Order". Consulate-General of the People's Republic of China in Los Angeles. 27 June 2015. China’s veto at the Security Council has always played an important role in checking the instinct of war and resisting power politics.
Jump up ^ "Veto right prevents UNSC from turning into 'rubber stamp' for US & allies – Churkin". RT International. 16 October 2016.
Jump up ^ UN Charter, Article 27, as amended in 1965. Before that date, Articles 27(2) and (3) had specified the affirmative votes of seven members. The change was part of the process whereby the size of the Council was increased from 11 to 15 members.
Jump up ^ "Membership of the Security Council". www.un.org. 2 May 2012. Archived from the original on 2012-05-02. Retrieved 25 October 2017.
Jump up ^ League of Nations Covenant, Article 5(1).
Jump up ^ Luck, Edward C. (2008). "Creation of the Council". In Lowe, Vaughan; Roberts, Adam; Welsh, Jennifer; et al. The United Nations Security Council and War: The Evolution of Thought and Practice since 1945. Oxford University Press. pp. 61–85.
Jump up ^ See e.g. Winston S. Churchill, The Second World War, vol. 6: Triumph and Tragedy, Cassell, London, 1954, pp. 181-2 and 308-13; Harry S. Truman, Year of Decisions: 1945 (London, 1955), pp. 194-5, 201, and 206-7; Charles de Gaulle, War Memoirs: Salvation 1944-1946 – Documents, tr. Murchie and Erskine (London, 1960), pp. 94-5.
Jump up ^ Truman, Year of Decisions: 1945, p. 207. See also US Department of State: "The United States and the Founding of the United Nations". October 2005. Retrieved 1 March 2012.
Jump up ^ Lowe, Vaughan; Roberts, Adam; Welsh, Jennifer; et al., eds. (2008). The United Nations Security Council and War: The Evolution of Thought and Practice since 1945. Oxford University Press. pp. 78–82, 135–7, 155–65, 688–705.
Jump up ^ Malanczuk, P. Akehurst's Modern Introduction to International Law, Ed. 7, page 375, Routledge, 1997
Jump up ^ Stueck, Wiliam (2008). "The United Nations, the Security Council, and the Korean War". In Lowe, Vaughan; Roberts, Adam; Welsh, Jennifer; et al. The United Nations Security Council and War: The Evolution of Thought and Practice since 1945. Oxford University Press. pp. 266–7, 277–8.
Jump up ^ Chesterman, Simon (2007). "Introduction". In Chesterman, Simon. Secretary or General? The UN Secretary-General in World Politics. Cambridge: Cambridge University Press. p. 7.
Jump up ^ "An Historical Overview on the Selection of United Nations Secretaries-General" (PDF). UNA-USA. Archived from the original (PDF) on 25 October 2007. Retrieved 30 September 2007.
^ Jump up to: a b Global Policy Forum (2008): "Changing Patterns in the Use of the Veto in the Security Council". Retrieved 30 December 2008.
Jump up ^ Veto database and information at Global Policy Forum
^ Jump up to: a b Security Council - Veto List at Global Policy Forum
Jump up ^ [1] United Nations Documentation at The United Nations
Jump up ^ Foroohar, Kambiz. "Jerusalem Embassy Vote Draws First U.S. Veto at UN Under Trump".
Jump up ^ Nichols, Michelle. "Russia casts 10th U.N. veto on Syria action, blocking inquiry renewal".
Jump up ^ "Double Veto Prevents Security Council from Adopting Draft Resolution Intended to Impose Sanctions for Use of Chemical Weapons in Syria". United Nations.
Jump up ^ List of vetoes in the United Nations Security Council. Retrieved 20 November 2011.
Jump up ^ Security Council - Veto List. Retrieved 13 April 2017.
Jump up ^ "Veto List". United Nations. Retrieved 2017-02-20.
^ Jump up to: a b c "Subjet of UN Security Council Vetoes". Retrieved 18 April 2013.
Jump up ^ "Changing Patterns in the Use of the Veto in The Security Council" (PDF). Global Policy Forum. Retrieved 29 October 2015.
^ Jump up to: a b "Security Council - Veto List". UN Dag Hammarskjöld Library. Retrieved 29 October 2015.
Jump up ^ "Emergency Special Sessions". United Nations. Retrieved 25 October 2015.
Jump up ^ "Israeli settlements: UN Security Council calls for an end". BBC News. 2016-12-23. Retrieved 2016-12-23.
Jump up ^ John J. Mearsheimer and Stephen Walt. "The Israel Lobby and U.S. Foreign Policy". KSG Faculty Research Working Paper Series. Harvard University. Archived from the original on February 2, 2007. Retrieved 2017-01-26.
Jump up ^ Section, United Nations News Service (2014-03-15). "UN News - UN Security Council action on Crimea referendum blocked". UN News Service Section. Retrieved 2017-01-26.
Jump up ^ "Amnesty calls on UN powers to lose veto on genocide votes - BBC News". BBC News. Retrieved 2017-01-26.
Jump up ^ Peter Nadin, UN Security Council Reform (Routledge, 2016), pp. 133-34.
Jump up ^ Sevak Joseph Manjikian, "Genocide and the Failure to Respond" in Civil Courage: A Response to Contemporary Conflict and Prejudice (ed. Naomi Kramer: Peter Lang, 2007), pp. 49-50.
Jump up ^ "Experts praise Poroshenko's call for restrictions on UN Security Council veto powers". KyivPost. Retrieved 2017-01-26.
Jump up ^ Edwin Egede & Peter Sutch, The Politics of International Law and International Justice (Edinburgh University Press, 2013), p. 142.
Jump up ^ Máiquez, Miguel (2011-04-19). "El derecho de veto continúa atrancando las decisiones de la ONU 65 años después". 20 Minutos (in Spanish). Madrid: 20 Minutos Editora. Retrieved 2017-01-26.
Jump up ^ UN's High-level Panel on Threats, Challenges and Change: "A more secure world: our shared responsibility". p.68, 1 December 2004.
Jump up ^ "Can the United Nations Reform"
Jump up ^ Hunt, C. "The 'veto' charade", ZNet, 7 November 2006. Retrieved 1 March 2008
Jump up ^ United Nations General Assembly Session 52 Document 856. A/52/856 Retrieved 2008-03-01.
Jump up ^ International Commission on Intervention and State Sovereignty. "The Responsibility to Protect", ICISS.ca, December 2001. Retrieved 1 March 2008.
Jump up ^ A/58/47 "Report of the Open-ended Working Group on the Question of Representation on and Increase in the Membership of the Security Council", UN.org, 21 July 2004. Retrieved 1 March 2008.
Jump up ^ Non-Aligned Movement. Ministerial Meeting of the Coordinating Bureau of the Non-Aligned Movement", UN.int, 27–30 May 2006. Retrieved 1 March 2008.
Jump up ^ Writings of Flavia Lattanzi, Kai Ambos and Claus Kress, inter alia
Further reading[edit]
Bardo Fassbender, UN Security Council Reform and the Right of Veto: A Constitutional Perspective, Kluwer Law International, The Hague / London / Boston, 1998. ISBN 90-411-0592-1.
Bardo Fassbender, 'Pressure for Security Council Reform', in: David M. Malone (ed.), The UN Security Council: From the Cold War to the 21st Century, Lynne Rienner Publishers, Boulder, Colorado, and London, 2004, pp. 341–355.
Bardo Fassbender, 'The Security Council: Progress is Possible but Unlikely', in: Antonio Cassese (ed.), Realizing Utopia: The Future of International Law, Oxford University Press, 2012, pp. 52–60.
Vaughan Lowe; Adam Roberts; Jennifer Welsh; Dominik Zaum (eds.). The United Nations Security Council and War: The Evolution of Thought and Practice since 1945, Oxford University Press, 2008. ISBN 978-0-19-953343-5 (hardback); ISBN 978-0-19-958330-0 (paperback). US edition. On Google.
David Malone (ed), The UN Security Council: From the Cold War to the 21st Century, Lynne Rienner, Boulder, Colorado, 2004. ISBN 1-58826-240-5 (paperback).
External links[edit]
"Can You Bypass a U.N. Security Council Veto?", Slate magazine
"Security Council veto power usage", Peace.ca
"Global Policy Forum", information on use of the veto power
Malone, D & Mahbubani, K: "The UN Security Council – from the Cold War to the 21st Century", UN World Chronicle, 30 March 2004.
See also[edit]
Vetocracy
[hide]
v
t
e
United Nations
António Guterres, Secretary-General
Amina J. Mohammed, Deputy Secretary-General
Peter Thomson, General Assembly President
United Nations System
United Nations Charter
Preamble
Principal organs
General Assembly
President
Security Council
Members
Economic and Social Council
Secretariat
Secretary-General
Deputy Secretary-General
Under-Secretary-General
International Court of Justice
statute
Trusteeship Council
Secretariat Offices
and Departments
Headquarters
Envoy on Youth
Spokesperson for the Secretary-General
Geneva
Palace of Nations
Nairobi
Vienna
Economic and Social Affairs
Political Affairs
Public Information
Dag Hammarskjöld Library
Safety and Security
Palestinian Rights
Peacekeeping Operations
Internal Oversight
Legal Affairs
Developing Countries
Sport for Development and Peace
Disarmament Affairs
Outer Space Affairs
Partnerships
Coordination of Humanitarian Affairs
UN organizations by location
United Nations Office for Developing Countries
Programmes and
specialized agencies
FAO
ICAO
IFAD
ILO
IMO
ITC
IPCC
IAEA
MINURSO
UNIDO
ITU
UNAIDS
SCSL
UNCTAD
UNCITRAL
UNCDF
UNDG
UNDP
UNDPI
UNDPKO
peacekeeping
UNEP
OzonAction
UNEP/GRID-Arendal
UNEP-WCMC
UNESCO
UNFIP
UNFPA
UN-HABITAT
OHCHR
UNHCR
UNHRC
UNICEF
UNICRI
UNIDIR
UNITAR
UN-Oceans
UNODC
UNOPS
UNOSAT
UNRISD
UNRWA
UNSSC
UNU
UNU-OP
UNU-CRIS
UNV
UN Women
UNWTO
UPU
WFP
WHO
WIPO
WMO
Members / observers
Full members
Founding members
UNSC Permanent members
Observers
European Union
History
League of Nations
Four Policemen
Declaration by United Nations
Peacekeeping missions
history
timeline
Enlargement
Resolutions
Security Council vetoes
General Assembly
66th
67th
Security Council
Cyprus
Iran
Iraq
Israel
Lebanon
Nagorno-Karabakh
North Korea
Palestine
Syria
Western Sahara
Elections
Secretary-General (2006
2016)
International Court of Justice 2011
General Assembly President (2012
2016)
Security Council (2015
2016)
Related
Bretton Woods system
Comprehensive Nuclear-Test-Ban Treaty
Criticism
Delivering as One
Flag
Honour Flag
Four Nations Initiative
Genocide Convention
UN Global Compact
ICC
International Decade for a Culture of Peace and Non-Violence for the Children of the World
International Years
UN laissez-passer
Military Staff Committee
Official languages
Organisation for the Prohibition of Chemical Weapons
Peacekeeping
Treaty Series
UN Day
Universal Declaration of Human Rights
Millennium Declaration
Summit
Development Goals
Security Council veto power
UN reform
Security Council reform
UN Art Collection
UN Memorial Cemetery Korea
Other
Outline
UN television film series (1964–1966)
In popular culture
Retrieved from "https://en.wikipedia.org/w/index.php?title=United_Nations_Security_Council_veto_power&oldid=820735266"
Categories:
Veto
United Nations Security Council
Vetoed United Nations Security Council resolutions
Hidden categories:
CS1 Spanish-language sources (es)
Articles with obsolete information from March 2013
All Wikipedia articles in need of updating
Articles needing additional references from February 2010
All articles needing additional references
Articles with multiple maintenance issues
All articles with unsourced statements
Articles with unsourced statements from October 2008
Articles with unsourced statements from February 2013
Articles with unsourced statements from April 2009
Navigation menu
Personal tools
Not logged in
Talk
Contributions
Create account
Log in
Namespaces
Article
Talk
Variants
Views
Read
Edit
View history
More
Search
Navigation
Main page
Contents
Featured content
Current events
Random article
Donate to Wikipedia
Wikipedia store
Interaction
Help
About Wikipedia
Community portal
Recent changes
Contact page
Tools
What links here
Related changes
Upload file
Special pages
Permanent link
Page information
Wikidata item
Cite this page
Print/export
Create a book
Download as PDF
Printable version
In other projects
Wikimedia Commons
Languages
العربية
Català
Deutsch
Español
فارسی
Français
Bahasa Indonesia
Português
Русский
Српски / srpski
Srpskohrvatski / српскохрватски
தமிழ்
Українська
中文
Edit links
This page was last edited on 16 January 2018, at 09:07.
Text is available under the Creative Commons Attribution-ShareAlike License; additional terms may apply. By using this site, you agree to the Terms of Use and Privacy Policy. Wikipedia® is a registered trademark of the Wikimedia Foundation, Inc., a non-profit organization.
Privacy policy
About Wikipedia
Disclaimers
Contact Wikipedia
Developers
Cookie statement
Mobile view
Enable previews

values: mw-page-base noprint

values: mw-head-base noprint

values: firstHeading firstHeading en

values: siteSub noprint

values: jump-to-nav mw-jump

attrs: class role tabindex

values: mw-collapsible-toggle button 0

value: b

attrs: class href

values: Talk:United Nations Security Council veto power

value: small

values: plainlinks metadata ambox ambox-content ambox-Update

values: Help:Introduction to referencing with Wiki Markup/1

values: plainlinks metadata ambox ambox-content ambox-Refimprove

values:
mw-collapsible
width:95%; margin: 0.2em 0;

values: plainlinks metadata ambox ambox-content ambox-multiple_issues compact-ambox

attrs: alt src width height class srcset data-file-width data-file-height

values: Permanent members of the United Nations Security Council

values: United Nations Secretary-General selection

values: Edit section: Origins of the veto provision

values:
/wiki/Republic_of_China
mw-redirect
Republic of China

values:
/wiki/Colonial_power
mw-redirect
Colonial power

values:
/wiki/Free_French_forces
mw-redirect
Free French forces

values: This claim needs references to reliable sources. (October 2008)

values:
noprint Inline-Template Template-Fact
white-space:nowrap;

values: This claim needs references to reliable sources. (February 2013)

values: Edit section: Selection of a Secretary-General

values: Edit section: Most recent veto per country

values: United Nations Security Council Resolution 166

values: Russian military intervention in Ukraine (2014–present)

values: United Nations Security Council Resolution 1441

values: United Nations General Assembly Resolution 377

values:
/wiki/Charles_W._Yost
mw-redirect
Charles W. Yost

values:
/wiki/Israel-Palestinian_conflict
mw-redirect
Israel-Palestinian conflict

values: United Nations Security Council Resolution 2334

values:
/wiki/John_J._Mearsheimer
mw-redirect
John J. Mearsheimer

values: List of members of the United Nations Security Council

values: List of the UN resolutions concerning Israel

values: Non-Align Movement (page does not exist)

values: Reform of the United Nations Security Council

values:
/wiki/Great_powers
mw-redirect
Great powers

values: This claim needs references to reliable sources. (April 2009)

values:
nofollow
external free
https://www.jstor.org/stable/1950035

values:
nofollow
external text
http://www.un.org/sc/members.asp

values:
/wiki/Winston_S._Churchill
mw-redirect
Winston S. Churchill

values:
/wiki/The_United_Nations
mw-redirect
The United Nations

values:
nofollow
external text
http://research.un.org/en/docs/sc/quick

values:
nofollow
external text
http://www.bbc.com/news/world-31617141

values:
nofollow
https://www.un.org/secureworld/
external text

values:
nofollow
external text
http://www.iciss.ca/menu-en.asp

values: -moz-column-width: 30em; -webkit-column-width: 30em; column-width: 30em; list-style-type: decimal;

values:
nofollow
http://www.slate.com/id/2080036/
external text

values: Deputy Secretary-General of the United Nations

values: President of the United Nations General Assembly

values: United Nations Economic and Social Council

values: Under-Secretary-General of the United Nations

values: Statute of the International Court of Justice

values: Office of the Secretary-General's Envoy on Youth

values: Office of the Spokesperson for the Secretary-General

values: United Nations Department of Economic and Social Affairs

values: United Nations Department of Political Affairs

values: United Nations Department of Public Information

values: United Nations Department for Safety and Security

values: United Nations Division for Palestinian Rights

values: United Nations Department of Peacekeeping Operations

values: United Nations Office of Internal Oversight Services

values: United Nations Office of the High Representative for the Least Developed Countries, Landlocked Developing Countries and Small Island Developing States

values: United Nations Office on Sport for Development and Peace

values: United Nations Office for Disarmament Affairs

values: United Nations Office for Outer Space Affairs

values: United Nations Office for the Coordination of Humanitarian Affairs

values: List of United Nations organizations by location

values: List of specialized agencies of the United Nations

values: International Civil Aviation Organization

values: International Fund for Agricultural Development

values: Intergovernmental Panel on Climate Change

values: United Nations Mission for the Referendum in Western Sahara

values: United Nations Industrial Development Organization

values: Joint United Nations Programme on HIV/AIDS

values: United Nations Conference on Trade and Development

values: United Nations Commission on International Trade Law

values: United Nations Fund for International Partnerships (UNFIP)

values: United Nations Human Settlements Programme

values: Office of the United Nations High Commissioner for Human Rights

values: United Nations High Commissioner for Refugees

values: United Nations Interregional Crime and Justice Research Institute

values: United Nations Institute for Disarmament Research

values: United Nations Institute for Training and Research

values: United Nations Office on Drugs and Crime

values: United Nations Office for Project Services

values: United Nations Research Institute For Social Development

values: World Intellectual Property Organization

values: United Nations General Assembly observers

values: List of United Nations peacekeeping missions

values: Timeline of United Nations peacekeeping missions

values: List of vetoed United Nations Security Council resolutions

values: United Nations General Assembly resolution

values: List of resolutions at the sixty-sixth session of the United Nations General Assembly

values: List of resolutions at the sixty-seventh session of the United Nations General Assembly

values: United Nations Security Council resolution

values: List of United Nations Security Council resolutions concerning Cyprus

values: List of United Nations resolutions concerning Iran

values: List of United Nations Security Council resolutions concerning Iraq

values: List of United Nations resolutions concerning Israel

values: List of United Nations resolutions relating to Lebanon

values: List of United Nations Security Council resolutions on the Nagorno-Karabakh conflict

values: List of United Nations Security Council resolutions concerning North Korea

values: List of United Nations resolutions concerning Palestine

values: List of United Nations resolutions concerning Syria

values: List of United Nations resolutions concerning Western Sahara

values: United Nations Secretary-General selection, 2006

values: United Nations Secretary-General selection, 2016

values: International Court of Justice judges election, 2011

values: United Nations General Assembly presidential election, 2012

values: United Nations General Assembly presidential election, 2016

values: United Nations Security Council election, 2015

values: United Nations Security Council election, 2016

values:
/wiki/International_observance
mw-redirect
International observance

values: Official languages of the United Nations

values: Organisation for the Prohibition of Chemical Weapons

values: nowraplinks hlist collapsible autocollapse navbox-inner

values: Category:United Nations Security Council

values: Category:Vetoed United Nations Security Council resolutions

values: Category:CS1 Spanish-language sources (es)

values: Category:Articles with obsolete information from March 2013

values: Category:All Wikipedia articles in need of updating

values: Category:Articles needing additional references from February 2010

values: Category:All articles needing additional references

values: Category:Articles with multiple maintenance issues

values: Category:All articles with unsourced statements

values: Category:Articles with unsourced statements from October 2008

values: Category:Articles with unsourced statements from February 2013

values: Category:Articles with unsourced statements from April 2009

values: Discussion about edits from this IP address [ctrl-alt-n]

values: A list of edits made from this IP address [ctrl-alt-y]

values: You are encouraged to create an account and log in; however, it is not mandatory

values: You're encouraged to log in; however, it's not mandatory. [ctrl-alt-o]

values: Discussion about the content page [ctrl-alt-t]

values: p-namespaces navigation vectorTabs p-namespaces-label

values:
p-variants
navigation
vectorMenu emptyPortlet
p-variants-label

values: Past revisions of this page [ctrl-alt-h]

values: p-views navigation vectorTabs p-views-label

values:
p-cactions
navigation
vectorMenu emptyPortlet
p-cactions-label

values:
mw-wiki-logo
/wiki/Main_Page
Visit the main page

values:
/wiki/Main_Page
Visit the main page [ctrl-alt-z]
z

values: Featured content – the best of Wikipedia

values: portal navigation p-wikibase-otherprojects p-wikibase-otherprojects-label

values:
uls-settings-trigger
Language settings
0
button
true

values: حق النقض في مجلس الأمن التابع للأمم المتحدة – Arabic

values: Poder de veto al Consell de Seguretat de les Nacions Unides – Catalan

values: Poder de veto del Consejo de Seguridad de las Naciones Unidas – Spanish

values: حق وتو در شورای امنیت سازمان ملل متحد – Persian

values: Droit de veto au Conseil de sécurité des Nations unies – French

values: Hak veto Dewan Keamanan Perserikatan Bangsa-Bangsa – Indonesian

values: Poder de veto do Conselho de Segurança das Nações Unidas – Portuguese

values: Право вето в Совете Безопасности ООН – Russian

values: Вето у Савету безбедности Организације уједињених нација – Serbian

values: Veto u Savetu bezbednosti Ujedinjenih nacija – Serbo-Croatian

values: வீட்டோ அதிகாரம் பெற்ற நாடுகள் – Tamil

values: Право вето в Раді Безпеки ООН – Ukrainian

values: 聯合國安全理事會否決權 – Chinese

values: /static/images/wikimedia-button-1.5x.png 1.5x, /static/images/wikimedia-button-2x.png 2x

values: /static/images/poweredby_mediawiki_132x47.png 1.5x, /static/images/poweredby_mediawiki_176x62.png 2x

values:
suggestions
display: none; font-size: 13px;

values: mediawiki ltr sitedir-ltr mw-hide-empty-elt ns-0 ns-subject page-United_Nations_Security_Council_veto_power rootpage-United_Nations_Security_Council_veto_power skin-vector action-view


text:
Spinal fusion
From Wikipedia, the free encyclopedia
Jump to: navigation, search
Spinal fusion
Fusion of L5 and S1
ICD-9-CM
81.0
MeSH
D013123
MedlinePlus
002968
[edit on Wikidata]
Spinal fusion, also called spondylodesis or spondylosyndesis, is a neurosurgical or orthopedic surgical technique that joins two or more vertebrae. This procedure can be performed at any level in the spine (cervical, thoracic, or lumbar) and prevents any movement between the fused vertebrae. There are many types of spinal fusion and each technique involves using bone grafting - either from the patient (autograft), donor (allograft), or artificial bone substitutes - to help the bones heal together.[1] Additional hardware (screws, plates, or cages) is often used to hold the bones in place while the graft fuses the two vertebrae together.
Spinal fusion is most commonly performed to relieve the pain and pressure on the spinal cord that results when a disc (cartilage between two vertebrae) wears out (degenerative disc disease).[2] Other common pathological conditions that are treated by spinal fusion include spinal stenosis, spondylolisthesis, spondylosis, spinal fractures, scoliosis, and kyphosis.[2]
Like any surgery, complications may include infection, blood loss, and nerve damage.[3] Fusion also changes the normal motion of the spine and results in more stress on the vertebrae above and below the fused segments. As a result, long-term complications include degeneration at these adjacent spine segments.[1]
Contents
[hide]
1 Medical uses
2 Contraindications
3 Epidemiology
4 Costs
5 Technique
5.1 Cervical spine
5.2 Thoracic spine
5.3 Lumbar spine
6 Risks
6.1 During surgery
6.2 Within a few days
6.3 Weeks to years following surgery
7 Recovery
8 Usage
9 References
10 Further reading
11 External links
Medical uses[edit]
Spinal fusion can be used to treat a variety of conditions affecting any level of the spine - lumbar, cervical and thoracic. In general, spinal fusion is performed to decompress and stabilize the spine.[3] The most common cause of pressure on the spinal cord/nerves is degenerative disc disease.[4] Other common causes include disc herniation, spinal stenosis, trauma, and spinal tumors.[3] Spinal stenosis results from bony growths (osteophytes) or thickened ligaments that cause narrowing of the spinal canal over time.[3] This causes leg pain with increased activity, a condition called neurogenic claudication.[3] Pressure on the nerves as they exit the spinal cord (radiculopathy) causes pain in the area where the nerves originated (leg for lumbar pathology, arm for cervical pathology).[3] In severe cases, this pressure can cause neurologic deficits, like numbness, tingling, bowel/bladder dysfunction, and paralysis.[3]
Lumbar and cervical spinal fusions are more commonly performed than thoracic fusions.[4] Degeneration happens more frequently at these levels due to increased motion and stress.[4] The thoracic spine is more immobile, so most fusions are performed due to trauma or deformities like scoliosis and kyphosis.[3]
Herniated disc pressing on spinal nerves.
Conditions where spinal fusion may be considered include the following:
Degenerative disc disease
Spinal disc herniation
Discogenic pain
Spinal tumor
Vertebral fracture
Scoliosis
Kyphosis (e. g., Scheuermann's disease)
Spondylolisthesis
Spondylosis
Posterior rami syndrome
Other degenerative spinal conditions[3]
Any condition that causes instability of the spine[3]
Contraindications[edit]
Bone morphogenetic protein (rhBMP) should not be routinely used in any type of anterior cervical spine fusion, such as with anterior cervical discectomy and fusion.[5] There are reports of this therapy causing soft tissue swelling, which in turn can cause life-threatening complications due to difficulty swallowing and pressure on the respiratory tract.[5]
Epidemiology[edit]
According to a report by the Agency for Healthcare Research and Quality (AHRQ), approximately 488,000 spinal fusions were performed during U.S. hospital stays in 2011 (a rate of 15.7 stays per 10,000 population), which accounted for 3.1% of all operating room procedures.[6] This was a 70 percent growth in procedures from 2001.[7] Lumbar fusions are the most common type of fusion performed ~ 210,000 per year. 24,000 thoracic fusions and 157,000 cervical fusions are performed each year.[4]
A 2008 analysis of spinal fusions in the United States reported the following characteristics:
Average age for someone undergoing a spinal fusion was 54.2 years - 53.3 years for primary cervical fusions, 42.7 years for primary thoracic fusions, and 56.3 years for primary lumbar fusions [4]
45.5% of all spinal fusions were on men [4]
83.8% were white, 7.5% black, 5.1% Hispanic, 1.6% Asian or Pacific Islander, 0.4% Native American [4]
Average length of hospital stay was 3.7 days - 2.7 days for primary cervical fusion, 8.5 days for primary thoracic fusion, and 3.9 days for primary lumbar fusion [4]
In-hospital mortality was 0.25% [4]
Costs[edit]
Costs associated with spinal fusion vary depending on the medical institution, insurance, type of surgery and the overall health of the patient.[8] Total costs typically include labs, medications, room & board, medical supplies, recovery room, operating room services, physical therapy, imaging, and hospital charges.[9] The average total hospital costs for spinal fusions increased from $24,676 in 1998 to $81,960 in 2008.[4] The average total costs of common fusion procedures are listed below:
$34,943 - Anterior cervical discectomy and fusion (ACDF) for someone with severe obesity and diabetes (2005-2008) [8]
$25,633 - ACDF for someone without obesity and diabetes (2005-2008) [8]
$65,782 - Lumbar decompression and fusion (LDF) for someone with diabetes and depression (2005-2008) [8]
$52,249 - LDF for someone without diabetes or depression (2005-2008) [8]
$80,095 - Upper thoracic level primary spinal fusion (2003-2013) [9]
$55,547 - Revision of previous fusion surgery due to adjacent segment disease (2003-2013) [9]
Technique[edit]
There are many types of spinal fusion techniques. Each technique varies depending on the level of the spine and the location of the compressed spinal cord/nerves.[3] After the spine is decompressed, bone graft or artificial bone substitute is packed between the vertebrae to help them heal together.[1] In general, fusions are done either on the anterior (stomach), posterior (back), or both sides of the spine.[3] Today, most fusions are supplemented with hardware (screws, plates, rods) because they have been shown to have higher union rates than non-instrumented fusions.[3] Minimally invasive techniques are also becoming more popular.[10] These techniques use advanced image guidance systems to insert rods/screws into the spine through smaller incisions, allowing for less muscle damage, blood loss, infections, pain, and length of stay in the hospital.[10] The following list gives examples of common types of fusion techniques performed at each level of the spine:
Anterior approach to cervical spine.
Cervical spine[edit]
Anterior cervical discectomy and fusion (ACDF)[3]
Anterior cervical corpectomy and fusion[3]
Posterior cervical decompression and fusion[3]
Thoracic spine[edit]
Anterior decompression and fusion[3]
Posterior instrumentation and fusion – many different types of hardware can be used to help fuse the thoracic spine including sublaminar wiring, pedicle and transverse process hooks, pedicle screw-rod systems, vertebral body plate systems.[3]
Lumbar spine[edit]
Posterolateral Fusion - bone graft is placed between the transverse processes in the back of the spine. These vertebrae are then fixed in place with screws and/or wire through the pedicles of each vertebra attaching to a metal rod on each side of the vertebrae.
Interbody Fusion - the entire intervertebral disc between vertebrae is removed and bone graft is placed in the space between the vertebra. A plastic or titanium device may be placed between the vertebra to maintain spine alignment and disc height. The types of interbody fusion are:
Anterior lumbar interbody fusion (ALIF) – the disc is accessed from an anterior abdominal incision
Posterior lumbar interbody fusion (PLIF) – the disc is accessed from a posterior incision
Transforaminal lumbar interbody fusion (TLIF) – the disc is accessed from a posterior incision on one side of the spine
Transpsoas interbody fusion (DLIF or XLIF) – the disc is accessed from an incision through the psoas muscle on one side of the spine
Oblique lateral lumbar interbody fusion (OLLIF) – the disc is accessed from an incision through the psoas muscle obliquely
Stabilization rods used after spinal fusion surgery.
Risks[edit]
Spinal fusion is a high risk surgery and complications can be serious, including death. In general, there is a higher risk of complications in older people with elevated body mass index (BMI), other medical problems, poor nutrition and nerve symptoms (numbness, weakness, bowel/bladder issues) before surgery.[3] Complications also depend on the type/extent of spinal fusion surgery performed. There are three main time periods where complications typically occur:
During surgery[edit]
Patient positioning on operating table [3]
Blood loss [3]
Damage to nerves and surrounding structures during procedure [3]
Insertion of spinal hardware [3]
Harvesting of bone graft (if autograft is used) [3]
Within a few days[edit]
Wound infections - risk factors include old age, obesity, diabetes, smoking, prior surgery[3]
Deep vein thrombosis (DVT) [3]
Pulmonary embolism (PE) [3]
Urinary retention [3]
Malnutrition[3]
Neurologic deficit [3]
Weeks to years following surgery[edit]
Infection[3]
Deformity - loss of height, alignment, and failure of fusion [3]
Pseudarthrosis - nonunion between fused bone segments. Risk factors include tobacco use, nonsteroidal anti-inflammatory drug use, osteoporosis, revision procedures, decreased immune system.[3]
Adjacent segment disease - degeneration of vertebrae above/below the fused segments due to increased stress and motion.[3]
Epidural fibrosis - scarring of the tissue that surrounds the spinal cord[3]
Arachnoiditis - inflammation of the thin membrane surrounding the spinal cord, usually caused by infection or contrast dye.[3]
Recovery[edit]
Recovery following spinal fusion is extremely variable, depending on individual surgeon's preference and the type of procedure performed.[11] The average length of hospital stay for spinal fusions is 3.7 days.[4] Some patients can go home the same day if they undergo a simple cervical spinal fusion at an outpatient surgery center.[12] Minimally invasive surgeries are also significantly reducing the amount of time spent in the hospital.[12] Recovery typically involves both restriction of certain activities and rehabilitation training.[13] Restrictions following surgery largely depend on surgeon preference. A typical timeline for common restrictions after a lumbar fusion surgery are listed below:
Walking - most people are out of bed and walking the day after surgery[13]
Sitting - can begin at 1–6 weeks following surgery[13]
Lifting - it is generally recommended to avoid lifting until 12 weeks[13]
Driving - usually can begin at 3–6 weeks[13]
Return to sedentary work - usually between 3–6 weeks[13]
Return to manual work - between 7–12 weeks[13]
Rehabilitation after spinal fusion is not mandatory. There is some evidence that it improves functional status and low back pain so some surgeons may recommend it.[13]
Usage[edit]
According to a report by the Agency for Healthcare Research and Quality (AHRQ), approximately 488,000 spinal fusions were performed during U.S. hospital stays in 2011 (a rate of 15.7 stays per 10,000 population), which accounted for 3.1% of all operating room procedures.[6]
References[edit]
^ Jump up to: a b c Chou, Roger (March 11, 2016). "Subacute and Chronic Low Back Pain: Surgical Treatment". UpToDate.
^ Jump up to: a b Rajaee, Sean (2012). "Spinal Fusion in the United States". Spine. 37: 67–76.
^ Jump up to: a b c d e f g h i j k l m n o p q r s t u v w x y z aa ab ac ad ae af ag ah ai aj Agulnick, Marc (2017). Orthopaedic Surgery Essentials: Spine. Two Commerce Square, 2001 Market Street, Philadelphia, PA 19103 USA: Lippincott Williams & Wilkins. p. 343. ISBN 978-1-49631-854-1.
^ Jump up to: a b c d e f g h i j k Rajaee, Sean S.; Bae, Hyun W.; Kanim, Linda E.A.; Delamarter, Rick B. "Spinal Fusion in the United States". Spine. 37 (1): 67–76. doi:10.1097/brs.0b013e31820cccfb.
^ Jump up to: a b North American Spine Society (February 2013), "Five Things Physicians and Patients Should Question", Choosing Wisely: an initiative of the ABIM Foundation, North American Spine Society, retrieved 25 March 2013 , which cites
Schultz, Daniel G. (July 1, 2008). "Public Health Notifications (Medical Devices) - FDA Public Health Notification: Life-threatening Complications Associated with Recombinant Human Bone Morphogenetic Protein in Cervical Spine Fusion". fda.gov. Retrieved 25 March 2014.
Woo, EJ (Oct 2012). "Recombinant human bone morphogenetic protein-2: adverse events reported to the Manufacturer and User Facility Device Experience database". The Spine Journal. 12 (10): 894–9. doi:10.1016/j.spinee.2012.09.052. PMID 23098616.
^ Jump up to: a b Weiss AJ, Elixhauser A, Andrews RM (February 2014). "Characteristics of Operating Room Procedures in U.S. Hospitals, 2011". HCUP Statistical Brief #170. Rockville, MD: Agency for Healthcare Research and Quality.
Jump up ^ Weiss AJ, Elixhauser A (March 2014). "Trends in Operating Room Procedures in U.S. Hospitals, 2001—2011". HCUP Statistical Brief #171. Rockville, MD: Agency for Healthcare Research and Quality.
^ Jump up to: a b c d e Walid, M. Sami; Robinson, Joe Sam (2011-01-14). "Economic impact of comorbidities in spine surgery". Journal of Neurosurgery: Spine. 14 (3): 318–321. doi:10.3171/2010.11.SPINE10139. ISSN 1547-5654.
^ Jump up to: a b c Theologis, Alexander A.; Miller, Liane; Callahan, Matt; Lau, Darryl; Zygourakis, Corinna; Scheer, Justin K.; Burch, Shane; Pekmezci, Murat; Chou, Dean (2016-08-15). "Economic Impact of Revision Surgery for Proximal Junctional Failure After Adult Spinal Deformity Surgery". Spine. 41 (16): E964–E972. doi:10.1097/brs.0000000000001523. ISSN 1528-1159.
^ Jump up to: a b Phan, Kevin; Rao, Prashanth J.; Mobbs, Ralph J. (2015-08-01). "Percutaneous versus open pedicle screw fixation for treatment of thoracolumbar fractures: Systematic review and meta-analysis of comparative studies". Clinical Neurology and Neurosurgery. 135: 85–92. doi:10.1016/j.clineuro.2015.05.016. ISSN 1872-6968. PMID 26051881.
Jump up ^ McGregor, Alison H.; Dicken, Ben; Jamrozik, Konrad (2006-05-31). "National audit of post-operative management in spinal surgery". BMC Musculoskeletal Disorders. 7: 47. doi:10.1186/1471-2474-7-47. ISSN 1471-2474. PMC 1481518  . PMID 16737522.
^ Jump up to: a b Shields, Lisa B. E.; Clark, Lisa; Glassman, Steven D.; Shields, Christopher B. (2017-01-19). "Decreasing hospital length of stay following lumbar fusion utilizing multidisciplinary committee meetings involving surgeons and other caretakers". Surgical Neurology International. 8. doi:10.4103/2152-7806.198732. ISSN 2229-5097. PMC 5288986  . PMID 28217384.
^ Jump up to: a b c d e f g h McGregor, Alison H.; Probyn, Katrin; Cro, Suzie; Doré, Caroline J.; Burton, A. Kim; Balagué, Federico; Pincus, Tamar; Fairbank, Jeremy (2013-12-09). "Rehabilitation following surgery for lumbar spinal stenosis". The Cochrane Database of Systematic Reviews (12): CD009644. doi:10.1002/14651858.CD009644.pub2. ISSN 1469-493X. PMID 24323844.
Further reading[edit]
Cervical Spinal Fusion. WebMD.
A Patient's Guide to Anterior Cervical Fusion. University of Maryland Medical Center.
Boatright, K. C. and S. D. Boden. Chapter 12: Biology of Spine Fusion. In: Lieberman, J., et al., Eds. Bone Regeneration and Repair. Totowa, New Jersey: Humana Press. 2005. pp. 225–239. ISBN 978-0-89603-847-9.
Holmes, C. F., et al. Chapter 9: Cervical Spine Injuries. In: Schenck, R. F., AAOS. Athletic Training in Sports Medicine. Jones & Bartlett Publishers. 2005. pp. 197–218. ISBN 0-89203-172-7
Camillo, F. X. Chapter 36: Arthrodesis of the Spine. In: Canale, S. T. and J. H. Beaty. Campbell's Operative Orthopaedics 2. (11th Ed.). Philadelphia: Mosby. 2007. pp. 1851–1874. ISBN 978-0-323-03329-9.
Williams, K. D. and A. L. Park. Chapter 39: Lower Back Pain and Disorders of Intervertebral Discs. In: Canale, S. T. and J. H. Beaty. Campbell's Operative Orthopaedics 2. (11th Ed.). Philadelphia: Mosby. 2007. pp. 2159–2224. ISBN 978-0-323-03329-9.
Weyreuther, M., et al., Eds. Chapter 7: The Postoperative Spine. MRI Atlas: Orthopedics and Neurosurgery – The Spine. trans. B. Herwig. Berlin: Springer-Verlag. 2006. pp. 273–288. ISBN 978-3-540-33533-7.
Tehranzadehlow, J., et al. (2005). Advances in spinal fusion. Seminars in Ultrasound, CT, and MRI 26(2): 103–113.
Resnick, D. K., et al. Surgical Management of Low Back Pain (2nd Ed.). Rolling Meadows, Illinois: American Association of Neurosurgeons. 2008. ISBN 978-1-60406-035-5.
Oblique Lateral Lumbar Interbody Fusion (OLLIF): Technical Notes and Early Results of a Single Surgeon Comparative Study. NIH.
External links[edit]
Wheeless, C. R., et al., Eds. Fusion of the Spine. Wheeless' Textbook of Orthopaedics. Division of Orthopedic Surgery. Duke University Medical Center.
Spinal Fusion. American Academy of Orthopaedic Surgeons. June 2010. Accessed 1 June 2013.
Spinasanta, S. What is Spinal Instrumentation and Spinal Fusion? SpineUniverse. September 2012. Accessed 1 June 2013.
Spinal fusion. Encyclopedia of Surgery. Accessed 1 June 2013.
[hide]
v
t
e
Orthopedic surgery, operations/surgeries and other procedures on bones and joints (ICD-9-CM V3 76–81, ICD-10-PCS 0P–S)
Bones
Facial
Jaw reduction
Dentofacial osteotomy
Genioplasty/Mentoplasty
Chin augmentation
Orthognathic surgery
Spine
Coccygectomy
Laminotomy
Laminectomy
Laminoplasty
Corpectomy
Facetectomy
Foraminotomy
Vertebral fixation
Percutaneous vertebroplasty
Upper extremity
Acromioplasty
Lower extremity
Femoral head ostectomy
Astragalectomy
Distraction osteogenesis
Ilizarov apparatus
General
Ostectomy
Bone grafting
Osteotomy
Epiphysiodesis
Reduction
Internal fixation
External fixation
Tension band wiring
Cartilage
Articular cartilage repair
Microfracture surgery
Knee cartilage replacement therapy
Autologous chondrocyte implantation
Joints
Spine
Arthrodesis
Spinal fusion
Intervertebral discs
Discectomy
Annuloplasty
Arthroplasty
Upper extremity
Shoulder surgery
Shoulder replacement
Bankart repair
Weaver–Dunn procedure
Ulnar collateral ligament reconstruction
Hand surgery
Brunelli procedure
Lower extremity
Hip resurfacing
Hip replacement
Rotationplasty
Anterior cruciate ligament reconstruction
Knee replacement/Unicompartmental knee arthroplasty
Ankle replacement
Broström procedure
Triple arthrodesis
General
Arthrotomy
Arthroplasty
Synovectomy
Arthroscopy
Replacement joint
imaging: Arthrogram
Arthrocentesis
Retrieved from "https://en.wikipedia.org/w/index.php?title=Spinal_fusion&oldid=821834754"
Categories:
Neurosurgical procedures
Orthopedic surgical procedures
Navigation menu
Personal tools
Not logged in
Talk
Contributions
Create account
Log in
Namespaces
Article
Talk
Variants
Views
Read
Edit
View history
More
Search
Navigation
Main page
Contents
Featured content
Current events
Random article
Donate to Wikipedia
Wikipedia store
Interaction
Help
About Wikipedia
Community portal
Recent changes
Contact page
Tools
What links here
Related changes
Upload file
Special pages
Permanent link
Page information
Wikidata item
Cite this page
Print/export
Create a book
Download as PDF
Printable version
In other projects
Wikimedia Commons
Languages
العربية
Deutsch
فارسی
Nederlands
Polski
Русский
ไทย
Edit links
This page was last edited on 22 January 2018, at 22:19.
Text is available under the Creative Commons Attribution-ShareAlike License; additional terms may apply. By using this site, you agree to the Terms of Use and Privacy Policy. Wikipedia® is a registered trademark of the Wikimedia Foundation, Inc., a non-profit organization.
Privacy policy
About Wikipedia
Disclaimers
Contact Wikipedia
Developers
Cookie statement
Mobile view
Enable previews

key: html

type: local

value: div

attrs: id class

values: mw-page-base noprint

values: mw-head-base noprint

value: a

attrs: id class lang

values: firstHeading firstHeading en

values: siteSub noprint

values: jump-to-nav mw-jump

value: th

attrs: colspan style

value: tr

value: img

attrs: alt src width height srcset data-file-width data-file-height

attrs: href class

value: td

attrs: href title

attrs: rel class href

value: span

values:
/wiki/Herniated_disc
mw-redirect
Herniated disc

values:
/wiki/Difficulty_swallowing
mw-redirect
Difficulty swallowing

values:
/wiki/Transverse_process
mw-redirect
Transverse process

values:
/wiki/Pedicle_of_vertebral_arch
mw-redirect
Pedicle of vertebral arch

values: Oblique lateral lumbar interbody fusion (page does not exist)

values: Edit section: Weeks to years following surgery

values:
/wiki/ABIM_Foundation
mw-redirect
ABIM Foundation

values:
/wiki/PubMed_Identifier
mw-redirect
PubMed Identifier

values:
nofollow
external text
//www.ncbi.nlm.nih.gov/pubmed/23098616

values:
nofollow
external text
//doi.org/10.3171%2F2010.11.SPINE10139

values:
nofollow
external text
//www.worldcat.org/issn/1547-5654

values:
nofollow
external text
//www.worldcat.org/issn/1528-1159

values:
nofollow
external text
//www.worldcat.org/issn/1872-6968

values:
nofollow
external text
//www.ncbi.nlm.nih.gov/pubmed/26051881

values:
nofollow
external text
//doi.org/10.1186%2F1471-2474-7-47

values:
nofollow
external text
//www.worldcat.org/issn/1471-2474

attrs: alt src title width height srcset data-file-width data-file-height

values:
nofollow
external text
//www.ncbi.nlm.nih.gov/pubmed/16737522

values:
nofollow
external text
//www.worldcat.org/issn/2229-5097

values:
nofollow
external text
//www.ncbi.nlm.nih.gov/pubmed/28217384

values:
nofollow
external text
//www.worldcat.org/issn/1469-493X

values:
nofollow
external text
//www.ncbi.nlm.nih.gov/pubmed/24323844

values: -moz-column-width: 32em; -webkit-column-width: 32em; column-width: 32em; list-style-type: decimal;

values: Template:Bone, cartilage, and joint procedures

values: Template talk:Bone, cartilage, and joint procedures

values:
/wiki/Dentofacial_osteotomy
mw-redirect
Dentofacial osteotomy

values:
/wiki/Human_vertebral_column
mw-redirect
Human vertebral column

values: nowraplinks collapsible autocollapse navbox-inner

values:
catlinks mw-normal-catlinks
catlinks mw-normal-catlinks
interface

values: Discussion about edits from this IP address [ctrl-alt-n]

values: A list of edits made from this IP address [ctrl-alt-y]

values: You are encouraged to create an account and log in; however, it is not mandatory

values: You're encouraged to log in; however, it's not mandatory. [ctrl-alt-o]

values:
/wiki/Spinal_fusion
View the content page [ctrl-alt-c]
c

values: Discussion about the content page [ctrl-alt-t]

values: p-namespaces navigation vectorTabs p-namespaces-label

values:
p-variants
navigation
vectorMenu emptyPortlet
p-variants-label

values: Past revisions of this page [ctrl-alt-h]

values: p-views navigation vectorTabs p-views-label

values:
p-cactions
navigation
vectorMenu emptyPortlet
p-cactions-label

values:
mw-wiki-logo
/wiki/Main_Page
Visit the main page

values:
/wiki/Main_Page
Visit the main page [ctrl-alt-z]
z

values: Featured content – the best of Wikipedia

values: Find background information on current events

values:
/wiki/Special:Random
Load a random article [ctrl-alt-x]
x

values: portal navigation p-navigation p-navigation-label

values: Guidance on how to use and edit Wikipedia

values: About the project, what you can do, where to find things

values: A list of recent changes in the wiki [ctrl-alt-r]

values: portal navigation p-interaction p-interaction-label

values: List of all English Wikipedia pages containing links to this page [ctrl-alt-j]

values: Recent changes in pages linked from this page [ctrl-alt-k]

values:
/wiki/Wikipedia:File_Upload_Wizard
Upload files [ctrl-alt-u]
u

values: A list of all special pages [ctrl-alt-q]

values: Permanent link to this revision of the page

values: Link to connected data repository item [ctrl-alt-g]

values: Printable version of this page [ctrl-alt-p]

values: portal navigation p-wikibase-otherprojects p-wikibase-otherprojects-label

values: دمج الفقرات – Arabic

values: جوش دادن مهره‌ها – Persian

values: Спондилодез – Russian

values: การผ่าตัดเชื่อมข้อกระดูกสันหลัง – Thai

values: mediawiki ltr sitedir-ltr mw-hide-empty-elt ns-0 ns-subject page-Spinal_fusion rootpage-Spinal_fusion skin-vector action-view