Spinal Fusion Surgery
Spinal fusion surgery is a drastic
back surgery
procedure in which two or more vertebrae are joined together (fused), so that no individual movement occurs in the operated vertebral levels. The idea of the surgery is to permanently connect the
vertebrae
to each other. This creates a solid piece of bone, rather than a joint that allows movement.The theory behind this practice is that nerves are being affected by movement in particular spinal levels, so by stopping all intervertebral motion, the pain will hopefully resolve. Although this makes some degree of sense in theory, real statistics for curative benefits offered by fusion are poor short-term and horrific long-term.
Reasons for Fusion Surgery
Fusion seems to be the great universal solution for all manner of back and neck pain issues. At least that is the way some doctors perceive it, since they prescribe fusion for virtually every type of causative condition, including all of the following and more:
* Correct a
spinal instability
* Correct serious
vertebral fractures
* Last resort for unresolved
herniated discs
* Stabilization of serious
scoliosis
* Correction of
spondylolisthesis
* Correction of severe
lordosis
* Correction of severe
kyphosis
How Does Fusion Work?
Spinal fusion
has many variations, but typically involves inserting bone grafts in between the operated vertebrae. These bone grafts heal and grow to form a living organic connection between the fused vertebrae. Bone grafts may be harvested from the patient or from a cadaver donor. New technology is exploring the possibility of using artificial bone as a graft substitute. Sometimes, additional pieces of hardware (plates, rods, screws, cage apparatus) are used to reinforce the bone graft or to further strengthen the fusion over several vertebral levels. The actual procedure has many variations in design and practice. Some procedures are performed through an incision on the back, some through an incision on the front. Some procedures are full open surgeries, while others are done using a smaller and less traumatic incisions. Even if spinal fusion is your only option, make sure to research the best surgical technique for your individual needs. Remember, a minimally invasive approach to care will reduce the chance for many complications, decrease healing time and dramatically improve post-surgical comfort.
Recovery from Spinal Fusion Surgery
This procedure is usually very invasive. There are less invasive versions available, but even these still require more recuperation time than other spinal surgeries. Patients typically remain as inpatients for 3 to 6 days and will require extensive
rehabilitation
after release from the hospital. Activity is strictly restricted, to allow the bone graft to heal and form a solid bond. The patient must take it easy for 3 to 4 months and will not be fully healed for up to 1 year. Patients should plan on being out of work for 2 to 6 months after a fusion procedure, since
recovering from back surgery
is a long and difficult road. If virtually any significant complication occurs, the entire process of healing can be voided. In these cases, patients often have to go though another operation to fix whatever went wrong the first (or second or third) time. Back to square one all over again.
Risks Of Spinal Fusion Surgery
Fusion has an extremely high risk of
back surgery complications,
especially when reinforcing hardware is utilized. There is a risk of infection, spinal fluid leak or nerve damage during this procedure. There is a moderate risk of continuing pain and poor surgical results. There is a risk of bone graft rejection, especially if the graft comes from a cadaver donor. Of course, there is always the significant risks posed by the general anesthetic, as well. Some patients wind up worse off after fusion… still in pain and further restricted in their movement.
Failed back surgery syndrome
is a very common occurrence in postoperative fusion patients. Even when all goes well, the inherent design of the surgery increases spinal degeneration exponentially in nearby vertebral levels. This often results in additional fusions every 5 to 9 years or so. Some patients may endure 4 or more of these horrible operations until almost their entire spine is firmly bound together, preventing all semblance of normal movement and life.
Recommendation for Spinal Fusion Surgery
Don’t do it… not if ANY other possible choice can be made. The spine is designed to move, not be cemented and screwed into a fixed shape. The fusion is likely to put stress on other levels of the spine, causing accelerated degeneration. If you have this procedure as a young patient, you might expect a future filled with additional back or neck pain and multiple surgeries. In the case of huge trauma to the spine, this procedure can be a life saver. It is also a good procedure for the correction of serious spinal curvature or dire vertebral misalignment. In almost any other circumstance, spinal fusion surgery can do more harm than good. A wise alternative for some patients might be to investigate
disc replacement surgery
as a viable option. Advertisement: |
Spinal Fusion Surgery to Back Pain
6/3/06 Revised 2/4/12
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