Is Spinal Fusion Right for Me?

Is Spinal Fusion Right for Me?
February 23, 2018

The idea of spinal fusion surgery sounds intimidating to many chronic back pain sufferers until they learn how this extremely common operation can enable them to resume their favorite activities and restore their quality of life, says Praveen Kadimcherla, MD, with Atlantic Spine Center. Most Americans will suffer from back pain at some point in their lives, and most patients’ pain levels will improve with time and conservative treatments such as medication, exercise, steroid injections, physical therapy, and heat/ice application. But for those whose back pain lingers beyond 3-6 months with conservative treatment, spinal fusion surgery may be an option depending on the cause of their pain, Dr. Kadimcherla explains.

What exactly is spinal fusion? The surgery corrects problems with spinal vertebrae by fusing, or joining together, vertebrae with surgical hardware so they can heal into a single, solid bone. By fusing vertebrae, the procedure helps vertebrae stop rubbing or grinding together, a problem that lead to bone spurs, arthritis and other painful back issues. “Spinal fusion stops damaging motion between spinal vertebrae, which can lower pressure on surrounding nerves,” Dr. Kadimcherla says. “Despite the trepidation many feel when they hear ‘spinal fusion,’ the goal of the surgery is really quite simple.”

Who’s a candidate for spinal fusion surgery and how well does it work?

Why undergo spinal fusion? The surgery may be advised for those suffering from lasting back pain due to a variety of conditions. According to Dr. Kadimcherla, these include:

  • Recurrent lumbar disc herniations, which happens when a disc’s jelly-like center bulges between vertebrae, pressing on nerves
  • Spondylolisthesis, which occurs when one vertebrae slides forward over the vertebrae beneath it, compressing nerves
  • Foraminal stenosis requiring disc height restoration, when a narrowing of spine openings leads in nerve compression
  • Lumbar degenerative disease, which triggers radiating pain from damaged discs in the spine

Among older adults, spinal fusion has become an increasingly common operation. Medicare patients ages 65 and over underwent 67 percent more spinal fusion surgeries in 2011 than just a decade earlier, according to 2014 figures by the Dartmouth Institute for Health Policy and Clinical Practice.But the statistics aren’t quite as clear when it comes to success rates for spinal fusion, according to Dr. Kadimcherla. “There’s no agreed-upon criterion for what constitutes success in this procedure,” he says. “Many physicians claim spinal fusion success rates as high as 90% or higher, but they don’t necessarily explain if that means the bones have successfully fused together, the patient’s symptoms have satisfactorily improved, or both.”

Types of spinal fusion surgeries:

There’s more than one way to perform spinal fusion surgery, and choosing the technique typically depends on several factors, Dr. Kadimcherla notes. These include a patient’s age, overall health and pre-existing conditions, as well as the surgeon’s experience level.

Traditional “open” spinal fusion surgery

A traditional spine fusion accesses spinal structures through one long incision. This technique typically requires at least an overnight hospital stay because of its more invasive nature.

Minimally invasive spinal fusion

This newer, less invasive, surgery necessitates much smaller incisions, enabling surgeons to achieve similar results with less pain and a quicker recovery time. But minimally invasive surgery isn’t possible for every patient, and Dr. Kadimcherla says you should speak with your doctor about what technique best fits your individual circumstances.

“If minimally invasive surgery is an option, it offers many benefits to open surgery, including a lower risk of postoperative complications,” Dr. Kadimcherla explains. “Minimally invasive surgery typically doesn’t require a hospital stay. It also results in less damage to muscles and tissues surrounding the spine, which is less painful for patients – meaning they’ll require less pain medication – and helps them heal more rapidly.” “But regardless of surgical technique, spinal fusion surgery does help many patients achieve their end goal: less pain and more mobility,” Dr. Kadimcherla adds. “Talk to your doctor to determine if spinal fusion is right for you.”

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