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What Are The Risks and Drawbacks of Spinal Fusion?

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Spinal fusion was first seen in its earliest form in the 1890s. We’ve come a very long way since then, and spinal fusion has since become a common treatment for chronic back pain and nerve compression.

Unfortunately, there are several risks and drawbacks associated with spinal fusion. Below, we’ll explore this topic to help patients better understand the treatments available for spinal conditions.

An Overview of Spinal Fusion

Spinal fusion is a common procedure used to stabilize the spine after decompression surgery. It’s implemented to help treat a broad range of spinal conditions, including:

  • Spinal stenosis
  • Spondylolisthesis
  • Herniated disc
  • Degenerative disc disease
  • Scoliosis
  • Vertebral fracture
  • Infection
  • Tumor in the spine

The Steps of Spinal Fusion

Spinal fusion essentially involves welding two vertebrae together using bone graft material. By fusing the affected vertebrae, the surgeon eliminates all motion between them. Though this leads to several notable drawbacks, it also prevents instability and re-injury.

The key steps of spinal fusion surgery include:

1. Administer General Anesthesia

The patient is fully asleep during spinal fusion.

2. Create the Incision

The incision may be made on the patient’s back (posterior incision), front (anterior incision), or side (lateral incision). The surgeon will use x-ray fluoroscopy or image guidance to map out the incision.

3. Pinpoint the Targeted Disc

Depending on the location of the incision, the surgeon may need to move various tissues and organs out of the way to access the disc. With an anterior approach, the surgeon moves the peritoneum sac, which protects the intestines, to the side of the belly.

4. Extract the Disc

With access to the affected disc, the surgeon can remove it. If multiple spinal levels are impacted, the surgeon may need to remove multiple discs.

5. Prep the Open Disc Space

Next, the surgeon needs to prepare the space where the bone graft material will be placed. This step typically involves measuring the disc space and positioning a trial spacer into the area. Then, the surgeon can take an x-ray to confirm that the implant will be effective.

6. Prep the Bone Graft Material

Once the open disc space is ready, the surgeon can prepare the bone graft material. This involves filing a spacer cage with the material.

7. Position the Bone Graft

Next, the surgeon places the permanent bone graft in the open disc space. This process may be directed by x-ray fluoroscopy. In some cases, the surgeon will use plates, rods, and pedicle screws for added stability.

8. Close the Incision

With the bone graft firmly in place, the surgeon can return tissues that have been moved aside into their regular positions and close the incision.

Risks and Drawbacks of Spinal Fusion

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Lost Mobility

Perhaps the largest downside of spinal fusion is that it reduces patients’ spinal mobility. Since the fusion process is designed to eliminate motion at the fused segment, the procedure limits patients’ ability to bend over, rotate, and stretch the back.

In many cases, lost mobility after spinal fusion compromises patients’ quality of life. Although patients attain relief from symptoms of spinal conditions after fusion, the surgery can severely limit their day-to-day activities.

Especially for patients to enjoy sports, yoga, dancing, and other forms of physical activity, fusion can have a far-reaching negative impact.

In severe cases (such as patients who undergo fusion at several spinal levels), fusion may require patients to use special tools to pick up objects off of the ground.

Extended Recovery

The recovery process is one of the key drawbacks of spinal fusion. Immediately after the procedure, patients typically must remain in the hospital for up to four days. A longer time spent in the hospital translates to higher medical bills and more time away from the comfort of home.

After returning home, patients usually must wait for four to six weeks before going back to a sedentary (or office) job.

Patients whose professionals require some physical activity may need to take three months (or even longer) off of work after spinal fusion. To return to strenuous physical activity, patients will likely need to wait six months or longer after the procedure.

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In spinal fusion, the bone graft material doesn’t immediately fuse the targeted vertebrae. This fusion process is lengthy, and it takes time for the bone to mature. Generally, it takes 12 to 18 months for the bone to completely solidify.

With this timeline in mind, the recovery process for spinal fusion can be highly disruptive for patients. It’s often difficult for patients to take long periods off of work, so extensive planning is required before the procedure.

Additionally, spinal fusion requires patients to avoid most physical activity for several months, which is challenging for those who are accustomed to an exercise routine.

Complications

Any surgical procedure comes with risks and potential complications. However, certain complications are unique to spinal fusion, such as adjacent segment disease.

Adjacent segment disease, or ASD, is a disorder that can develop after spinal fusion. It occurs when the vertebrae above and below the fused segment must bear added strain as a result of the fusion. Over time, this causes the affected vertebrae to degenerate at a more rapid rate.

Adjacent segment disease can lead to symptoms including chronic back pain, radiating pain, neurological symptoms, and difficulty walking or standing.

Are Alternatives To Spinal Fusion Available?

Thanks to recent medical advancements and innovations, patients now have more treatment options for spinal conditions at their disposal. Among the current spinal fusion alternatives is a no fusion spinal implant. This type of spine device stabilizes the affected vertebrae without fusing them to restore a controlled range of motion.

This process provides stability after procedures like laminectomy without compromising the patient’s movement (or requiring an extensive back surgery recovery).

If you’ve been diagnosed with a spinal condition that may require surgery, understand that there are numerous treatment options at your disposal.

Talk to your doctor about the latest advancements in spine surgery to ensure that your treatment plan is the best fit for your needs.

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