You’ve had back pain for awhile. You see a specialist, who suggests that a spinal fusion will improve your symptoms. But do you really need it? Spinal fusion surgery can be quite helpful for certain conditions, but it isn’t always the best course of treatment. Let’s discuss spinal fusion surgery, and when it should be considered as a treatment option.
What is a Spinal Fusion?
Spinal fusion is a surgical procedure that involves fusing together two vertebrae that are causing pain, creating one solid piece of bone. Fusions prevent motion between the two vertebrae, as well as the stretching of the surrounding nerves, muscles, and ligaments. Fusions are generally only recommended when your doctor can pinpoint the source of the pain; often, x-ray, MRI, and CT scans are used to help doctors find out what is causing the pain.
Although spinal fusions can reduce flexibility in the spine, the procedure will not inhibit motion much, since fusions usually involve small segments of the spine. Depending on your individual needs, the procedure can be done from the back (posterior) or the front (anterior). Bone grafts are used to help the two vertebrae fuse together, and plates, screws, and rods may be affixed to the spine to provide added stability.
When Spinal Fusion Should Be Considered (and When it Shouldn’t)
Generally, most doctors will try to treat a spinal condition without surgery first. Only once nonsurgical methods have failed is surgery considered. Fusing two vertebrae together forever changes the mechanics of the back, so it is important to make sure that the surgery is absolutely necessary before proceeding.
Spinal fusion is most often done in the lower back. Before proceeding with surgery, your doctor must be certain that the pain originates in the segment of the spine being fused together. If the pain isn’t being caused by that area of the spine, it won’t help to fuse those vertebrae together. Spinal fusion can be used to treat several conditions, including degenerative disc disease, spondylolisthesis, spinal stenosis, scoliosis, fractures, and spinal tumors.
Spinal fusion is a somewhat controversial topic. Some doctors do not believe spinal fusions work at all. In the past, too many spine fusions were performed that did not meet the criteria most well reputed surgeons abide by, which has contributed to skepticism regarding the procedure. However, this should not be the case; in the proper hands and with the proper indications, spinal fusions can, in fact, be highly effective. Generally, patients undergo nonsurgical treatment for six months to a year before a surgeon will consider a spinal fusion. If your doctor cannot determine the exact cause of the pain, he or she will likely try other treatment methods before resorting to a fusion. Even when the procedure is done impeccably, if the joint is not the cause of the patient’s pain, the surgery will not be successful.
If you feel you are being pressured into an unnecessary spinal fusion by your healthcare provider, don’t be afraid to get a second opinion. At the end of the day, you are in charge of your healthcare decisions, and you should be able to make an informed decision.