Back pain is a prevalent health concern across the globe. While everyone is likely to experience back pain at some point in life, a small portion of people will need spinal surgery to relieve chronic pain. 

Spinal fusion surgery is a procedure that’s been used for decades to resolve pain from a range of spinal conditions. While this surgical procedure can effectively improve spinal pain, it comes with several downsides. To avoid the side effects and prolonged recovery of spinal fusion, many patients opt for other treatment options. 

Here, we’ll discuss spinal fusion and the available alternatives to resolve chronic pain in the spine. 

What Exactly is Spinal Fusion Surgery?

In spinal fusion, the surgeon removes a portion of a damaged spinal disc to place a bone graft in between the affected vertebrae. Over time, the bone graft will permanently fuse the vertebrae. This process prevents motion in between the vertebrae for pain relief. 

When is Spinal Fusion Needed?

Spinal fusion surgery is generally only considered if the patient has undergone 6 months to a year of non-surgical treatments, such as physical therapy, chiropractic care, and medications. If these treatments fail to provide relief, your doctor may recommend surgery. 

Conditions That May Require Spinal Fusion

Spinal fusions surgery may be done to treat:

• Degenerative disc disease

Degenerative disc disease is the most common reason why patients undergo spinal fusion. This condition occurs as a result of gradual, age-related wear and tear on the spine. The discs that cushion the spine dry out and break down over time, often leading to back and nerve pain. 

• Herniated disc

A herniated disc may occur as a result of degenerative disc disease. This spinal injury occurs when the firm exterior of a spinal disc cracks, allowing the soft interior to protrude. The disc interior may press on spinal nerves, leading to pain and other symptoms. 

• Severe spinal arthritis

Arthritis that affects the spine can wear down the cartilage that protects the facet joints. A potential side effect of severe spinal arthritis is spinal instability and weakness, which can be treated with spinal fusion. 

• Spinal deformities

Spinal deformities that cause pain and reduced function of the spine, like some cases of scoliosis, may benefit from spinal fusion. By fusing the affected vertebrae into a single bone, spinal fusion may stop the abnormal curve of the spine from worsening.  

Fusion with Spinal Decompression Surgery

Spinal fusion is often performed along with spinal decompression surgery. Decompression is a type of spine surgery that’s done to alleviate compression of the spinal cord and/or nerves.

Decompression surgery may involve removing damaged discs, damaged vertebrae, part or all of the lamina, and other spinal tissues. Taking away the tissues that are pressing on the nerves can alleviate pain while creating a better environment for the spine to heal. 

The exact steps of the procedure will depend on the patient’s condition and which tissues need to be removed. However, in many cases, removing tissues in decompression surgery can lead to spinal instability. So, fusion is frequently performed to stabilize the spine and prevent re-injury. 

Downsides of Spinal Fusion

Unfortunately, spinal fusion has several downsides. Most notably, spinal fusion surgery can severely inhibit the patient’s range of motion of the spine. After this procedure, patients may no longer be able to twist, stretch, or even bend over to pick something up off of the ground. 

Along with reduced spinal function, fusion surgery usually involves an extensive recovery period. The surgery often requires the patient to remain in the hospital for 2 to 4 days, and patients may need 4 to 6 weeks before returning to basic activities. The complete recovery process for spinal fusion surgery may take 6 months to a year. 

Complications From Spinal Fusion

Spinal fusion comes with the risk of developing adjacent segment disease. This condition occurs when the segments surrounding the fused vertebrae bear more impact as a result of the fusion. This can make the segments degenerate more quickly than they usually would. 

Adjacent segment disease can increase your risk of developing various degenerative spinal conditions, including:

• Herniated disc
• Spondylosis
• Spondylolisthesis
• Spinal stenosis
• Degenerative scoliosis

Spinal Fusion Alternatives

Patients with chronic spinal pain who want to avoid the complications associated with spinal fusion surgery may want to consider the following alternatives:

• Non-surgical treatments

We’ve already mentioned that doctors generally don’t recommend spinal fusion surgery unless the patient has failed to improve after non-invasive treatment methods. However, it’s worth noting that patients who don’t want to undergo spinal surgery may opt to continue with non-surgical methods. 

Steroid injections, physical therapy, chiropractic care, and pain/anti-inflammatory medications are non-surgical treatments that can help with symptoms of spinal conditions. 

• XLIF (Extreme Lateral Interbody Fusion)

XLIF is a surgical procedure that still involves fusing two of the vertebrae in the spine. However, unlike conventional spinal fusion surgery, XLIF is considered minimally-invasive. It has a shortened recovery period, reduced the stay in the hospital after surgery, and allows the patient to walk on the same day as the procedure. 

• Spinal implants

Spinal implants are often an effective fusion surgery alternative. Specifically, a spine device can be placed between the affected vertebrae to provide stability while retaining the motion of the spine. Spinal fusion alternatives can also spare patients from an extensive spine surgery recovery time. 

• Regenerative treatments

Regenerative medicine is an emerging field that may be applied to spinal conditions as an alternative to fusion. Regenerative treatments, such as stem cell injections, may stimulate the regeneration of damaged spinal discs and/or help slow down the progression of degenerative disc disease. 

While regenerative medicine is a promising alternative to spinal fusion, the research to support it is still in the early stages. It may take a long time for disc regeneration to become a widely-used and supported treatment option for spinal conditions. 

Spinal fusion alternatives can help you steer clear of the risks and complications associated with fusion. Make sure to consult with your doctor about the best treatment options for you.