You’ve tried everything for your back pain: chiropractic, physical therapy, decompression treatments, massage, acupuncture – yet the pain hasn’t gone away. If your back pain is caused by disc degeneration, you’re likely considering spinal fusion as a last resort.
Spinal fusion surgery is by far the most common surgical procedure administered for degenerative discs. With high costs and the risk of long-term complications, the prevalence of the procedure is now being called into question, especially considering the existence of a cheaper and potentially more effective option.
Spinal fusion carries with it other risks associated with nearly any surgical procedure: infection, bleeding and scar tissue formation. An additional risk specific to the operation is adjacent segment degeneration, also called transitional syndrome. The fused segment limits mobility and increases the amount of pressure experienced by nearby spinal discs, as the disc removed is no longer available for shock absorption. The risk of adjacent segment degeneration greatly increased with the number of levels fused.
There is no exact percentage available for the rate of adjacent segment degeneration associated with spinal fusion. One study, shows that 5.6% of participant required re-operation at adjacent levels within four years of initial fusion surgery.
Artificial Disc Replacement: An Alternative
The above study compares the effectiveness of spinal fusion surgery compared to artificial disc replacement, a procedure that has been performed in the U.S. since 2000. The operation entails the removal of a degenerated disc and its replacement by a synthetic one designed to perform the same tasks as a natural disc, including mobility facilitation and shock absorption.
The study showed that the number of patients requiring re-operation at 4 years was 4 times higher among the spinal fusion group (11.3% versus 2.9%). The pain reduction scores of patients who underwent disc replacement were on par with those who received fusion surgery.
The criteria for receiving disc replacement are more limiting than those for receiving fusion. Artificial disc replacement is not recommended for those with spinal misalignment, joint problems like arthritis, multilevel degeneration or bone weakness associated with osteoporosis.
If you are considering surgery, talk with your doctor and surgeon about spinal fusion risks and alternatives. It is always beneficial to do your own research and make sure your health care professionals are looking out for your best interests instead of just their own. Surgery is a serious decision, and you deserve to be well-informed.