What is Spinal Fusion Surgery?
April 25th, 2018
If you find your lower back pain to be a constant disruptor in your life, know that you’re not alone. Lower back pain is very common. In fact, 31 million Americans experience lower back pain at any given time.1
Here are the facts about lower back pain:
- Low back pain is the single leading cause of disability worldwide, according to the Global Burden of Disease 2010.1
- Back pain is one of the most common reasons for missed work. In fact, back pain is the second most common reason for visits to the doctor’s office, outnumbered only by upper-respiratory infections.1
- One-half of all working Americans admit to having back pain symptoms each year.
- Experts estimate that as much as 80% of the population will experience a back problem at some time in their lives.1
- Most cases of back pain are mechanical or non-organic—meaning they are not caused by serious conditions, such as inflammatory arthritis, infection, fracture or cancer.
- Americans spend at least $50 billion each year on back pain—and that’s just for the more easily identified costs.1
What Causes Lower Back Pain?
There are several different reasons why you might experience pain in your lower back. Your back is made up of bones, ligaments, muscles, and joints. You can tear ligaments, strain muscles, and slip disks - all of which can cause pain. It’s even possible to do these things without realizing it. More often than not, there is some preexisting injury that never healed properly or is still in the process of healing.
While a back injury is a common cause of pain - it’s not the only culprit. Back pain can also be caused from non-injury ailments such as poor posture, arthritis, obesity, and even stress.1
Degenerative Disk Disease
One of the most common conditions that lead to low-back pain is Degenerative Disk Disease. Basically, this disease refers to the pain that you feel in your lower back due to high amounts of wear and tear on your neck (also known as your cervical spine) and spine.2 There are many things that can result in bone loss, age being one of them, but something that most don’t know is that an inadequate amount of omega-3 fatty acids in your diet can, also. It’s been shown that high doses of Omega 3s may actually help to delay degeneration of the spine - but consult your physician before considering this option.6 Degenerating disks is a natural part of aging - but there are things that can be done to help relieve the pain.
Is Surgery the Best Option?
It’s important to remember that very few people with low back pain actually require surgery. Even though low back pain is common, most people can control their back pain with an exercise or physical therapy program. However, for some, exercises don’t work to get rid of the pain. When your pain isn’t alleviated and starts limiting your daily activities and quality of life, then it’s time to think about spinal fusion surgery.3
If you’ve been experiencing chronic back pain - back pain lasting longer than six months - then go see your doctor. They will look into your patient history, perform a physical exam, and exercise diagnostic studies to determine whether or not you’re a candidate for spinal fusion.
A physician will look at your patient history which involves reviewing when the pain occurs, where the pain is located, how it began, any previous treatments and the extent to which your low back pain limits your daily activities and function. Your doctor will also try to determine if there are other factors contributing to your pain, such as depression or other psychological factors. Your general health will also be looked at since other diseases and conditions can influence the role of spine surgery. Having a history of heart or lung disease, for example, are things your physician will be looking for. 5
A physical exam is done to determine whether there is evidence for any neurologic (nerve-related) injury. If your lower back pain is stemming from nerve damage or injury then spinal fusion won’t be a good option for you.5
Typically, a doctor will only perform this surgery if they can pinpoint source of your pain. There are a number of diagnostic studies, such as X-rays, CT scans and MRI scans, that are available to investigate the cause of the back pain. The most common is an X-ray of the low back, which can show if there is some boney instability or deformity to the spine. It can also image such things as a fracture, or in advanced stages, it can show tumors of the spine. Although done frequently, they usually fail to demonstrate the cause of the back pain.. Almost all individuals need additional studies to establish an anatomic diagnosis.5
Spinal Fusion Surgery
It’s important to understand he ins and outs of a surgical procedure before you opt to go under the knife.
Spinal fusion, also called lumbar spinal fusion, surgery is a procedure to correct problems with the small bones of your spine. You can think of the surgery as a “welding” process where the painful vertebrae are fused together to create one, solid bone.4 Not only does spinal fusion eliminate motion between vertebrae, but it also prevents nerves, ligaments, and muscles from stretching. Spinal fusion is an option when motion is the source of your pain. The theory behind this surgery is simple, if the painful vertebrae don’t move, then they shouldn’t hurt.4
Before opting for this surgery, it’s important to remember that this surgery does not “fix” your back and it does not create a normal back. The objective is to minimize the pain by stopping the motion at a painful segment in your spine so it won’t cause you as much as pain. While the surgery won’t fix your back, it is intended to minimize pain so you can increase your ability to function.3
Fusion surgery can be used for lower back pain, but it can also be an option for someone who suffers from chronic neck pain. Your cervical spine, or your neck, can be fused together in the same way that your spine can. If you hear the term cervical fusion, or cervical spine fusion, it’s referring to fusion surgery performed on the cervical part of the spine - or your neck. If you suffer from neck pain, consult your doctor to see if fusion surgery or cervical disc replacement surgery would be an option for you.
Lumbar spinal fusion surgery is not a new surgery and has been performed for decades. There are several different techniques and approaches used to fuse the spine. With an anterior approach, your surgeon will make an incision in the lower abdomen and reach your spine from the front. With a posterior approach, the opposite of anterior, your surgeon will go in from the back. Another option is a lateral approach, which will cause an incision in your spine.4
The surgery consists of graphing a piece of another bone and using that piece to fuse together the painful vertebrae. In the past, harvesting bone from the hip was the only option but this causes an extra incision and extra recovery time. Today, there are several options including cadaver bone and even synthetic “bone” material.4After bone grafting, the vertebrae need to be held together to help the fusion progress.
In many cases, surgeons will use plates, screws, and rods to help hold the spine still. This is called internal fixation and allows for most patients to move earlier after surgery.4
Pain is a natural part of the healing process. After surgery, it is normal to feel some pain. There are options that will help to reduce your pain and recover faster.
Medications are often prescribed for short-term pain relief after surgery. Many types of medicines are available to help manage pain, including opioids, non-steroidal anti-inflammatory drugs (NSAIDs), and local anesthetics. Your doctor may use a combination of these medications to improve pain relief.4
The fusion process doesn’t happen during surgery. Imagine using wood glue to attach two pieces of wood. The surgery is the process of applying the glue, attaching the pieces, and applying the clamps. It then takes time for that glue to set and dry to fuse the two pieces together. This is how your spine works. In the surgery, your bones were grafted together and made stable - but it will take several months for the fusion process to be complete. During this healing time, your spine must be kept in proper alignment. Your physician and physical therapists will work with you and teach you the proper way to move, reposition, sit, stand, and walk.4
Over time, your symptoms and mobility will improve. Directly after surgery, it will most likely be recommended that you only have light activity, such as walking. As your strength builds, you will slowly be allowed to increase your activity level.4
Maintaining a healthy lifestyle and following your doctor's instructions will greatly increase your chances for a successful outcome.4
If you’re suffering from back or neck pain that’s lasted more than six months - see your doctor. They will most likely check your history, run some tests, and suggest healthier lifestyle choices at first. Be aware of your pain and track your symptoms so you can clearly communication to your doctor how you’re feeling. If it’s right for you, fusion surgery on your spine or cervical spine can provide relief and allow you to return to normal daily functions and activities.