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Spinal fusion is a commonly performed procedure for the treatment of disc disease. The biggest area of controversy surrounding this procedure is: IS IT NECESSARY!! This question is raised the a Newsweek article in April 2004 and is a question back pain suffers often have to answer: Do I need a spinal fusion?

Plusses and minusses for spinal fusion:

  • If successful spinal fusion eliminates that disc level as a level that can have herniations and bulging discs or discogenic disease. If successful, people can get a good result, with little back and leg pain by eliminating abnormal motion and recurrent disc
  • Success rate for fusion is 75% first time
  • Accelerated degeneration of adjacent levels will occur and may need surgery later
  • It causes a stiff back
  • It requires prolonged rehabilitation
  • Because it is a long and complicated procedure, there are many possible complications including blood loss, dural tears, torn nerve roots, damage at other levels, painful bone graft sites

 

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Fusion Procedure type

Expectation

Success Rate

Standard lumbar fusion
spnfus102

Stabilization of the spinal segment. No fixation but bracing to aid immobilization

75% in non-smokers

Standard lumbar fusion with instrumentationspine_link

Stabilization of spinal segment with accelerated healing

~80-88% fusion rate in younger patients without smoking and other factors

Standard posterolateral fusion with instrumentation and spinal osteostimulator        postlat_fus1s

Stabilization of spinal segment with discectomy, fusion, and acceleration of the process

May reach 90% in non-smokers

Anterior lumbar fusion
antlumfus1xs02

Removal of the disc with stabilization using bone grafts and optional vertebral plating. Done through the abdomen and complications should be expected

bongrft1sBone grafts may often taken from the patient’s iliac crest but the Bone Bank can be used.

Spinal fusion 360o (Front and back procedure, fusing both sides of the spine

Stabilization of the spinal segment with disc removal and “front and back” fusion of the spinal segment

80-93% fusion rate. Result must be weighed against the very long surgery

Cage fusions             
spn_fus3xs

Disc removal and replacement using a cage device

Success rate as low as 50% because of problem with failed fusion
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©2007 - Kenneth P Burres MD APC
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