Xray showing spinal fusion

The idea of spinal fusion surgery tends to make people nervous. Some patients worry it will cause even more back pain than they had before. But the fact is that for many people, spinal fusion means less pain and a return to normal activities. It may not solve their back problems forever, but it can make a big difference in their quality of life.

Spinal fusion surgery is for people with a common condition called degenerative disc disease. A quick anatomy lesson can help explain what this is. The spinal cord is enclosed in the spinal canal, a column of 32 vertebrae (bones). Inside each vertebra is a round disc that acts as a shock absorber for the spine. Degenerative disc disease happens when one or more discs start to wear out. The vertebrae rub together abnormally, and this damages nearby muscles and z nerves. It causes symptoms such as chronic back pain and weakness, numbness and tingling in the arms or legs.

Degenerative disc disease is a form of arthritis, and it can happen anywhere in the spine, including the neck (cervical), mid-back (thoracic) and lower back (lumbar). It is usually just a result of the normal aging process but also can develop because of a traumatic spine injury or a spinal tumor.

Stabilizing the spine through fusion

The first line of treatment is typically noninvasive therapy, such as pain medication, physical therapy or injections to bring down inflammation. Chiropractic care or acupuncture may be helpful, too. The goal is to ease symptoms and delay or eliminate the need for surgery.

If these measures don’t provide enough relief, fusion surgery might be the next step. The surgery involves removing the diseased disc or discs, then adding bone or bone-like material to that space. Metal plates, screws and rods, or a cage help hold the material in place. Within three to six months, new bone grows around the metal implants. The two vertebrae become one. This stabilizes the spine and can relieve pain and prevent future damage.

Creating a personalized plan

Each patient is different, so it’s important to create a personalized surgical plan based on the person’s anatomy, symptoms and other health issues.

Most people only need two vertebrae to be fused together—this is called a single-level fusion. Some people need two or more fusions, which can mean a longer recovery. The goal is to get the best result with the least amount of surgery. Depending on what a patient needs, the surgeon might do one fusion now and consider doing more later.

Decompression can relieve pain, too

Spinal fusion surgery often includes a step called decompression. This procedure is for people who have degenerative disc disease and spinal stenosis. These two conditions often go hand in hand.

With spinal stenosis, the spinal canal narrows, usually due to the aging process. Nerves can’t pass freely through the canal, which causes more back pain and numbness, tingling and weakness in the arms and legs. Decompression surgery opens up the canal. It also helps restore a person’s balance by straightening the spine.

Spinal fusion surgery (with or without decompression) involves general anesthesia. The incision for each fusion is usually about two inches long. Some patients go home the same day, but most stay at the hospital for two to three days.

People who have a single-level fusion can probably be back to work in about a month with some short-term restrictions. But people who have multiple fusions might need up to a year before they can return to all of their normal activities. Physical therapy, pain relief medications and other noninvasive measures often help.

Fusion surgery can sound scary. But an experienced surgeon and careful follow-up treatment can make all the difference. Afterward, many people ask themselves why they didn’t do it sooner. It can be an important step in getting them back to the activities they enjoy.