Effectiveness of Spinal Fusion

[admin]

The Journal Spine published a paper in May 2009 looking at the effectiveness of surgery for low back pain. The doctors who did the research were from Portland, Oregon.

These researchers found "fair evidence that fusion is no better than intensive rehabilitation with a cognitive-behavioral emphasis for improvement in pain or function, but slightly to moderately superior to standard (nonintensive) nonsurgical therapy."

They went on to say that less than 50% of the patients experience "optimal outcomes" after fusion. Where they define an optimal outcome as no more than sporadic pain, slight restriction of function, and occasional analgesics.

Have you had fusion, how did it go for you?

[VideoBackCoach]

Yes, I did have spinal fusion about 16 years ago. I also had several herniated disks at the same time. As far as I know, I had some disk material removed and then my spine was fused together. I recovered from the surgery in about 2 months time. I don't remember noticing any loss of flexibility as some might worry about. I can certainly play golf and lead a very active lifestyle. I would caution people though into having a false sense of security after having spinal fusion surgery or back surgery in general. In other words, don't believe for one minute or ever take for granted that you won't have back pain again just because you had surgery to fix the issue. I experienced back pain again less than a year after my surgery. It was demoralizing to say the least. You MUST learn to manage your back pain the right way. It is something you have to work on throughout your entire life. "The harder you work, the easier it gets" is my motto.

[Augustine5I]

As a licensed physical therapist, I see plenty of post surgical spinal fusion patients. This is otherwise known as spinal decompression.

The biggest issue I find following surgical intervention is that many people following a spinal fusion never address the weakness in the core muscles of the spine. As they are certainly weakened after surgery, they need considerable attention. These are the multifidus muscle(s), transverse abdominis, quadratus lumborum, internal and external obliques, and erector spinae muscles.

Secondly, having lost the functional movement of the spine at the segment or segments repaired, it is only natural for the body intelligence to make up the difference above and below the fused vertebrae. This can cause problems later on down the road. Especially as the areas may already show signs of a bulging or herniated disc.

As I tell many clients, having the surgery is the easy part. It is the rehabilitation and management after the fact that becomes the hard part. This surgery is not for everyone, and much contemplation should be made prior to a decision such as this one.

Best Regards,

Tommy Hoffman, P.T.

www.backpainfirstaid.com

[Leeann]

One more thing I caution people is that surgery begets more surgery. It doesn't seem to matter whether it is the regular herniated disc surgery or spinal fusion ~ when the spine is operated on, it becomes unstable. Other levels fail due to having to take on additional loads. When a level is fused, often the level above or below will fail. In my case, I had a hemilaminectomy/diskectomy at L4-5 and later L3-4 failed. I've done research on this event , and it happens more often than not. Surgery should be a LAST RESORT, when all else has failed and when the spinal cord is compromised or when there is a chance of severe nerve damage. All other times, the conservative approach should be used, as surgery WILL NOT ease the pain. Doctors do not tell their patients that pain is NOT a reason for surgery - many times you'll still have the same pain or worse. Surgery only corrects mechanical problems. Wish I had known that back when I had my surgeries. No one told me.

[marchse]

A spine fusion surgery involves using bone graft to cause two vertebral bodies to grow together into one long bone. Bone graft can be taken from the patient's hip (auto graft bone) during the spine fusion surgery, harvested from cadaver bone (allo graft bone) or manufactured (synthetic bone graft substitute).