Alternatives to Lumbar Fusion

When discussing low back pain, our slogan
“Because life happens in motion”, says it all!

Low Back Issues & Importance of Mobility

The principle of maintaining motion in major joints of the body is essential for continuing mobility, walking, reaching, functioning without pain and having the stamina for participating in activities for long periods of time.   Maintenance of painless mobility in the low back is as important as mobility in other joints of the body.As spine physicians, we see a range of patients whose spine pain can be cleared up with exercise, rest and over-the counter medications to more serious conditions.  In some cases, our patients may have had major traumas or injuries resulting in very painful motion of a hip or knee or even complete loss of motion.  These conditions drastically impact daily function and quality of life.

The vast majority of the problems occurring with low back pain are degenerative, meaning the loss of function has occurred over a period of time.  Unfortunately, this deterioration can begin affecting the spine in the late teenage and early adult years and it often continues throughout life.

Our Spine Team
Pictured from left to right, Dr. Scott Hodges, Dr. Shay Richardson,
Dr. Alex Sielatycki and Dr. Candace McKee

Our Spine Motion Preservation Center

Most spine issues can be treated without the need for surgery through conservative methods.   This philosophy is the major focus of our Spine Motion Preservation Center.Our team’s multidisciplinary approach utilizes medications, physical therapy, spine mobilization, injection therapies, chiropractic care, acupuncture, yoga, massage therapy, and cognitive behavior therapy. When a conservative approach has been exhausted, consideration is given to possible surgical options.

Dr. Alex Sielatycki and I frequently present studies at national and international conferences and we are leading the way in pioneering motion preservation surgery of the low back. Our research centers around imaging studies quantifying which surgical techniques allow natural mobility of the low back and we are now utilizing outpatient minimally invasive limited surgeries to replace lumbar fusions. When larger surgery requires stabilization of the spine, motion preserving devices are always the first consideration.  The good news is that most conditions can be treated with outpatient, minimally invasive surgical options that allows for maintenance of motion in the low back.  Motion preserving procedures requiring no implants include discectomy and nerve decompression.  Procedures requiring devices include cervical and lumbar disc replacement.

When the Conservative Approach Fails

Even when larger operations are required, maintenance of mobility should continue to be a guiding principle of surgical treatment.Lumbar fusion is an operation that places implants into the bones of the low back, connecting one or more vertebrae, permanently eliminating motion between them.  For a variety of reasons, there has been a marked increase in the number of spinal fusion surgeries over the last two decades.

Following fusion surgery and recovery, more than half of the patients continue to suffer with back pain, leg pain, stiffness, mechanical issues and limited mobility in the low back.  Lack of mobility may ultimately create issues around the area of the fusion, leading to the possibility of degeneration and resulting in the need for additional surgery.

A small group of patients who have serious disorders such as infection, tumor, major trauma or major deformities will continue to require fusion as the primary procedure. In all of these disorders, the surgery is considered a necessary procedure toward maintaining the most mobility, the least amount of pain and as active of a lifestyle as possible. Our future research will focus on being able to reduce the number of people with these serious disorders requiring major reconstructive spine fusions.

In summary, our spine team is here to listen to our patients, evaluate their condition, create a thorough treatment plan beginning with a conservative approach, communicate with them throughout the process and follow the plan toward ensuring they have the best possible outcome.
Scott Hodges, D.O.
“Because Life Happens in Motion”
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