Alternatives to Spinal Fusion

*Originally published in Health Scope Magazine

Is chronic back pain getting on your nerves? These treatment options can provide relief while maintaining range of motion.

A spinal fusion is a surgical technique designed to join two or more vertebrae – you can think of it like a “welding” process. The goal of this procedure is to fuse damaged vertebrae into a single, solid bone to eliminate pain and restore stability to the spine.

In the past, spinal fusions were standard for many back problems including degenerative disc disease, scoliosis, herniated discs, and more. However, the procedure tends to be more invasive and requires a lengthier recovery. Over the years, orthopedic surgeons have learned that spinal fusions may not always be necessary – that there are ways to take pressure off the nerves without fusion.

Alternative Options

Depending on your particular case, your doctor may recommend one or more of the following alternatives to alleviate pain while preserving range of motion:

PHYSICAL THERAPY – Physical therapy is designed to improve muscle strength and endurance while reducing pain. Beyond that, it is great for overall health and aerobic fitness.

STEROID INJECTIONS – Meant for symptom control, this minimally invasive procedure can temporarily relieve pain in the neck, arms, back, and legs caused by inflammation of the spinal nerves.

RADIOFREQUENCY ABLATION – With this minimally invasive procedure, heat is used to “ablate,” or burn, the nerve causing chronic pain in the lower back, neck, or arthritic joints. This prevents pain signals from reaching the brain.

SURGICAL OPTIONS – Sometimes surgery is necessary to relieve nerve compression causing pain or weakness, but non-fusion options are less invasive and offer quicker recovery times.

Benefits for Older Adults

One of the most significant downsides of spinal fusion in older adults is a potential loss of motion in the spine. Fusions can also put pressure or stress on the vertebrae levels above and below the fusion, which can cause them to break down and degenerate more quickly. This leads to an increased likelihood of further surgery down the road.

Through nonsurgical alternative methods, older adults can find improvement without the risks of surgery and anesthesia. If surgery is required, non-fusion options can be performed using minimally invasive techniques that allow for shorter operating time, quicker recovery, and minimal blood loss. Most patients go home the same day.

An Expert Weighs In

“Spinal fusion should be considered a salvage procedure, which means that it should not be the first option in most cases. I would encourage people to be well-educated about their back problems, particularly if they are considering surgery. It’s important to have a good understanding of the condition and the options. Sometimes a fusion may be the best choice, but consider all options before making that decision.”

Dr. Alex Sielatycki
Spine Surgeon
Center for Sports Medicine & Orthopaedics

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