Common Problems After Spinal Fusion

Spinal fusion is a common surgical procedure that’s done for conditions like spinal stenosis and spondylolisthesis. During the procedure, the surgeon places bone graft material between one or more vertebrae to gradually fuse them into a single bone. 

Table of Contents

  • What to Expect 6 Months After Spinal Fusion?
  • Can Spinal Fusion Cause Problems Later in Life?
  • Hardware Failure After Spinal Fusion
  • Why Does My Back Still Hurt Years After Spinal Fusion?
  • What Are The Signs of a Failed Fusion?
  • Can Spinal Fusion Cause Nerve Damage?
  • What Are The Signs of Nerve Damage After Spinal Fusion?
  • Can Spinal Fusion Cause Paralysis?
  • The Best Alternative to Lumbar Spinal Fusion
  • Due to the nature of the procedure, spinal fusion involves certain restrictions, complications, and problems. Fusion permanently removes all motion at the fused vertebrae, which can alter how the rest of the spine bears weight. This, combined with possible surgical complications, can (understandably) leave patients with many questions. 

    In this article, we’ll explore common problems from spinal fusion to consider before undergoing the procedure. 

    What to Expect 6 Months After Spinal Fusion?

    Six months after spinal fusion, you can expect to start the final stages of the recovery process. Between six months and one-year post-op, patients can typically start returning to all of their normal activities, including some bending and twisting. During this stage, your spinal surgeon will likely be able to confirm that the vertebrae have successfully fused. 

    Keep in mind that even after the fused vertebrae have fully healed, patients must still adhere to certain restrictions. With all motion eliminated at the fused segment, patients can’t bend, twist, and flex as much as they used to.  

    Can Spinal Fusion Cause Problems Later in Life?

    Spinal fusion can cause problems later in life, namely hardware failure, adjacent segment disease (ASD), or spinal muscle injuries. All of these problems can lead to new or reoccurring back pain and neurological symptoms.  

    Hardware Failure After Spinal Fusion

    Hardware including rods, pedicle screws, cages, and spacers may be used for stability in lumbar spinal fusion. Though it’s designed for lifetime use, this hardware can wear out and break over time. 

    Symptoms of hardware failure are often similar to the symptoms that patients experience before spinal fusion: persistent back pain and/or weakness, tingling, and numbness. 

    Why Does My Back Still Hurt Years After Spinal Fusion?

    If your back still hurts years after spinal fusion, it’s likely due to increased stress and degeneration of the adjacent spinal segments. Known as adjacent segment disease, or ASD, this potential complication of spinal fusion occurs when the fused segments increase the strain on the surrounding segments. This can lead to back pain and neurological symptoms years after the fusion.   

    What Are The Signs of a Failed Fusion?

    The possible signs of a failed fusion include chronic back pain, reduced mobility, neuropathic pain, and radicular pain. With a failed fusion, the patient’s initial symptoms may return, or they may experience new problems. 

    • Chronic back pain

    Pain is considered chronic if it’s significant, continuous, and lasts for over 12 weeks. Failed spinal fusion typically causes chronic back pain that doesn’t improve, even after the expected recovery period.  

    • Reduced mobility

    One of the goals of spinal fusion is to improve mobility. Patients with a failed fusion may experience spinal mobility limitations that go beyond the normal restrictions associated with fusion. 

    • Neuropathic pain

    Neuropathic pain occurs when the nerves or spinal cord become damaged. It manifests as numbness, tingling, burning, and/or weakness that may move throughout the body. 

    • Radicular pain

    Radicular pain is a type of neuropathic pain that radiates from one part of the body to another. For example, the pain may radiate from the lower back down the buttocks and legs. 

    Can Spinal Fusion Cause Nerve Damage?

    Yes, spinal fusion can cause nerve damage. This is because spinal surgery involves navigating delicate nerve structures, including the spinal cord and spinal nerve roots. Additionally, inflammation in the tissues surrounding spinal nerves can cause nerve damage after fusion. 

    Although nerve damage is possible during spinal surgery, surgeons use many different techniques to prevent this complication. These techniques include:

    • Advanced imaging technology used to plan the surgery with 3D images of the patient
    • Microscopes used to light and magnify the operative field
    • Detailed intraoperative imaging and visualization that allows for precise instrument and implant positioning 

    What Are The Signs of Nerve Damage After Spinal Fusion?

    The signs of nerve damage after spinal fusion include tingling, numbness, burning, and weakness. If a nerve that supplies the pelvis becomes damaged, you may also experience sexual dysfunction. 

    Nerve damage is a serious problem that may require immediate medical attention. If you’re experiencing signs of nerve damage after spinal fusion, contact your doctor right away. 

    Can Spinal Fusion Cause Paralysis?

    Spinal fusion can cause paralysis, but it’s one of the rarest possible complications. It may result from one of the following problems during the procedure:

    • Extradural spinal hematoma, which involves bleeding within the spinal column
    • Incidental durotomy, which occurs when spinal fluid leaks
    • Accidental injury to the nerves when they’re repositioned during the operation
    • Accidental injury to the blood vessels that deliver blood to the spinal cord

    The Best Alternative to Lumbar Spinal Fusion

    The best alternative to lumbar spinal fusion is an advanced non-fusion implant, like the TOPS System. Non-fusion implants work by stabilizing the affected vertebrae with a device. In the case of the TOPS System, the device moves with the spine to create a controlled range of motion. 

    The TOPS System works by replacing the spinal structures removed during spinal decompression. It’s anchored to the spine and includes a patented crossbar configuration, which exerts less impact on the screws than fusion implant devices. The device recreates motion in every direction, including flexion, extension, axial rotation, and lateral bending. 

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    Bonnie explains why TOPS surgery was the right decision for her

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    Scott speaks about going to surgery

    In a study of the TOPS System for lumbar spinal stenosis and degenerative spondylolisthesis, the visual analog scale (VAS) for back and leg pain lowered from 56.2 before the procedure to 12.5 at six weeks, 13.7 at one-year follow-up, 3.6 at two years follow-up, and 19 at seven years follow-up. These results showed that TOPS can continue to provide a clinical improvement over time. 

    Patients who are concerned about the complications from spinal fusion can speak with a specialist in their area to learn more about the available alternatives.