Does The Term “Flexible Spinal Fusion” Exist in Medicine?
For spinal conditions including spinal stenosis, spondylolisthesis, and degenerative disc disease, surgery may be necessary for symptom relief. To avoid instability after spine surgery, your doctor may recommend spinal fusion.
Unfortunately, spinal fusion limits the flexibility of the spine by nature. But, have advancements in medical technology spawned the possibility of flexible spinal fusion? Continue reading to find out.
What is Spinal Fusion?
Spinal fusion is a surgical procedure that’s done to permanently join spinal bones, called vertebrae. In most cases, two bones are fused in spinal fusion, although multiple vertebrae can be joined in the procedure.
In spinal fusion, a surgeon places bone graft material in between the targeted vertebrae. As time passes after the procedure, the graft will stimulate new bone growth, eventually causing the vertebrae to form a single bone.
The goal of spinal fusion is to resolve spinal instability. It can also help relieve back pain from chronic conditions and improve spinal deformities.
Which Conditions May Require Spinal Fusion?
Spinal fusion may be used to treat a variety of conditions. If the symptoms of a spinal condition don’t resolve after several months of non-invasive treatment, surgery (including spinal fusion) might be recommended.
Some of the most common conditions that are treated with spinal fusion include:
- Spinal stenosis
Spinal stenosis is a condition that occurs when the space in the spinal canal starts to diminish. As the spinal canal becomes more restricted, it may place pressure on the spinal cord and adjacent nerves.
The most prevalent cause of spinal stenosis is spinal degeneration caused by osteoarthritis. However, it can also be triggered by scoliosis, thickening of the ligaments in the spine, spinal injuries, and, less frequently, tumors in the spine.
In the lumbar spine, spinal stenosis can cause lower back pain, as well as numbness, weakness, and/or tingling in the lower extremities. In the cervical spine, this condition can trigger neck pain, balance problems, and numbness, weakness, and/or tingling in the upper extremities.
Spondylolisthesis occurs when one of the vertebrae in the spine shifts out of its normal position. The displaced vertebra then sits on the vertebra below it.
There are several possible causes of spondylolisthesis. These include:
- Genetic spinal defects
- Age-related spinal degeneration
- Spondylosis, which involves a crack or break in the vertebra
- Overextension of the spine (often in sports or other physical activities)
Chronic back pain, weakness, numbness, or tingling in the legs, and bladder control problems (in severe cases) can result from spondylolisthesis. While physical therapy, a back brace, anti-inflammatory medications, and epidural steroid injections can often effectively treat these symptoms, some cases of spondylolisthesis require surgery with spinal fusion.
- Degenerative disc disease
Degenerative disc disease develops as a result of age-related changes to the intervertebral discs. Over time, the discs that cushion each of the vertebrae in the spine become drier and thinner. This makes the discs more susceptible to damage.
The signs and symptoms associated with degenerative disc disease include:
- Back pain, namely while bending, twisting, or lifting weighty objects
- Spinal instability (a feeling that the back is giving out)
- Muscle tension
- Pain that radiates to the extremities
- Herniated disc
The outer layer of an intervertebral disc can crack with impact or overuse, causing the soft disc interior to jut out. If the damaged disc presses on close-by spinal nerves, it can trigger back pain and neurological symptoms.
Spinal decompression surgery (discectomy, in particular) with fusion is a common treatment method for a herniated disc that doesn’t respond to conservative treatment.
Lost Mobility From Spinal Fusion
One of the most prominent downsides of spinal fusion is that it compromises that patient’s spinal mobility. In fusing the affected vertebrae, the surgeon prevents motion in the fused portion of the back.
Fusion is permanent and irreversible. With each vertebra that’s fused, the patient will lose a significant degree of mobility. This can eliminate the patient’s ability to:
- Partake in certain sports and physical activities
- Stretch, bend, and twist the spine
- Pick up objects off of the floor (in some cases)
Lost mobility in the fused vertebrae must be compensated for by the rest of the spine. Specifically, the vertebrae directly on top of and beneath the fused vertebrae will bear more impact to make up for it. This can result in adjacent segment disease.
Adjacent Segment Disease
Adjacent segment disease, or ASD, is a potential complication of spinal fusion. It occurs when the vertebrae surrounding the fused portion of the spine degenerate more rapidly than usual. The most common symptoms of ASD include:
- Lower back pain
- Radiating pain from the lower back to the legs and feet
- Numbness, tingling, and/or weakness in the legs and feet
Does Flexible Spinal Fusion Exist?
Spinal fusion and a flexible back often don’t go together. Traditional spinal fusion prevents motion in the fused vertebrae, which inevitably compromises the flexibility of the spine. With this in mind “flexible spinal fusion” is a term that’s not yet commonplace in medicine.
However, with rapidly advancing medical technology, select spinal implants are now making flexible spinal fusion possible. Considered spinal fusion alternatives, these devices can provide stability to the spine while retaining the patient’s flexibility.
Spinal Fusion Alternatives
The Premia Spine TOPS System is an example of an implant that facilitates flexible spinal fusion. This device, positioned between two titanium plates, is designed to replace spinal structures that may be removed during spinal decompression, such as the lamina, facet joint, natural bony components, supraspinous ligament, interspinous ligament, and ligamentum flavum.
The TOPS System can make flexible spinal fusion possible because it restores the spine segment’s ability to move in each direction while providing strength, support, and pain relief.
In short, flexible spinal fusion with the TOPS System can resolve the symptoms of spinal disorders without the complications associated with conventional fusion. To learn more, contact Premia Spine at (646) 583-0995.