Is There an Alternative to Spinal Fusion?

Spinal fusion is a surgical procedure that can correct problems in the small bones of the spine. In a sense, it’s like a welding process, but for bones instead of metal. The basic idea is that you fuse two or more of the vertebrae so that they can heal as a solid, singular bone.

The spinal fusion surgery decision is between you and your doctor. However, many people dislike the idea of having surgical procedures.

You probably want to learn how to avoid spinal fusion surgery and if there are modern spinal fusion techniques that could help you. Here, we’ll answer the popular question: What are alternatives to spinal fusion?

Table of Contents

  • Spinal Fusion Indications
  • Spinal Fusion Pros and Cons
  • How Serious is Spinal Fusion Surgery?
  • Why You Shouldn’t Get a Spinal Fusion?
  • What Can Be Done Instead of a Spinal Fusion?
  • Premia Spine TOPS for Spinal Fusion
  • Spinal Fusion Indications

    Typically, spinal fusion surgery is done for mechanical low back pain. Often, the pain you experience increases with various activities and could be related to degenerative disc disease. Sometimes, it occurs from low-grade slippage of your spinal bones, such as with isthmic spondylolisthesis and degenerative spondylolisthesis.

    Most doctors recommend surgery as a final option if no other treatment has helped. Other indications for spinal fusion can include:

    • Tumors
    • Fractures
    • Spinal stenosis
    • Scoliosis 

    Spinal Fusion Pros and Cons

    The benefits of spinal fusion are plentiful. This is particularly true for those who live with back pain every day. This can diminish your quality of life. But, ultimately, good candidates for spinal fusion therapy are those who could damage their spinal cord and become paralyzed.

    However, there are risks involved with any surgical procedure. You could develop an infection, profuse bleeding, nerve damage, or blood clots. With spinal fusion, you could feel immense pain in the area where the bones are fused. Sometimes, patients even have poor bone formation, so the fusion isn’t successful.

    These cons are key deciding factors for patients considering alternatives to spinal fusion for scoliosis and other spinal conditions. 

    How Serious is Spinal Fusion Surgery?

    Patients often inquire about the seriousness of surgical procedures before considering them. Spinal fusion is a very serious surgical procedure that must be performed by a qualified neurosurgeon or orthopedic surgeon. Additionally, surgeons generally have a complete surgical team for assistance throughout the procedure. 

    As aforementioned, all surgical procedures involve a degree of risk. Most surgeries present the risk of blood clots, bleeding, pain, infection, and complications from anesthesia. Other potential complications from spinal fusion include:

    • Nerve injury, which can cause numbness, tingling, and/or weakness in the extremities
    • Pseudoarthrosis, which occurs when the bone doesn’t fuse properly and the patient must return for another surgery. This complication is more likely among patients who exercise too soon after the procedure, smoke, or have diabetes.
    • Returning symptoms, which occur when a spinal fusion isn’t effective the patient’s back pain comes again within a few months

    How Painful is a Spinal Fusion?

    As an invasive procedure involving bone formation, spinal fusion generally causes significant pain during the recovery process. However, your spine specialist can prescribe pain medications to help you get through this period. 

    In the days and weeks immediately after spinal fusion, your back will likely feel sore and tight. It may be difficult to stand or sit in the same position. Additionally, you may need four to six weeks to return to basic day-to-day tasks. 

    Four weeks following spinal fusion, the worst of your post-operative pain should be over. Although you may still have some pain, it will continue to gradually improve. In some cases, patients experience pain after spinal fusion three to six months following the procedure. 

    Post-operative pain from spinal fusion requires patients to take time off of work. Patients with professions that don’t involve physical labor can typically go back to work within one to two months. However, patients with professions that involve light physical labor may need to take three to six months off of work. 

    Why You Shouldn’t Get a Spinal Fusion

    An increasing number of patients are opting not to get a spinal fusion and instead choosing spinal fusion alternatives. Key reasons to not get a spinal fusion include:

    Lost Spinal Mobility

    Possibly the most prominent downside of spinal fusion is lost spinal mobility. When the targeted vertebrae are fused, all mobility in that spinal segment is lost. This means that the patient loses the ability to bend, flex, and twist that area of the spine. 

    You may be surprised at how many day-to-day activities are dependent on the flexibility of the spine. Whenever you bend down to pick up an object off of the floor or reach upward to retrieve an object from a high shelf, your spine moves to complete the task. So, with a fused spinal segment, you may lose the ability to perform various tasks. 

    Besides routine motions, lost spinal mobility can significantly shorten the list of physical activities and sports that you can partake in. After spinal fusion, many patients lose the ability to participate in their favorite form of exercise. 

    Risk of Continued Pain and Degeneration

    Unfortunately, spinal fusion doesn’t promise complete symptom relief. Some patients continue to have back pain after undergoing fusion.

    Additionally, fusion creates the risk of accelerated degeneration in the neighboring spinal segments. This can lead to further pain and neurological symptoms down the road. 

    Possible Complications

    As we mentioned above, spinal fusion comes with a sizable risk of complications. This is true of any surgical procedure. But, given that spinal fusion involves the spine, which contains many nerves and the spinal cord, this presents the added risk of nerve injury. 

    What Can Be Done Instead of a Spinal Fusion?

    Now that we’ve gone over the downsides of spinal fusion, let’s answer a crucial question: What are the alternatives to spinal fusion surgery?

    Spinal Fusion Alternatives


    IDET stands for intradiscal electrothermal coagulation. It may be one of the effective alternatives to spinal fusion surgery for lumbar disc degeneration. 

    During the IDET procedure, your provider will insert a needle into the lumbar disc area. Then, a catheter is passed through the needle and the disc’s outer shell is gently heated. 

    This non-surgical process may alleviate pain by bolstering collagen fibers in the disc exterior. Thickened collagen fibers may repair cracks in the disc exterior and provide pain relief for some patients. 

    Regenerative Medicine

    Regenerative medicine is an emerging field that may be implemented for certain cases of chronic back pain. Stem cell therapy is a treatment that falls under the categories of regenerative medicine and spinal fusion surgery alternatives. 

    Stem cells can regenerate into virtually any type of cell in the body. In stem cell therapy, stem cells from the patient or a donor are injected directly into the area with damaged tissue (such as a damaged intervertebral disc). Over time, the stem cells will work to repair the tissue and alleviate the patient’s pain. 

    There is still research to be done on the efficacy of regenerative treatments for back pain. However, it may soon be considered one of the successful alternatives to spinal fusion for spondylolisthesis and other spinal conditions. 

    Dynamic Stabilization Systems

    Dynamic stabilization systems differ from spinal fusion in that they aim to stabilize the spine while preserving spinal motion. This spinal fusion alternative involves securing a specialized device to the affected spinal segment, typically after spinal decompression. 

    The TOPS System is one dynamic stabilization system that’s one of the effective alternatives to lumbar spinal fusion available today. 

    TOPS for Spinal Fusion

    The TOPS System is a spinal implant that can stabilize the area without having to fuse together the diseased vertebrae. That way, you can relieve the pain from your condition without spinal fusion surgery.

    Typically, TOPS works well for spinal stenosis, which narrows the spinal canal and causes nerve roots and spinal cord compression. TOPS can also be used for degenerative spondylolisthesis, which involves the displacement of a spinal bone.

    Ultimately, the TOPS System can be used for L3 to L5 vertebrae. You can also use it with the Premia Fixation system to address various spine diseases. Modern spinal fusion techniques like this are still being tested and studied. However, the indications are good that it could be a superior treatment option to traditional spinal fusion.

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    It’s important to note that the TOPS System still involves surgery. When the decompression is complete, the surgeon uses the TOPS System to replace any extracted bone and stabilize your spine. The surgeon can remove all of the elements that press on the nerve roots without requiring enough bone to fuse them together.

    Instead of locking those two vertebrae together permanently, the TOPS implant allows them to function normally. This system ensures full motion but prohibits the patient from excessively turning and twisting. The result is that you preserve your motion, have optimal decompression, gain spine stability, and experience pain relief.

    Most patients experience immediate pain relief after the procedure. Plus, you can walk around and be on your feet the next day. There’s less movement restriction because no bone fusion occurs in the lower back.

    Description of the Device

    TOPS for spinal fusion is one of the many modern spinal fusion techniques out there. The device is just a mechanical implant, and it’s a great surgical alternative to traditional spinal fusion. If you have moderate or severe lumbar spinal stenosis or related spinal problems, you can benefit from this option.

    You no longer have to worry about the drawbacks of spinal fusion because the TOPS System addresses the two most critical spinal functions – preserving motion and maintaining stability.  With the Posterior Arthroplasty procedure, a surgeon removes the bones that press on your nerves. Once this process is complete, the doctor can implant the TOPS System to reestablish a controlled movement range and stabilize the spine. 

    If you have spinal stenosis symptoms (sciatica, low back pain, or leg pain while walking), you can ultimately regain the ability to flex, bend, and walk. 

    The Benefits of TOPS

    With the TOPS System, you can move in all directions. This includes axial rotation, lateral bending, extensions, and flexion. However, it also works to block the sheer forces that are naturally exerted in the lower spine and could be quite painful.

    The TOPS System is clinically proven to offer sustained and immediate pain relief while improving your quality of life. There are three primary benefits of using TOPS to treat spinal stenosis:

    1. This procedure can stabilize your posterior spine to help reestablish a controlled range of motion.
    2. Patients can bend, walk, flex, and enjoy their normal activities.
    3. People can experience immediate pain relief that continues for a long time.

    Clinical studies have been conducted since 2005, and they all show that the TOPS System can alleviate persistent low back and leg pain in patients with moderate or severe spinal stenosis or spondylolisthesis. 

    How It Works

    TOPS for spinal fusion is the mechanical implant device that can replace the soft and bony tissues that the surgeon must remove or that become compromised during spinal decompression surgery. Alternatives to spinal fusion like this have a higher success rate and fewer associated risks.

    Ultimately, this surgery can be used to treat lumbar spinal stenosis, which is the narrowing of your spinal canal. However, the TOPS System can only be used on the lumbar segments between L3 and L5. These are the segments that are most commonly affected by spinal stenosis.

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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 general, the TOPS System can be the transitional segment between your disease-free spine segments and the rigid fixation of normal fusion techniques. 

    TOPS uses two titanium endplates, which house a centralized artificial articulation. This means that you can move around in all directions – lateral bending, axial rotation, flexion, and extension as if you had a healthy, normal spine. Therefore, patients can easily straighten up, twist, and bend at the spine level, even if they have spinal stenosis of the lumbar spine.

    A traditional posterior surgical procedure is used to implant the device, which stabilizes the affected vertebrae. Spinal decompression surgery can be used to remove the diseased facet joints and lamina and replace them with the TOPS System.

    As with other modern spinal fusion techniques, the TOPS System gets anchored to the spine using four screws. However, it features a unique and patented crossbar to exert less force on those screws. Before making your spinal fusion surgery decision, consider TOPS as one of the alternatives to the spinal fusion of the lumbar region.