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 together 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.

Spinal Fusion Indications

Typically, spinal fusion surgery is done for mechanical low back pain. Often, the pain you experience increases with various activities and it could be related to degenerative disc disease. Sometimes, though, it happens from low-grade slippages of your spine, 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. You probably live with back pain every day, and it doesn’t go away. This can affect your daily life. 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 procedures. You could get an infection, have profuse bleeding, nerve damage, or blood clots. With spinal fusion, though, you could feel immense pain in the area where the bones are fused. Sometimes, patients even have poor bone formation, so the fusion doesn’t work (pseudarthrosis).

Other drawbacks of spinal fusion include:

  • Long recovery time
  • Severe movement restriction
  • Can be hard to find the vertebrae causing the problems

TOPS for Spinal Fusion – What It Is

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 and don’t require spinal fusion therapy.

Typically, it works well for spinal stenosis, which narrows the spinal canal and causes pinching of your nerve roots and spinal cord. TOPS can also be used for degenerative spondylolisthesis, which is when one slip of the spinal vertebra causes pain in the legs and low back.

Ultimately, the TOPS system can be used for L3 to L5 vertebrae. On top of that, you can use it along with the Premia Fixation system to address different spine diseases. Modern spinal fusion techniques like this are still being tested and studied. However, the indications are good that it could be a better treatment option than traditional spinal fusion.

It’s important to note that the TOPS system is still a surgery. When the decompression is complete, the surgeon uses the TOPS system to replace any extracted bone and stabilize your spine. The doctor 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, they are allowed to function normally with the TOPS implant. This system ensures full motion, but it prohibits the patient from excessively turning and twisting. The result is that you preserve your motion, have the optimal decompression, there’s spine stability, and you experience pain relief.

Immediate relief of pain is experienced by most patients right after surgery. Plus, you can walk around and be on your feet the next day. There’s less restriction of movement because there’s no fusion happening 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 is a great surgical alternative to traditional spinal fusion. If you’ve got 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 that’s done, 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. That way, you can enjoy normal activities again that used to be painful and impossible.

The Benefits of TOPS

With the TOPS system, you can move around 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 and dangerous.

The TOPS system is clinically proven to offer sustained and immediate pain relief while improving your quality of life.

Ultimately, the spinal fusion surgery decision is gone because you can get better outcomes with the TOPS system. On top of that, there are three primary benefits of using it 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 with/without facet arthrosis (a bone spur) or spondylolisthesis (slipped disc). 

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 the spinal decompression surgery.

Modern spinal fusion techniques like this have a higher success rate and fewer risks associated with them.

Ultimately, this surgery can be used to treat lumbar spinal stenosis, which is the narrowing of your spinal canal. You could have slipped discs or facet joint cysts, as well.

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.

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

There are two titanium endplates, which houses a centralized artificial articulation. This means 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 (lumbar).

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


With the TOPS system, you can replace your functionality, even as the problem areas are removed from the body through spinal decompression surgery. 

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 for spinal fusion.