Permanent Restrictions After Spinal Fusion

Spinal fusion is frequently performed for conditions like spinal stenosis, spondylolisthesis, and spinal deformities. This surgical procedure effectively welds two or more vertebrae to create stability. 

Though fusion has proven to be successful in many cases, it also presents numerous risks and downsides. In this article, we’ll hone in on the permanent restrictions that patients may be subject to after spinal fusion. 

What To Expect After Spinal Fusion?

Many patients wonder about the spinal fusion recovery process, especially at the six-month mark. Fusion involves bone healing, which leads to a notoriously lengthy recovery. Three months of rest is crucial after the surgery to allow the vertebrae to properly fuse. 

However, three to six months after the procedure, patients can begin to introduce certain activities into their routines. Patients will likely experience a loss in muscle tone, strength, and flexibility during the resting period. These effects can be offset by gentle exercises to alleviate stiffness and gradually strengthen the muscles that support the spine. 

Six months after spinal fusion, physicians typically still advise against high-impact exercise. However, if the vertebrae are successfully fused, patients can slowly start to return to a regular lifestyle. 

Most patients fully recover from spinal fusion around eight to 12 months after the procedure. At this point, patients may be able to partake in all of their normal activities.

However, spinal fusion patients will never regain the ability to bend, twist, or flex the fused segment. This is because spinal fusion eradicates all motion at the fused segment. 

How Many Years Does a Spinal Fusion Last? 

If a spinal fusion is successful, it permanently fuses the affected vertebrae. Ideally, the patient won’t require another procedure. 

Unfortunately, in some cases, patients require revision surgery after spinal fusion. It’s difficult for researchers to determine the exact revision rate for adult spinal fusion surgeries. However, it’s estimated to range from 9% to 45%.

What Are the Common Issues After Spinal Fusion Procedure?

Certain problems that can arise after spinal fusion must be resolved with revision surgery. These problems include:

  • Pseudoarthrosis

Pseudoarthrosis is the medical term used when the bone graft fails to fuse the vertebrae after spinal fusion. This condition may cause lower back pain, but requires imaging tests for diagnosis. 

  • Recurrent back pain after the procedure

Spinal fusion surgery doesn’t always eradicate lower back pain. Many people who experience recurrent back pain after fusion go through additional surgeries within five years of the initial procedure. 

  • Adjacent segment disease

Adjacent segment disease, or ASD, is a prevalent complication after spinal fusion. It involves the degeneration of the spinal segments neighboring the fused vertebrae. This occurs because the adjacent segments must bear additional impact than usual to accommodate the lack of motion in the fused segment.

ASD can cause new pain in the area of the back located above or below the fused segment. Eventually, patients may have trouble standing or walking for any length of time. 

  • Neurological symptoms like tingling, weakness, numbness, and radiating pain

Whether due to pseudoarthrosis, ASD, or a related issue, neurological symptoms stemming from the lumbar spine can disrupt patients’ daily activities. 

  • Muscle atrophy

Muscle atrophy can affect the back muscles in the area of spinal fusion. This issue commonly affects patients who experience continued pain after spinal fusion. Unfortunately, muscle atrophy can diminish support for the spine and may increase the risk of pseudoarthrosis.  

Lost Mobility After Spinal Fusion

In addition to the medical concerns listed above, spinal fusion can lead to lost mobility in the spine. This can greatly affect patients’ lifestyles by limiting their physical activities and even their ability to carry out basic tasks. In some multi-level fusion cases, patients lose the ability to bend over to retrieve objects from the floor after the surgery. 

The L4 and L5 vertebrae, which are the lowest bones of the lumbar spine, often afford the most motion for the lower back. These vertebrae may be fused in patients suffering from conditions like advanced lumbar spinal stenosis and spondylolisthesis. After an L4-L5 fusion, patients may experience a significant loss of motion in the lower back. 

How To Avoid Spinal Fusion?

Considering the complications and restrictions that are associated with spinal fusion, many patients seek out ways to avoid this procedure. In these cases, patients may either opt for non-surgical treatment options or surgical spinal fusion alternatives. 

Non-Surgical Spinal Fusion Alternatives

Patients suffering from chronic back pain and neurological symptoms from conditions like spinal stenosis and herniated disc often benefit from conservative treatment. In fact, spine specialists generally first recommend conservative treatment, only suggesting surgery if the non-surgical treatment route fails after several months. 

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Conservative treatments that may help patients avoid spinal fusion include:

  • Physical therapy
  • Lifestyle adjustments, such as losing weight, starting a low-impact exercise regimen, adopting an anti-inflammatory diet, and refraining from high-impact activities
  • Chiropractic care
  • Acupuncture and massage therapy

These therapies can help reduce the impact on the spine, improve muscular support for the spine, reduce inflammation, and promote healing. Most physicians recommend a combination of non-surgical treatments for chronic back pain.

Surgical Spinal Fusion Alternatives

When spinal pain becomes debilitating and/or severely interferes with the patient’s daily activities, surgery may be unavoidable. But, with modern medical advancements, patients now have non-fusion surgical treatment options to consider. 

Dynamic stabilization systems are among the most prominent of these options. The goal of this treatment is to stabilize the spine without inhibiting its motion, usually with a specially-designed device. This device is generally placed in the affected segment after surgical spinal decompression. 

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The TOPS System is one example of a dynamic stabilization system that’s used as an alternative to lumbar spinal fusion. It replaces the tissues removed in spinal decompression to prevent spinal stability while restoring the natural motion of the spine.  

Patients who are concerned about permanent restrictions after spinal fusion should reach out to a spine specialist to learn more about the fusion alternatives available today.