Spinal fusion surgery

10 Years After Spinal Fusion: Studies and Research

Spinal fusion has been used for several decades to treat spinal conditions like scoliosis, spondylolisthesis, and spinal stenosis. Considering its expansive history, we can evaluate the long-term outcomes of spinal fusion 

While spinal fusion is largely considered a successful treatment for long-term results, patients have recurring pain after the procedure. As long as 10 years after the procedure, problems including adjacent segment degeneration and hardware damage can cause symptoms to reappear. 

This article will explore the studies and research relating to the longevity of spinal fusion, as well as available treatment alternatives to consider.  

How Many Years Does a Spinal Fusion Last?

Spinal fusion is intended to last for life, as the results are permanent. Many spinal fusion patients experience improved pain and mobility for many years after the surgery.

However, the hardware used in spinal fusion can break down over time, creating the need for reoperation. Additionally, recurring back pain is a common problem among spinal fusion patients.  

Is Spinal Fusion a Disability?

Spinal fusion may be considered a disability if the patient meets certain qualifications, including specific mobility restrictions. Qualifying spinal fusion patients can receive Social Security benefits. 

To receive disability benefits after undergoing lumbar spinal fusion, patients must have been diagnosed with a disorder of the spine, such as:

• Spinal stenosis
• Spondylolisthesis
• Degenerative disc disease 
• Vertebral fracture
• Osteoarthritis
• Any other spinal disorder that affects the spinal cord or nerve root

Restrictions after the spinal fusion procedure can make it difficult to work. Disability benefits can help patients maintain their quality of life while they heal from spinal fusion. 

Will I Have Restricted Mobility After Spinal Fusion?

You will have some degree of restricted mobility after spinal fusion. This is because the goal of spinal fusion is to eliminate motion between the affected vertebrae. With this process comes permanently restricted spinal mobility. 

For most patients who undergo a single-level spinal fusion, mobility restrictions aren’t dramatically life-altering. Once the spine has fully healed, these patients can often partake in their normal activities, though spinal bending, rotations, and stretches may be marginally limited. 

Patients who have multiple spinal levels fused are likely to experience significant mobility restrictions. In some cases, patients may not be able to bend over as they once could and may need a device to retrieve dropped or fallen objects. 

Pain 10 Years After Spinal Fusion

Pain 10 years after spinal fusion is relatively common, with up to 40% of patients experiencing continued pain after back surgery. Over 10 years, the fused vertebrae or fusion hardware can develop various issues that lead to pain. 

Studies: Recurrent Pain After Spinal Fusion

Multiple studies have evaluated the long-term effects of spinal fusion. Here are a few to consider:

• A 2020 prospective 10-year follow-up assessment for spinal fusions reported a 7.5% chance of revision surgery 10 years after the procedure. Patients reported quality of life at the 10-year mark that’s only slightly lower than healthy peers and notably higher than scoliosis patients who didn’t undergo spinal surgery.  
• A 2003 study evaluated pain five years after lumbar spinal fusion. It found that there was a high incidence of pain five years after posterolateral spinal fusion surgery, although the patients experienced significant general improvement over the five-year period. This study concluded that lumbar spinal fusion may be considered a pain-reducing procedure, rather than a pain-removing procedure. 
• A 2018 study evaluated the long-term outcome of posterior spinal fusion for correcting idiopathic scoliosis in teens. This study found that while the procedure is safe and effective, it can result in permanent complications like degenerative disc disease. Researchers concluded that physicians should discuss the risk of post-operative disability with patients considering spinal fusion surgery. 
• A 2017 study found that lumbar fusion surgery for degenerative conditions was associated with long-term pain and psychotropic medication use. According to this study, 62.5% of the participants continued to chronically use narcotics after spinal fusion. 95% of patients who had been taking narcotics before the procedures continued to take them two years after fusion.

What Can Cause Recurrent Pain After Spinal Fusion?

The most common causes of recurrent pain after spinal fusion include:

• Fusion Failure (Pseudoarthrosis)

When the vertebrae fail to merge into a single bone after spinal fusion, it’s known as pseudoarthrosis. While some patients who develop this condition don’t experience symptoms, it typically causes recurring pain and neurological symptoms. Another spinal fusion procedure is the typical treatment for pseudoarthrosis. 

One study reported that pseudoarthrosis occurs in at least 15% of primary lumbar fusions. Though this complication is typically associated with lower back pain or radicular pain, it can be asymptomatic. 

• Hardware Failure

As we mentioned in a previous section, the hardware used in spinal fusion surgery is highly durable, but doesn’t last forever. Some patients with recurring pain 10 years after spinal fusion may be experiencing the effects of hardware failure. 

Pedicle screws, rods, spacers, and cages are all types of hardware commonly used in spinal fusion. This hardware can degenerate or even break over time, especially if the spine is subject to significant stress and impact. Worn-out or broken hardware can lead to recurrent spinal pain, along with neurological symptoms. 

• Adjacent Segment Disease (ASD)

Adjacent segment disease is a possible complication of spinal fusion. It develops when the vertebrae surrounding the fused segment endure the brunt of the impact from day-to-day motions. This occurs because the adjacent vertebrae must compensate for the lost mobility in the fused segment.

According to a clinical review published in Clinical Spine Surgery, between 2% to 4% of spinal fusion patients per year experience adjacent segment disease. It leads to symptoms including:

• Back pain
• Pain that radiates from the back into the legs and/or feet
• Numbness, tingling, and/or weakness in the legs and/or feet
• Trouble standing
• Pain while walking

Lumbar Spinal Fusion Alternative

A lumbar fusion alternative is often a good option for patients seeking to avoid recurring pain after spinal fusion. The TOPS System from Premia Spine is one option to correct lumbar spinal disorders while omitting the fusion process. 

The TOPS System is a unique device that replaces the anatomical spinal structures removed in decompression surgery. For example, the facet joint or lamina may be removed during decompression to alleviate nerve impingement. Then, the TOPS System can be secured to the affected area to restore a stabilized range of motion. 

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Since the TOPS System reestablishes motion in every direction, including extension, flexion, lateral bending, and axial rotation, patients aren’t subject to significant mobility restrictions after the procedure. Additionally, this complete range of motion removes the risk of adjacent segment disease and related complications. 

Clinical studies performed since 2005 have presented the TOPS System’s ability to relieve chronic lower back and leg pain in patients with lumbar spinal stenosis and degenerative spondylolisthesis. 

If you’re concerned about the possibility of pain 10 years after spinal fusion, reach out to a specialist in your area to learn more about the alternative treatment options available.