spinal fusion

Laminectomy with Fusion

When spinal conditions don’t improve despite ongoing non-surgical treatment, surgery may be the logical next step. Laminectomy with fusion is one of the most prominent spinal decompression procedures for conditions like spinal stenosis, spondylolisthesis, and herniated disc. 

Table of Contents

What is Laminectomy with Fusion?

How Successful Is a Laminectomy With Fusion?

Do You Need Fusion with Laminectomy?

What Is the Recovery Time for a Lumbar Laminectomy With Fusion?

Returning to Work After a Lumbar Laminectomy with Spinal Fusion

What Are The Risks of Laminectomy With Fusion?

Can You Walk Normally After Laminectomy With Fusion?

Non-Fusion Implants For Laminectomy

How Premia Spine TOPS System Cures Spondylolisthesis and Spinal Stenosis Without Fusion

But, what exactly does laminectomy with fusion involve, and is it the right choice for you? Read on to learn more about this topic and how it may impact your spinal recovery. 

What is Laminectomy with Fusion?

Laminectomy is a form of spinal decompression that’s commonly done with fusion to stabilize the spine. During a laminectomy, the surgeon removes the smallest quantity of the lamina possible while effectively resolving the nerve compression. 

The lamina is a piece of bone that forms part of the vertebral arch. It acts like a roof over the posterior side of the spinal canal. 

Conventionally, spinal fusion is performed after a laminectomy (and most other forms of spinal decompression). During spinal fusion, the surgeon places an implant containing bone graft material between the vertebrae. Over time, this graft stimulates bone tissue fusion, creating a single vertebra. 

Fusion after laminectomy effectively lowers the risk of injuries due to spinal instability. However, it also eliminates all motion at the fused segment, which may permanently limit the patient’s mobility.  

How Successful Is a Laminectomy With Fusion?

Laminectomy with fusion is widely considered a successful procedure for disorders like spinal stenosis and spondylolisthesis. A study published in The New England Journal of Medicine concluded that lumbar laminectomy with spinal fusion provided a slightly greater improvement in overall physical health when compared to laminectomy alone. This study included 66 patients with degenerative grade 1 spondylolisthesis. 

However, laminectomy alone is considered safer than spinal fusion. According to Dr. Steven Atlas, an associate professor of medicine at Harvard Medical School, laminectomy provides 80% to 90% pain relief for spinal stenosis, without the risks associated with fusion.  

Do You Need Fusion with Laminectomy?

You may need fusion with laminectomy if a part of the spine is unstable after laminectomy. Spinal instability creates the risk of further injury.

However, innovations in spinal medicine have produced alternatives to fusion for stability after decompressive laminectomy. We’ll discuss these innovations, including the TOPS System from Premia Spine, in a later section. 

What Is the Recovery Time for a Lumbar Laminectomy With Fusion?

The recovery time for a lumbar laminectomy with fusion can last between two months and a full year. Many factors can affect this recovery period, including the patient’s age and overall health, as well as the severity of the spinal condition. 

Spinal fusion extends the recovery period after a lumbar laminectomy. This is because spinal fusion involves bone tissue recovery, which is a lengthy process. 

Returning to Work After a Lumbar Laminectomy with Spinal Fusion

Generally, healthy patients with non-strenuous jobs can expect to return to work following a lumbar laminectomy with spinal fusion after four to six weeks of rest. Older patients or those with strenuous jobs may need four to six months of recovery time before returning to work. 

What Are The Risks of Laminectomy With Fusion?

The risks of laminectomy with fusion include those associated with all surgical procedures, including bleeding, infection, blood clots, and complications from anesthesia. Since this surgery involves the spine, it also presents a low risk of injury to the spinal cord or spinal nerve roots.

In permanently fusing two or more vertebrae of the spine, fusion creates the risk of a few other complications, including:

• Pain at the graft site

Some patients experience pain at the site of the bone graft. In 2.8% to 39% of patients, this pain has been reported to last for over three months. Graft site pain has been reported to last for up to two years in 15% to 39% of patients. 

• Pseudoarthrosis

Pseudoarthrosis refers to bone fusion failure. This complication is significantly higher in patients who smoke, as nicotine hinders the bone fusion process. Unfortunately, patients who experience pseudoarthrosis will likely require extra surgeries to reliably fuse the vertebrae. 

• Adjacent segment disease

Adjacent segment disease, or ASD, occurs when the spinal segments around the fused bone degenerate after fusion. The surrounding segments may undergo additional impact to compensate for the fused bone, leading to degeneration. Regrettably, ASD can lead to re-operation if it causes chronic back pain and neurological symptoms that don’t improve with non-invasive methods. 

Can You Walk Normally After Laminectomy With Fusion?

You can gradually walk normally after laminectomy with fusion, typically with the help of a physical therapist. Walking is actually highly beneficial after spinal surgery, as it’s a low-impact activity that promotes circulation and mobility.

Typically, surgeons recommend that patients stand up and gently walk (with assistance) the day after laminectomy with fusion to prevent muscle stiffness and atrophy. For the first six weeks or so after the procedure, walking may be the sole physical activity that you can safely complete. Many physicians recommend working up to two 30-minute walks per day in this early recovery stage. 

Non-Fusion Implants For Laminectomy

Non-fusion implants provide a solution for laminectomy without fusion. This allows patients to avoid the downsides of spinal fusion while achieving relief from chronic back pain and neurological symptoms. According to a research article published in BMC Musculoskeletal Disorders, walking time in the first week after lumbar spine surgery is one of the factors that predicts notable improvement at six months post-op. 

There are multiple non-fusion implants available to patients today, including artificial discs, expandable rods, and complete implant systems like the TOPS System. These devices (which are also referred to as motion preservation devices) generally fall under one of three categories: total disc replacement, posterior stabilization devices, and prosthetic nuclear implants. 

How Premia Spine TOPS System Cures Spondylolisthesis and Spinal Stenosis Without Fusion

The Premia Spine TOPS System cures spondylolisthesis and spinal stenosis without fusion by establishing a controlled range of motion in the spine. It’s a mechanical implant device designed to be implanted in the L2 to L5 segments of the spine with a posterior surgical approach. 

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The TOPS System facilitates motion in all directions, including axial rotation, lateral bending, extension, and flexion. Unlike fusion, it replaces the vertebral structures extracted in spinal decompression, such as the lamina removed during laminectomy. It also features a patented crossbar configuration, which imparts less stress on the screws than fusion implants. 

After nerve compression in spondylolisthesis and spinal stenosis patients is resolved during a laminectomy, the TOPS System can be placed to prevent instability. This technique effectively cures spondylolisthesis and spinal stenosis without fusion, with the TOPS system providing an average improvement of 81% in a clinical study published in the Operative Neurosurgery journal. 

Though the TOPS System has been used successfully for many years in Europe and other regions, it’s currently being tested in clinical trials across the United States. The device was awarded the FDA’s Breakthrough Device Designation in 2021, which will prioritize its process of obtaining FDA approval. 

If you’re interested in the TOPS System as an alternative to laminectomy with fusion, find a doctor in your area to learn more about this treatment option.  

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. 

L4-L5 Fusion: Success Rate and Recovery

Spinal fusion is a longstanding procedure that stabilizes the spine and helps alleviate symptoms of various spinal conditions. Though it may be done on virtually any part of the spine, fusion is commonly done on the L4-L5 segment of the lumbar spine. 

Table of Contents

What is L4-L5 Fusion Surgery?

How Long to Recover from L4-L5 Fusion?

How to Wash Hair After Spinal Fusion Surgery on L4-L5?

What to Expect After L4-L5 Fusion?

What is The Success Rate for L4-L5 Spinal Fusion?

How Successful is Lumbar Fusion Surgery L4-L5?

What Are The Risks of L4-L5 Spinal Fusion?

The Best Modern Alternative for L4-L5 Fusion

This article will explore the success rate, recovery process, and available alternatives for L4-L5 fusion. 

What is L4-L5 Fusion Surgery?

L4-L5 fusion involves fusing the L4 and L5 vertebrae in the lumbar spine. It’s commonly performed to treat lumbar spine conditions including spinal stenosis, spondylolisthesis, disc degeneration, vertebral fractures, and herniated disc. 

The spine consists of four sections: the cervical spine (the neck), the thoracic spine (the mid-back), the lumbar spine (the lower back), and the sacral spine (directly above the tailbone). Each of the vertebrae of the spine has been assigned a letter and a number according to these sections. The lumbar spine includes the L1 through the L5 vertebrae. 

Spinal fusions are most commonly performed on the lumbar spine. Over 300,000 lumbar spine procedures are estimated to be performed in the United States each year. 

How Long to Recover from L4-L5 Fusion?

It takes between six months and one year to fully recover from L4-L5 fusion. You may need four to six weeks to return to basic activities around the house after the procedure, and one to two months to return to work. 

If your job involves light physical activity, you may need to take three to six months off of work after L4-L5 fusion. Patients whose jobs require hard physical labor generally can’t return to those occupations after the procedure. 

Fusion requires such a lengthy recovery process because it involves bone healing. Bone tissue takes longer to heal than soft tissue. 

How to Wash Hair After Spinal Fusion Surgery on L4-L5?

To wash your hair after L4-L5 spinal fusion, use a hand-held shower head. If you don’t have one, bend at the knees and waist to fit your head under the shower head. Make sure not to arch your back to wash your hair after fusion, as doing so may strain your spine. 

Additionally, consider purchasing a long-handled shower brush before undergoing lumbar fusion. With this tool, you can wash all areas of your body without bending. Many fusion patients also benefit from using liquid soap after fusion to prevent having to pick up a fallen bar of soap. 

After L4-L5 spinal fusion, basic tasks like washing your hair may be extremely difficult. To combat this, take the following steps to prepare your home before the surgery:

• Move items in your kitchen and bathroom off of the high shelves so that you won’t have to strain to reach them. 
• Stock your kitchen with nutritious ready-made meals so that you don’t have to worry about cooking while you recover. 
• Do all of your laundry and set out comfortable clothes to wear during the early stages of your spinal fusion recovery. 

What to Expect After L4-L5 Fusion?

After L4-L5, you can expect to stay in the hospital for two to three days. Additionally, expect to experience stiffness and soreness in the lower back. Your doctor will likely prescribe pain medication to ease discomfort in the first few days or weeks after the procedure. 

You’ll be advised to avoid lifting, bending, and twisting your spine for at least two weeks after L4-L5 fusion. Most patients are told to avoid lifting any objects heavier than five pounds for at least two weeks after spinal fusion. 

As aforementioned, expect to take four to six weeks off of work after L4-L5 fusion (or longer, if your occupation requires physical exertion). 

What is The Success Rate for L4-L5 Spinal Fusion?

The estimated success rate of lumbar spinal fusion is 70% to 90%. This rate can vary depending on the condition that the procedure’s used to treat. 

How Successful is Lumbar Fusion Surgery L4-L5?

Lumbar fusion surgery at the L4-L5 spinal segment is considered a long-standing and widely successful procedure. However, the success of L4-L5 fusion depends on both the fusion of the vertebrae and the patient’s symptom improvement. Spinal fusions rarely provide a total cure for the patient’s back and leg pain. 

Certain factors can reduce the chance of success in L4-L5 lumbar fusions. These factors include:

• Smoking or using other nicotine products
• Obesity
• Osteoporosis
• Some chronic conditions
• Engaging in strenuous activities during the recovery process

What Are The Risks of L4-L5 Spinal Fusion?

The risks of L4-L5 spinal fusion include:

• Failure of the bone to fuse
• Hardware failure
• Nerve injury
• Adjacent segment disease
• Lingering lower back pain
• Need for reoperation

These risks accompany the risks associated with all surgical procedures, including infection at the surgical site, thrombosis, and complications from anesthesia. 

The Best Modern Alternative for L4-L5 Fusion

The best modern alternative for L4-L5 fusion is an innovative non-fusion device, such as the TOPS System. The TOPS System is a mechanical device made to be implanted between the L2 and L5 segments. It’s most often used for lumbar stenosis, degenerative spondylolisthesis, and joint arthrosis.  

The TOPS System is the best modern alternative for L4-L5 fusion because it stabilizes the spine without eliminating the independent motion of the spinal segments. The device establishes a safe range of motion in the lumbar spine to preserve patients’ mobility. This is unlike spinal fusion, which eradicates the natural motion of the fused segments. 

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As an alternative to L4-L5 fusion, the TOPS System can also reduce the risk of adjacent segment disease (ASD). ASD is a potential complication of spinal fusion that occurs when the adjacent segments degenerate more rapidly due to the lack of movement in the fused segment. 

In one study, TOPS was found to provide clinical improvement and radiologic stability in patients with spinal stenosis and degenerative spondylolisthesis after seven years. 

If you’re suffering from symptoms of lumbar spinal stenosis, spondylolisthesis, or related conditions, modern treatment options are at your disposal. Contact a local spine specialist to learn more. 

When is Spinal Fusion Necessary?

Performed since the 1900s, spinal fusion is a long-established surgical procedure used to correct spinal conditions, injuries, and deformities. It involves permanently welding two to four vertebrae using bone graft material. As the vertebrae form a single bone, the risk of spinal instability is drastically reduced. 

Table of Contents

Who is a Candidate for Spinal Fusion?

What is The Best Age for Spinal Fusion?

Can You Ever Bend Again After Spinal Fusion?

Does Spinal Fusion Shorten Life Expectancy?

What Are The Disadvantages of Spinal Fusion?

Premia Spine TOPS System – Alternative for Lumbar Spinal Fusion

When Premia Spine TOPS System is Not The Solution

As a major surgical procedure that permanently reduces spinal mobility, spinal fusion isn’t considered until all conservative treatment options have been exhausted. However, spinal fusion may be necessary for certain cases of severe spinal pain. 

Who is a Candidate for Spinal Fusion?

Candidates for spinal fusion typically experience severe back pain, reduced mobility, and a diminished quality of life from one of the following conditions:

• Spinal stenosis
• Spondylolisthesis
• Degenerative disc disease
• Scoliosis
• Spinal instability
• Spinal fractures

Keep in mind that your physician will also consider your medical history and the extent of your condition to determine if you’re a candidate for spinal fusion. Additionally, physicians typically don’t consider patients as candidates for spinal fusion until they’ve undergone conservative treatments for six to 12 months, to no avail. 

You may not be considered a candidate for spinal fusion if you:

• Smoke, as nicotine can sabotage the healing process
• Use steroids
• Are obese
• Have diabetes or osteoporosis

What is The Best Age for Spinal Fusion?

There is no best age for spinal fusion. The procedure can be used to alleviate spinal symptoms in adults aged 20 to 80 if the patient is in good overall health. 

With that said, patients who undergo spinal fusion early in adulthood are more likely to experience the effects of adjacent segment degeneration. This is because they simply have more time to develop spinal degeneration from wear and tear.  

Can You Ever Bend Again After Spinal Fusion?

After spinal fusion, you’ll no longer be able to bend at the fused segment. As a result, patients’ mobility is restricted after the procedure. However, patients usually regain the ability to bend and twist the rest of the spine after the fused segment has fully healed. 

Does Spinal Fusion Shorten Life Expectancy?

Spinal fusion doesn’t shorten patients’ life expectancies. The procedure may only impact life expectancy if life-threatening surgical complications, such as infection or thrombosis, occur. 

However, spinal fusion can cause long-term complications, including:

• Non-union

In some cases, the vertebrae targeted during spinal fusion fail to fuse. Certain factors increase the risk of non-fusion, including smoking or vaping. 

• Hardware failure

In spinal fusion, hardware including screws, plates, cages, and bolts may be used for stability. But, the stress imparted on the lumbar spine with daily motions may cause this hardware to break or loosen after spinal fusion. One study found the incidence of hardware failure after lumbar fusion to be 36%. 

• Adjacent segment disease

Adjacent segment disease, or ASD, is a term used to describe new degeneration at a spinal level adjacent to the fused level. This complication can lead to persistent back pain, stiffness, weakness, numbness, and tingling. 

What Are The Disadvantages of Spinal Fusion?

The main disadvantages of spinal fusion include:

• Reduced mobility
• Extensive recovery process
• Persistent pain
• Risk of complications

Reduced Mobility

As we mentioned earlier, spinal fusion eliminates all motion at the fused segment. So, patients lose the ability to bend, twist, and flex the spine at the fused segment. 

Most fusions involve just two spinal levels, which is known as a two-level fusion. But, if the patient requires a three or even four-level fusion, they’ll experience more significant mobility restrictions. 

Extensive Recovery Process

Unfortunately, spinal fusion requires a lengthy recovery process. After the procedure, it can take as long as four to six weeks to return to basic activities around the house. To fully recover from spinal fusion, most patients need between six months and one year. 

Persistent Pain

Spinal fusion isn’t guaranteed to eliminate patients’ back pain. In one study, 10% of patients continued to experience pain at the site of the fusion five years after the procedure. 

Risk of Complications

Like all forms of surgery, spinal fusion comes with a risk of complications including infection, thrombosis, and adverse reactions to anesthesia. However, it can also cause the complications listed earlier, such as hardware failure and ASD. 

Premia Spine TOPS System – Alternative for Lumbar Spinal Fusion

Given that spinal fusion comes with many downsides, patients are often interested in alternatives to the procedure. The Premia Spine TOPS System is an alternative to lumbar spinal fusion that stabilizes the spine without eliminating the motion of the treated segment.

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The TOPS System is a non-fusion implant device that’s used to replace the tissues removed during spinal decompression. Soft and bony tissues are removed to alleviate nerve compression, and the TOPS System restores a controlled range of motion in the spine. This prevents spinal instability while relieving the symptoms of conditions including spinal stenosis and spondylolisthesis. 

TOPS offers numerous benefits as an alternative for lumbar spinal fusion:

• Shorter recovery period
• Fewer restrictions on physical activity and a greater range of motion
• Reduced risk of adjacent segment degeneration
• Immediate pain relief
  

To learn more about the range of treatment options that Premia Spine offers, find a specialist in your area today. 

When Premia Spine TOPS System is Not The Solution

If your spine specialist determines that the TOPS System isn’t the right solution for your symptoms or spine section, you may be asked to consider spinal fusion. Learn other spinal fusion alternatives that might work for you including:   

• Artificial disc replacement

If your spinal pain is caused by a severely degenerated spinal disc, artificial disc replacement may work for you. In this procedure, the damaged disc tissue is removed and replaced with an artificial disc. There are several artificial discs available today, and your spine specialist will determine the right one for you. 

• IDET

IDET, or intradiscal electrothermal coagulation, involves gently heating the exterior of a spinal disc with a needle passed through a catheter. This process is thought to boost collagen fibers in the disc exterior, leading to pain relief. 

• Stem cell therapy

Stem cell therapy may help patients overcome spinal pain without fusion. This treatment involves injecting stem cells directly into the spine. Stem cells can regenerate into any type of cell and may help restore damaged spinal tissue. 

Spinal fusion can make your quality of life better in separate cases, you do not have to live through daily discomfort of terrible chronic pain.

Common Problems After Spinal Fusion

Spinal fusion is a common surgical procedure that’s done for conditions like spinal stenosis and spondylolisthesis. During the procedure, the surgeon places bone graft material between one or more vertebrae to gradually fuse them into a single bone. 

Table of Contents

What to Expect 6 Months After Spinal Fusion?

Can Spinal Fusion Cause Problems Later in Life?

Hardware Failure After Spinal Fusion

Why Does My Back Still Hurt Years After Spinal Fusion?

What Are The Signs of a Failed Fusion?

Can Spinal Fusion Cause Nerve Damage?

What Are The Signs of Nerve Damage After Spinal Fusion?

Can Spinal Fusion Cause Paralysis?

The Best Alternative to Lumbar Spinal Fusion

Due to the nature of the procedure, spinal fusion involves certain restrictions, complications, and problems. Fusion permanently removes all motion at the fused vertebrae, which can alter how the rest of the spine bears weight. This, combined with possible surgical complications, can (understandably) leave patients with many questions. 

In this article, we’ll explore common problems from spinal fusion to consider before undergoing the procedure. 

What to Expect 6 Months After Spinal Fusion?

Six months after spinal fusion, you can expect to start the final stages of the recovery process. Between six months and one-year post-op, patients can typically start returning to all of their normal activities, including some bending and twisting. During this stage, your spinal surgeon will likely be able to confirm that the vertebrae have successfully fused. 

Keep in mind that even after the fused vertebrae have fully healed, patients must still adhere to certain restrictions. With all motion eliminated at the fused segment, patients can’t bend, twist, and flex as much as they used to.  

Can Spinal Fusion Cause Problems Later in Life?

Spinal fusion can cause problems later in life, namely hardware failure, adjacent segment disease (ASD), or spinal muscle injuries. All of these problems can lead to new or reoccurring back pain and neurological symptoms.  

Hardware Failure After Spinal Fusion

Hardware including rods, pedicle screws, cages, and spacers may be used for stability in lumbar spinal fusion. Though it’s designed for lifetime use, this hardware can wear out and break over time. 

Symptoms of hardware failure are often similar to the symptoms that patients experience before spinal fusion: persistent back pain and/or weakness, tingling, and numbness. 

Why Does My Back Still Hurt Years After Spinal Fusion?

If your back still hurts years after spinal fusion, it’s likely due to increased stress and degeneration of the adjacent spinal segments. Known as adjacent segment disease, or ASD, this potential complication of spinal fusion occurs when the fused segments increase the strain on the surrounding segments. This can lead to back pain and neurological symptoms years after the fusion.   

What Are The Signs of a Failed Fusion?

The possible signs of a failed fusion include chronic back pain, reduced mobility, neuropathic pain, and radicular pain. With a failed fusion, the patient’s initial symptoms may return, or they may experience new problems. 

• Chronic back pain

Pain is considered chronic if it’s significant, continuous, and lasts for over 12 weeks. Failed spinal fusion typically causes chronic back pain that doesn’t improve, even after the expected recovery period.  

• Reduced mobility

One of the goals of spinal fusion is to improve mobility. Patients with a failed fusion may experience spinal mobility limitations that go beyond the normal restrictions associated with fusion. 

• Neuropathic pain

Neuropathic pain occurs when the nerves or spinal cord become damaged. It manifests as numbness, tingling, burning, and/or weakness that may move throughout the body. 

• Radicular pain

Radicular pain is a type of neuropathic pain that radiates from one part of the body to another. For example, the pain may radiate from the lower back down the buttocks and legs. 

Can Spinal Fusion Cause Nerve Damage?

Yes, spinal fusion can cause nerve damage. This is because spinal surgery involves navigating delicate nerve structures, including the spinal cord and spinal nerve roots. Additionally, inflammation in the tissues surrounding spinal nerves can cause nerve damage after fusion. 

Although nerve damage is possible during spinal surgery, surgeons use many different techniques to prevent this complication. These techniques include:

• Advanced imaging technology used to plan the surgery with 3D images of the patient
• Microscopes used to light and magnify the operative field
• Detailed intraoperative imaging and visualization that allows for precise instrument and implant positioning 

What Are The Signs of Nerve Damage After Spinal Fusion?

The signs of nerve damage after spinal fusion include tingling, numbness, burning, and weakness. If a nerve that supplies the pelvis becomes damaged, you may also experience sexual dysfunction. 

Nerve damage is a serious problem that may require immediate medical attention. If you’re experiencing signs of nerve damage after spinal fusion, contact your doctor right away. 

Can Spinal Fusion Cause Paralysis?

Spinal fusion can cause paralysis, but it’s one of the rarest possible complications. It may result from one of the following problems during the procedure:

• Extradural spinal hematoma, which involves bleeding within the spinal column
• Incidental durotomy, which occurs when spinal fluid leaks
• Accidental injury to the nerves when they’re repositioned during the operation
• Accidental injury to the blood vessels that deliver blood to the spinal cord

The Best Alternative to Lumbar Spinal Fusion

The best alternative to lumbar spinal fusion is an advanced non-fusion implant, like the TOPS System. Non-fusion implants work by stabilizing the affected vertebrae with a device. In the case of the TOPS System, the device moves with the spine to create a controlled range of motion. 

The TOPS System works by replacing the spinal structures removed during spinal decompression. It’s anchored to the spine and includes a patented crossbar configuration, which exerts less impact on the screws than fusion implant devices. The device recreates motion in every direction, including flexion, extension, axial rotation, and lateral bending. 

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In a study of the TOPS System for lumbar spinal stenosis and degenerative spondylolisthesis, the visual analog scale (VAS) for back and leg pain lowered from 56.2 before the procedure to 12.5 at six weeks, 13.7 at one-year follow-up, 3.6 at two years follow-up, and 19 at seven years follow-up. These results showed that TOPS can continue to provide a clinical improvement over time. 

Patients who are concerned about the complications from spinal fusion can speak with a specialist in their area to learn more about the available alternatives. 

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

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.

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.

Steps For Faster And Easier Spinal Fusion Surgery Recovery

Spinal fusion is a relatively common surgical procedure used for spinal conditions and deformities. It’s widely used to prevent spinal instability after spinal decompression surgery, which may be used for spinal stenosis, spondylolisthesis, herniated disc, and related medical concerns. 

Table of Contents

• How To Get Prepared For Lumbar Spinal Fusion Surgery?
• How Long After Spinal Fusion Does It Stop Hurting?
• How Can You Make Your Lumbar Spinal Fusion Heal Faster?
• Are There Any Permanent Restrictions After Spinal Fusion?
• Should I Consider Avoiding Spinal Fusion?

Regrettably, spinal fusion surgery involves a lengthy recovery period that can last from six months to a year in total. With this in mind, many patients seek out ways to shorten their recovery and get back on their feet faster. 

In this article, we’ll explore strategies for shortening your spinal fusion surgery recovery and maintaining lasting pain relief. 

How To Get Prepared For Lumbar Spinal Fusion Surgery?

Preparing for lumbar spinal fusion is the first (and arguably most important) step in shortening your spinal fusion recovery. Here are our best tips to ready yourself for the procedure:

1. Talk to your doctor about every medication and supplement that you’re currently taking. This includes not only prescription drugs but also over-the-counter medications and even herbal supplements. Patients may be required to stop taking specific medications before fusion to ensure that the procedure and their recovery process go off without a hitch. 
2. If you smoke, quit as soon as possible. Smoking is detrimental to the body’s healing process, increases the risk of complications, and diminishes the success rate of spinal fusion. You can consult your physician for resources to help you quit smoking, as well as your loved ones for support. 
3. Optimize your diet. Consuming a nutrient-dense, fiber-rich diet before and after spinal fusion promotes healing and prevents constipation, which can be caused by prescription pain medications. Limit processed, high-fat, and high-sugar foods. 
4. Prep your kitchen with ready-made and throw-together meals. Make sure that everything you’ll need in the kitchen is on a shoulder-height shelf, as you won’t be able to reach or bend after the spinal fusion procedure. 
5. Gather any equipment that you may need, such as a cane, toilet seat riser, and reacher tool. 
6. Ask friends and family members for support. You’ll need a ride home from the hospital after the procedure, and it may be helpful to have a loved one stay with you for assistance during the first few days at home. You can also contact an in-home caregiver to help you during this period.  

How Long After Spinal Fusion Does It Stop Hurting?

After lumbar spinal fusion, the most severe pain typically abates after four weeks. Following this benchmark, you may still experience pain, but it should gradually diminish with time.

Patients may continue to feel some degree of pain three to six months after spinal fusion. Physical therapy and healthy lifestyle habits can help you manage this pain as you recover from the procedure. 

How Can You Make Your Lumbar Spinal Fusion Heal Faster?

There are a handful of ways to accelerate healing after spinal fusion, including:

• Following all of your surgeon’s recommendations. After the fusion procedure, your surgeon will offer basic guidance on what to do and what to avoid. Following these instructions carefully will benefit your recovery process. 
• Keeping a close eye on the incision. Identifying signs of inflammation, irritation, or discoloration as soon as possible will help ensure that any complications are addressed promptly. 
• Staying mobile after the procedure. While following all of your doctor’s guidance, get up and walk around during your spinal fusion recovery. Doing so will keep blood circulating throughout your body, prevent atrophy, and reduce your risk of blood clots. 
• Refraining from smoking. As important as it is to quit smoking before spinal fusion, it’s also crucial to avoid smoking throughout your recovery process, as smoking can speed up spinal degeneration. 

What Foods Are Good For Healing After Spinal Fusion Surgery?

As mentioned in a prior section, high-fiber, nutrient-dense foods are ideal for patients undergoing spinal fusion. Here are other dietary recommendations to consider after spinal fusion surgery:

• Pack your diet with lean protein. 

Protein is essential for healing after surgery. So, pack your diet with plenty of low-fat protein, including poultry, fish, lean meat, eggs, low-fat dairy, and tofu. As a bonus, foods that are high in protein also typically contain high amounts of zinc, which supports your body’s ability to fend off infection. 

• Pair fiber-rich foods with plenty of water. 

To prevent constipation after spinal fusion, eat fiber-rich foods including vegetables, fruits, and whole grains. Prunes and prune juice are also helpful, as they act like natural laxatives. Make sure to wash down these foods with plenty of water to support your digestive system during the recovery period. 

• Consume more calories. 

After spinal fusion surgery, your metabolism kicks into high gear to accommodate the body’s healing process. To fulfill this heightened demand, you’ll need to consume more calories, ideally through nutritious foods including fruits, vegetables, legumes, and whole grains. 

Are There Any Permanent Restrictions After Spinal Fusion?

The spinal fusion procedure permanently fuses the targeted vertebrae of the spine. This process also permanently eliminates all motion at the affected segment. So, patients do experience permanent restrictions on their mobility, such as an inability to twist, bend, and lift heavy objects. 

In some cases, patients need a reacher tool to retrieve objects from the floor or on high shelves after spinal fusion. With a significant loss of spinal flexibility, patients may lose the ability to participate in some of their favorite physical activities. 

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Should I Consider Avoiding Spinal Fusion?

The lost mobility, risk of complications, and lengthy recovery period associated with spinal fusion lead many patients to consider avoiding lumbar spinal fusion altogether. While in past decades this may have been a challenge, there are currently spinal fusion alternatives available to the public. 

Non-fusion spinal implants like Premia Spine’s TOPS System provide stability after spinal decompression surgery without fusing the vertebrae. This results in a controlled range of motion without the extensive recovery and lost mobility of fusion. 

Before undergoing fusion, don’t hesitate to contact your spine specialist to discuss every available treatment option for your spinal condition. 

How to Prepare for Spinal Fusion Back Surgery?

Spinal fusion is often performed in conjunction with spinal decompression surgery for various spinal conditions. Decompression surgery alleviates pressure on pinched nerves that extend from the spine. This process reduces pain and restricted mobility stemming from nerve compression.

Unfortunately, spinal decompression also involves removing portions of the vertebrae. This makes the spine weaker and less stable at the affected segment. To prevent further injury, spine specialists commonly use spinal fusion to stabilize the spine after decompression.

Spinal fusion involves fusing two or more adjacent vertebrae into a single bone with a bone graft. As a major surgery, spinal fusion requires extensive preparation and recovery to achieve the best possible results.

What Should You Do Before Spinal Fusion Surgery?

The process of preparing for spinal fusion surgery is similar to preparing for any other spinal operation. However, there are a few specifics to be aware of. 

How To Prepare For Lumbar Spinal Fusion?

Firstly, be prepared to undergo a thorough examination before the surgery. This is essential for your physicians to plan every aspect of the operation. Radiograph assessments for spinal stability, electromyography (EMG) for nerve function, and an MRI, CAT, or other imaging tests to identify nerve compression are often performed.

Your doctors will also assess your overall physical condition to ensure that you’re in sufficient health to undergo the rigors of the surgery. You’ll need to discuss all pre-existing medical conditions with your physicians. These conditions may need to be further evaluated before proceeding with spinal fusion surgery.

With this in mind, one of the most important ways to prepare for spinal fusion is to get into the best possible physical condition. This may involve quitting smoking, improving your diet, and increasing your physical fitness (while following all of your doctor’s instructions). Being in good physical condition translates into fewer complications during surgery and a faster recovery afterward.

How To Equip Your Home For Better Recovery After Spinal Fusion

Most patients are cleared to return home two to four days after spinal fusion. Make sure to plan ahead and have someone drive you home from the hospital. Typically, patients aren’t allowed to drive for a few weeks after lumbar fusion.

There are several ways to equip your home for smooth spinal surgery recovery. Our best tips include:

1. Plan for simple meals after the surgery. Consider subscribing to a grocery delivery service or, better yet, a meal kit service. Many meal kits require little to no preparation and are delivered straight to your doorstep. This will help simplify your meals after the surgery.
   
   For a DIY version of delivery meal kits, consider meal prepping before the procedure and placing the dishes in the freezer. When you’re at home post-fusion, you can defrost the meals to stay nourished without the need to cook.
   
   Keep in mind that the ideal post-spinal surgery diet should be high in protein and fiber. Additionally, try to avoid processed foods and stick with whole grains, nuts, seeds, beans, lean protein, fruits, and vegetables. 

2. Purchase ice packs and heating pads, if you don’t have them already. Both cold and heat therapy are useful after spinal surgery. Cold therapy can help alleviate inflammation, while heat therapy can help ease muscle tension.
   
   Make sure to take your doctor’s advice for heat and cold therapy, and limit your use to 15 to 20 minutes at a time. 

3. Consider a walker or cane. Moving around your home can be difficult in the early days and weeks after fusion. A walker or cane can help provide stability and prevent accidents. 

4. Place everyday items in an easy-to-access location that you won’t need to twist or bend over to reach. You can also consider purchasing a reacher/gripper/grabber device, which will help you retrieve items without straining your spine. 

5. Prep the bathroom with a toilet riser and shower seat or mat. These devices will make it easier to use the toilet and to spend more time in the shower, which can help alleviate pain and tension. 

6. Sleeping can be difficult after spinal fusion. To make it easier, consider purchasing a body pillow, which may help you find more comfortable sleeping positions.  

How Many Years Does a Spinal Fusion Last?

The results of spinal fusion are permanent. This means that the affected vertebrae are permanently fused and can’t be separated. However, there are some instances in which patients require revision surgery, including:

• Fusion failure

Fusion failure occurs when the targeted vertebrae fail to combine into a single bone after the procedure. When this occurs, the patient will continue to experience back pain and neurological symptoms. Patients who have used corticosteroids are at a higher risk of fusion failure, as are patients who underwent fusion without fusion hardware.

• Hardware failure

Hardware is often used during spinal fusion to stabilize the bone graft. Rarely, this hardware may become damaged or malfunction after the procedure. In these cases, the hardware may move around and irritate the neighboring tissue, leading to pain.

• Adjacent segment disease, or ASD

Adjacent segment disease can develop when the vertebrae adjacent the fused segment break down at a faster-than-usual rate. Since the fusion eliminates all motion at the fused segment, the adjacent vertebrae must undergo added strain. Adjacent segment disease can lead to back pain and neurological symptoms, creating the need for revision surgery.

• Scar tissue

The body produces scar tissue during its natural healing process. Generally, scar tissue doesn’t cause any problems. However, after spinal procedures like spinal fusion, scar tissue may irritate or constrict a nerve root, which can cause neurological symptoms.

What Are The Long-Term Effects of Spinal Fusion Surgery?

In a perfect world, spinal fusion surgery would rid all patients of chronic back pain without future complications. But, in reality, spinal fusion creates the risk of various complications later in life.

Can spinal fusion cause problems later in life?

Future complications that may result from spinal fusion surgery include:

• Adjacent segment disease
• Spinal muscle injury, which may lead to instability and further injuries
• Chronic pain at the bone graft site
• Spinal nerve damage
• Poor spinal mobility at the site of the fusion, which can limit patients’ activities

Alongside chronic pain, poor mobility is a major concern among patients facing spinal fusion. Without the ability to bend, flex, or twist at the fused segment, many patients lose the mobility required for their favorite activities. Some patients may always need a reacher device to pick up items off of the floor.

With these possible complications in mind, spinal surgery of any kind, including spinal fusion should only be considered a last resort. Physicians only recommended it if more conservative treatments have proven ineffective.

Are Lumbar Spinal Fusion Alternatives Available?

Considering the prominent downsides of spinal fusion, it’s unsurprising that many patients with spinal conditions seek out alternative treatments. Now, patients undergoing spinal decompression have an alternative procedure to consider.

The TOPS (Total Posterior Solution) System has long been used in Europe and Australia, with better outcomes than spinal fusion. Now, it’s being used across many states in the U.S. and has earned the FDA breakthrough designation.

TOPS is a non-fusion lumbar spine implant that stabilizes the spine without eliminating the independent motion of the individual vertebrae. With TOPS, patients recover with far fewer restrictions and in a much shorter time frame than with spinal fusion.

One of the best ways to prepare for spinal fusion is to discover if an alternative solution like the TOPS System from Premia Spine makes more sense than spinal fusion for you or a loved one. Contact your spinal specialist to learn more about all of the treatment options available today.

5 Ways To Avoid Spinal Fusion Surgery

Table of Contents

• What to Expect After Spinal Fusion Surgery?

• Risks of Spinal Fusion Surgery

• What Are The Alternatives to Lumbar Fusion?

• 5 Ways to Avoid Spinal Fusion Surgery

• Future Complications From Spinal Fusion

When back pain from a spinal condition becomes chronic, physicians may present the option of spinal fusion surgery to patients. However, few patients want to undergo spinal fusion unless it’s the last resort. Spinal fusion involves all of the risks of other surgical procedures, along with the prospect of significantly reduced spinal mobility. 

Thankfully, medical advancements in recent decades have made way for spinal fusion alternatives. This article will discuss strategies for avoiding spinal fusion surgery while obtaining relief from persistent back pain. 

What is Spinal Fusion Surgery?

Spinal fusion surgery is a medical procedure that involves fusing two or more spinal vertebrae so that they can heal and become a single bone. This procedure eliminates motion between the targeted vertebrae while preventing irritation to the surrounding nerves and ligaments.

To perform spinal fusion, the surgeon extracts a bone graft from the patient’s pelvis or uses a synthetic bone graft. The graft is then positioned and secured between the affected vertebrae. Metal plates, screws, and rods are sometimes used to hold the two spinal vertebrae together while the bone graft heals. This surgical procedure improves stability and corrects spinal deformities. 

How Long Does It Take to Recover From Spinal Fusion Surgery?

Usually, it takes about 4 to 6 months to return to gentle activities after spinal fusion surgery. It can take between 6 and 12 months to make a full recovery from the procedure.

Keep in mind that the healing process can differ from person to person, and several factors can influence recovery. Diet, weight, age, and lifestyle can go a long way in determining how fast the patient will recover from the surgery. 

Patients are advised to undergo physical therapy, avoid strenuous activities, and maintain a healthy diet after spinal fusion surgery to enhance the recovery process. You’ll likely need to take four to six weeks off of work after fusion surgery, or longer if your occupation is physically demanding.  

What to Expect After Spinal Fusion Surgery

Just like any other spinal surgery, spinal fusion surgery comes with several risks; a nerve could get damaged, there could be infection, bleeding, blood clots, poor wound healing or pain in the pelvis area where the bone graft was harvested, loss of bowel or bladder control may occur too. 

Spinal fusions can also put pressure on the bones that are above and below the fusion, which can cause them to break down and degenerate more quickly. Subsequently, this leads to an increased likelihood of further surgery in the nearest future. 

Spinal fusion is a surgery that risks leaving patients in pain or needing the procedure again in the future.

The only time you should think of undergoing spinal fusion surgery is when you know that you are capable of taking a long time from work without your finances being affected, say 4 to 6 months. Or you have good insurance that can cater to you and your family. 

If you can not confidently boast of any of the above then it is advisable for you to avoid spinal fusion surgery. 

Risks of Spinal Fusion Surgery

Just like any other spinal surgery, spinal fusion surgery comes with several risks, including:

• Nerve damage
• Infection
• Bleeding
• Blood clots
• Poor wound healing
• Pelvic pain at the area where the bone graft was harvested
• Loss of bowel or bladder control, in severe cases

Spinal fusion can also place pressure on the bones located above and below the fusion. This may cause them to break down and degenerate more rapidly. Known as adjacent segment disease, or ASD, this spinal fusion complication leads to an increased likelihood of future revision surgery. 

Patients should generally only consider undergoing spinal fusion surgery if:

• Several months of non-surgical treatments have failed
• They’re capable of taking a long time off of work (around 4 to 6 months) without their finances being affected, say 4 to 6 months
• They have good insurance that can cover the cost of the procedure 

Additionally, patients should speak at length with a spinal specialist before considering fusion to ensure that they’ve exhausted every other available treatment option. 

What Are The Alternatives to Lumbar Spinal Fusion?

In addition to non-surgical treatment approaches, advanced non-fusion spinal implants present an alternative to lumbar spinal fusion for many patients. One such implant is the TOPS System from Premia Spine. 

The Premia Spine TOPS System is a non-fusion spinal implant that provides a genuine alternative to spinal fusion. It’s a mechanical device positioned between two titanium plates that offers stability while retaining spinal mobility in all directions. It replaces the spinal structures, such as the lamina or facet joint, that are removed during lumbar spinal decompression surgery. 

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The TOPS System is designed to be used between the L2 and L5 spinal segments, which are often affected by lumbar spinal stenosis and spondylolisthesis. It re-establishes a controlled range of motion within the lumbar spine to alleviate pain without limiting the patient’s activities. 

In a 7-year clinical study, the TOPS System was found to maintain clinical improvement and radiologic stability over time in patients with spinal stenosis and degenerative spondylolisthesis. 

Get in touch with a medical professional to discuss your treatment options today.

5 Ways to Avoid Spinal Fusion Surgery

1. Physical Activity and Targeted Exercises

Many people believe that taking enough rest from physical activity is the best way to care for back pain. There’s no denying that rest can prevent you from overstressing the spine. Additionally, rest is essential to the healing process for many back injuries, namely acute back injuries and sports injuries. 

However, many spinal injuries and conditions benefit from physical activity. Exercise increases blood flow and, as a result, the flow of oxygen and nutrients to the spine. This stimulates the healing process while helping to alleviate stiffness that can worsen back pain. 

Despite the benefits of physical activity for spinal pain, certain precautions will ensure that your exercise routine doesn’t do more harm than good:

• Avoid high-impact activities, like running and weightlifting, which can cause further injury. Low-impact activities, such as walking and water aerobics, are safe options. 
• Talk to your doctor before starting any new exercise routine, and ease into it. 
• If you experience spinal pain (not muscle soreness) while exercising, stop and rest. 

Additionally, targeted exercises can benefit your recovery from spinal conditions. Exercise can strengthen the muscles that support the spine, namely those in the back and abdomen. By strengthening these muscles, you can reduce the impact exerted on your spine with day-to-day motions. 

Here are a few simple exercises to try at home: 

• Lie on your back, bend your knees, and place your feet flat on the floor. Gently lift your buttocks a few inches off the floor toward the ceiling. Complete three sets of 10 repetitions.
• Lie on your back and hug your knees to your chest. Gently roll side to your side, just a few inches, to massage and stretch your lumbar back area. Return to the starting position and repeat to the other side. 
• From a standing position, bend at the waist with your fingers reaching for the floor. Go only as far as your body naturally permits. Now, just hang there and breathe naturally for one minute. With each breath, let your back and legs relax and stretch. Repeat three times.

2. Physical Therapy

Physical therapy is almost always recommended for patients struggling with chronic back pain from spinal conditions. While your physical therapist may recommend exercises for muscle development like those listed above, they can offer unique insight and recommendations for your recovery process. In general, physical therapy improves strength, mobility, and stamina for patients with spinal pain. 

Your physical therapist can specifically target the problem areas of your spine. They may correct abnormalities in your gait, posture, and lifting techniques to reduce spinal compression. Paired with targeted training and pain management strategies, these methods work to alleviate symptoms of spinal conditions. 

It may take several months for physical therapy to improve your back pain and other symptoms. However, patients often find that physical therapy allows them to exercise with less frequent and less severe pain. PT also frequently improves patients’ ability to comfortably complete day-to-day activities, like grocery shopping and gardening. 

Talk to your doctor before scheduling an appointment with a physical therapist. Your doctor can likely refer you to a PT that specializes or is highly experienced in your condition.

3. A Healthy Diet and Weight Loss

As the saying goes, an apple a day keeps the doctor away. While an apple might not keep your back pain at bay, maintaining a healthy weight is crucial to your spinal health. 

Being overweight increases the strain on all of your joints, as well as your spine. Each extra pound adds to the impact exerted on your spine with every stride or repetition at the gym. 

Clinical research has supported the claim that body weight is related to back pain. A 2010 review in the American Journal of Epidemiology found that the risk of lower back pain is directly linked to body mass index or BMI. 

Additionally, a 2017 study conducted at the University of Tokyo Hospital found that after reviewing 1,152 men’s medical histories from 1986 to 2009, a patient’s BMI and body fat percentage correlated to the risk and incidence of back issues. 

Eating a diet rich in vegetables, fruits, whole grains, and lean protein can help you maintain a healthy diet. Avoid consuming foods that are high in sugar and cholesterol, as well as trans and saturated fats). These foods can contribute to inflammation throughout your body and in your spine, which may worsen spinal pain while inhibiting your recovery process. 

Additionally, eating a nutritious diet and maintaining a healthy weight will support the health of your entire body. With greater overall health, patients can often recover from spinal conditions more rapidly.

4. Spinal Manipulation

Spinal manipulation is a technique typically performed by chiropractors to restore spinal alignment. It can help resolve back pain and nerve compression caused by spinal misalignment. Additionally, by realigning the spine, spinal manipulation can improve the flow of blood (and, as a result, oxygen, and nutrients) to the injured spinal tissues.

There’s a range of different techniques that chiropractors may implement for spinal manipulation. However, the most common technique is the high-velocity low-amplitude (HVLA) thrust.

The HVLA thrust often causes a “pop” that patients can hear. When using this method, the chiropractor will apply an abrupt force to a joint with their hands while the body is in a specific position. 

In some cases, chiropractors may opt for a gentler method known as spinal mobilization or low-force methods. These techniques don’t require twisting the body or applying a sudden force to the body. They may be implemented to suit the patient’s comfort level, preferences, or size, or for specific conditions (like osteoporosis, for example. 

Many spinal conditions can be exacerbated by spinal misalignment and, therefore, benefit from spinal manipulation. The most common of these conditions include spinal stenosis, spondylolisthesis, and herniated disc.

When combined with other treatment options listed here, spinal manipulation and other chiropractic methods may help patients avoid spinal fusion surgery. However, if your back pain has resulted from a traumatic injury, like a spinal fracture, this treatment likely won’t work for you. 

5. Epidural Steroid Injections

Epidural steroid injections can help calm pain caused by an irritated or compressed spinal nerve. These injections contain powerful anti-inflammatory medication that can offer relief within just a few days.

While steroid injections are quick and accessible, they’re not generally used as a long-term solution. Undergoing more than three to four injections per year can lead to tissue damage. Additionally, make sure to consult your doctor about the benefits and drawbacks of steroid injections for your particular spinal condition. 

Future Complications From Spinal Fusion

Given that spinal fusion surgery may be correlated with accelerated degeneration of the joints surrounding the fused vertebrae, many professionals believe that fusion can lead to future spinal issues. This is especially true for patients who undergo spinal fusion relatively early in adulthood. 

This implies that the longer you live after undergoing spinal fusion surgery, the higher your chances are to experience future spinal problems. 

According to a study published in the Journal of Spine Surgery, revision spinal surgery after the initial spinal fusion procedure takes place in 8% to 45% of cases. The reasons for revision include non-union, implant failure, recurring spinal stenosis, adjacent segment disease, infection, and flatback syndrome. 

Complications from spinal fusion may contribute to chronic back pain in the future. Whether caused by adjacent segment disease, spinal muscle injuries, hardware malfunction, or graft site pain, pain after spinal fusion can be debilitating. 

With these risks in mind, it’s generally recommended to avoid spinal fusion whenever possible and opt for safer options. Thankfully, medical advancements have paved the way for spinal fusion alternatives that can provide lasting stability and pain relief, like the TOPS System. These alternatives can improve your quality of care, alleviate your back pain, and give you a greater overall quality of life. 

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

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)
• Osteoporosis

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.