If you've been suffering from back pain for some time, you're likely already familiar with the conventional treatment methods — rest, over-the-counter pain relievers, physical therapy and sometimes even prescription medications.
And if chronic back pain is seriously affecting your quality of life, your doctor has perhaps mentioned back surgery, too. It's often the last resort for many patients, but surgery can provide life-changing results for people.
One common back surgery — spinal fusion — permanently fuses two vertebrae together to eliminate painful movement between them.
Dr. Derrick Y. Sun, a neurosurgeon at Houston Methodist, explains everything you need to know about the procedure.
Who might benefit from spinal fusion?
"If your back pain is caused by abnormal or excessive motion between two vertebrae, spinal fusion may help relieve symptoms and improve day-to-day functioning," says Dr. Sun.
Your doctor can pinpoint the source of pain with imaging tests, such as X-rays, computed tomography (CT) and magnetic resonance imaging (MRI) scans, or diagnostic electromyography/nerve conduction velocity (EMG/NCV) test.
Spinal fusion may be an option for those who suffer from:
- Degenerative disk disease or recurrent herniated disks
- Weak or unstable spine (caused by infections or tumors)
- Fractures or injuries to the bones in the spine
- Spinal deformities, such as scoliosis or kyphosis (abnormal curvatures of the spine)
- Spondylolisthesis (when one vertebra slips forward on top of another)
For patients with multiple spinal conditions, spinal fusion can be performed along with diskectomy (to treat herniated spinal disks) or other procedures for spinal stenosis, such as laminectomy (to remove part or all the vertebral bone) and foraminotomy (to relieve pressure on compressed nerves).
What happens during spinal fusion?
If you are a candidate for spinal fusion, your doctor will discuss the risks and benefits, and help you prepare for surgery.
There are several different surgical techniques for spinal fusion, but in general the steps include:
- General anesthesia is used so no pain is felt during surgery
- The surgeon makes an incision to access the spine
- Bone grafts are used to fuse the vertebrae together. Bone grafts may come from a bone bank, your own body (sometimes the pelvic bone) or synthetic bone material
- Instruments, such as cages, plates, screws or rods, hold the vertebrae together until the bone graft fully heals
What to expect after spinal fusion
"After surgery, you may need to stay in the hospital for a couple of days," says Dr. Sun. "You may experience some pain and discomfort, but it can usually be managed with medications."
Back at home you need to refrain from normal activities until your body has solidly fused the vertebrae. Depending on your job or daily activities, you may be able to resume normal duties within four to six weeks for less demanding work, four to six months for physically demanding work. Your doctor and physical therapist will advise you on when you can return to normal activities.
Your doctor may also recommend wearing a brace to keep your spine properly aligned.
"You may also benefit from physical therapy and back exercises to strengthen and condition your body to move, sit and stand in ways that protect your spine," Dr. Sun adds.
