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Alternatives to Spinal Fusion: The Complete Guide to Alternate Options

Alternatives to Spinal Fusion: The Complete Guide to Alternate Options
Alternatives to Spinal Fusion: The Complete Guide to Alternate Options

Alternatives to Spinal Fusion: The Complete Guide to Alternate Options

Alternatives to spinal fusion have recently been a highly discussed topic of treatment rather than jumping right into getting a surgical procedure. Spinal fusion surgery is considered the common remedy for back pain and orthopedic disease; one that involves the union of two or more vertebrae or spinal bones into a single solid bone. And although a highly effective procedure with an 80-85 percent success rate, the procedure is seen as not ideal. Indeed, few people savor the idea of major surgery of any sort, especially when it involves a sensitive and vital body part such as the back and may fall just short of 100 percent effectiveness. This is why many back pain patients actively seek out alternatives to spinal fusion.

Alternatives to Spinal Fusion

With today’s cutting-edge medical technology and sophisticated back pain treatment options, back pain patients can investigate many alternatives to spinal fusion. Yet before we investigate these many and varied methods of high tech and often less invasive alternatives to spinal fusion, let’s take a closer look at this popular but not unproblematic form of major surgery.

A spinal fusion is a brand of low back surgery custom designed to treat lower back pain, discomfort often emanating from a condition known as degenerative disc disease. In this procedure, small bone morsels are positioned either in front of the spine, in the disk region, and/or in the posterolateral gutter along the back of the spine; causing the bone to fuse that specific segment of the spine. By eliminating motion in that fused section of the spine, spinal fusion is intended to lessen or eliminate totally any and all back pain caused by said motion.

Although spinal fusion is a thorough and effective form of spine surgery, there are indeed drawbacks to spinal surgery.

Drawbacks to Spinal Fusion Surgery

  • Spinal fusion surgery  is an elongated process, as the actual fusion process can take anywhere from three to 18 months to complete.
  • Spinal fusion is generally considered when the back pain has not found sufficient relief through verified alternatives to spinal fusion. When all else fails over an extended period of time, then major surgery is considered.
  • Spinal fusion is best recommended for those whose back pain is particularly intense, or that generates from the disc area.
  • Spine fusion surgery is most effective if only a single level of the spine is afflicted with pain–not when multiple levels are involved in the back pain case.
  • If the disc in need of care was somehow misidentified during the diagnostic process, then more back pain may ensue following the procedure. This could result in an instance of Failed Back Surgery Syndrome; a condition that results in both intense discomfort and substantial emotional and psychological trauma. Indeed and ironically, surgery may be required to reverse the effects of Failed Back Surgery Syndrome.
  • The recovery process for spinal fusion can take anywhere from three to 18 months. This lengthy recovery period is not unusual for back surgery, but can be problematic for an active person who wants to get back to their work, their favorite activities, their family, their lives.
  • Spinal fusion can affect permanent changes on the back, even perhaps exerting pressure on nonfused back joints.
  • Spinal fusion may not be recommended for those facing certain other medical conditions, including smoking, obesity, steroid use, osteoporosis, diabetes and related ailments, previous instances of fusion or surgery, and malnutrition.
  • As the act of spinal fusion effectively locks the spine, the procedure can throw one’s balance off kilter and effectively produce a locked posture; making movement, in general, more difficult.
  • Spinal fusion is surgery. While this statement may seem painfully simplistic in context, it is nonetheless relevant to this discussion–and, indeed, these words stand as the very reason that people seek alternatives to spinal fusion. No one enjoys the experience of surgery, regardless of the level of invasiveness involved. They do not anticipate with any degree of enthusiasm the act of undergoing surgery, not to mention the procedures for preparing and recovering from any given procedure. All things considered, no one is overly eager to undergo surgery; which is exactly what makes the prospect of alternatives to spinal fusion such a popular and much discussed one.

All things considered, it might be a good idea for the back pain patient to consider available alternatives to spinal fusion; specifically, non-surgical alternatives to spinal fusion.

Non Surgical Alternatives to Spinal Fusion

  • Cold and Warm Pads: Back pain often is treated and remedied via warm and cool pads and cloths, with cooling pads, in particular, serving to soothe the ache and heal many instances of strain and illness. Indeed, a cold pack can both numb and comfort the afflicted area and ease the associated pain; also working to help heal any strained or sprained back muscles.
  • Massage: A solid and frequent regimen of therapeutic massage does much to remedy many cases of back pain and discomfort. When professionally administered, orthopedic massage can remedy or at least ease or alleviate many instances of lower back pain.  Just be sure to seek the services of a licensed and professional massage therapist, and make them aware of the exact nature and location of your back pain, as advised by a doctor.
  • Decompression: This minimally invasive procedure, performed via a minute insertion, relieves pressure from the afflicted nerve to reduce and alleviate pain and strain.
  • IDET (Intradiscal electrothermal coagulation) or annuloplasty: An injection that involves the insertion of a needle into the lumbar disc space, the passage of a catheter through the needle, and the heating of the outer core of the disc region. The overall aim and objective to this method is the use of heat to contract and thicken collagen fibers within the disc wall, sealing tears and alleviating pain as well as cauterizing and desensitizing nerve endings in those suffering from more mild cases of degenerative disc disease.
  • Wait and see: Some patients and doctors elect to adopt a wait and see attitude when it comes to mild back pain; opting for a prescription of rest and pain medication over surgery. This method varies in success, depending on the severity of the condition.
  • Exercise: Although vigorous, strenuous and improperly conducted exercises can indeed be a source of back pain, exercise as a whole can actually be a tool in the fight against orthopedic disorders. A regular and mindfully conducted regimen of gentle but deliberate stretches can actually help to alleviate many instances of back pain. Just be sure to consult your physician and perhaps a professional fitness trainer to develop and determine the perfect exercise routine to combat back pain. And if at any time during your exercise routine you feel strained or pained, then please stop immediately and consult your physician as soon as possible.
  • Rest and relaxation: Often a favored method of dealing with back pain, especially among patients and it’s little wonder why, a restful regimen can indeed do much to combat back pain. A little R&R can do wonders for an aching back in some cases, even if it means abstaining for a bit from favorite dance or athletic activities. A well-rested back can heal faster, and rest in general can work wonders for the body as a whole, as well as the nerves and psyche.

In addition, those who are facing specific spinal and orthopedic conditions also have options when it comes to alternatives to spinal fusion. Indeed, each condition is highly individual in it’s traits and characteristics, causes and symptoms. It makes sense, then, that each condition calls for its own special and particular set of treatments and remedies.

One common orthopedic condition, spondylolisthesis, is one frequently treated via the spinal fusion process. This condition indicates the forward slippage of the vertebra and the spinal region above it. This condition ultimately can produce a lack of vertebral stability; a potentially highly traumatic and degenerative condition.

When it comes to the condition of spondylolisthesis and related lower back conditions, artificial disc replacement is often considered top among the alternatives to spinal fusion.


Why is disc replacement considered top among alternatives to spinal fusion for spondylolisthesis?

Artificial disc replacement is a surgical procedure where an intervertebral disc nucleus in the lower back or neck region is replaced by an artificial disc made of metal and plastic composites. This artificial disc is placed between vertebral bodies; leaving the disc annulus and facets whole and intact. As the spacer prevents collapse, permitting the patient to remain active and mobile. Artificial disc replacement is used when our spine discs have been injured past the point of repair.

Disc replacement is considered top among alternatives to spinal fusion for spondylolisthesis for a number of reasons. First, Spondylolisthesis usually occurs in children and young adults who participate in stressful, impact sports like BMX, gymnastics, skateboarding, football, weightlifting, and lacrosse. Spondylolisthesis is when there is a crack or stress fracture from the continuous impact on the vertebrae, which cause it to slip or slide out of its usual position. Since disc replacement still allows patients to use their spines to bend and twist after a successful and healed surgery, this procedure is considered top to losing that precious mobility at a young age.

Cervical Spine Fusion

Some back pain patients, by contrast, may be seeking alternatives to cervical spinal fusion; a procedure done generally to repair pinched nerves in the neck and/or spine.

When speaking specifically about alternatives to cervical neck fusion, cervical disc replacement surgery is considered chief among alternatives to spinal fusion. In this procedure, the surgeon makes an incision from the front and replaces a herniated or degenerated disc with an artificial disc. The joints stay in place, thus facilitating freedom of movement.

And when it comes to alternatives to spinal fusion, “alternatives” to anterior cervical discectomy and fusion are much discussed in the medical field.

This procedure is generally required to remedy instances of cervical stenosis. And particularly for younger patients, alternatives to spinal fusion are often considered in treating this condition; this owing to the fact that–in younger patients–cervical spinal fusion may be “associated with accelerated degeneration of the joints above or below the fusion levels. This is known as adjacent segment disease. Adjacent segment disease can result in chronic neck pain or even new pinched nerve roots or a pinched spinal cord. It may require another fusion to treat that joint. Then the next joint may be at risk, rarely resulting in a “domino effect” in worst case situations.”  And again, in cases involving multiple discs and joints, a loss of spinal motion may occur as well as newly exerted pressure on related joints.

Among alternatives to spinal fusion in cases of cervical stenosis, artificial disc replacement is again highly recommended; or the removal of the herniated disc along with all related (and highly uncomfortable) bone spurs and decompression of any and all pinched nerves. Another noted procedure and ranking high among alternatives to spinal fusion is cervical laminoplasty, or the reconstruction of the posterior cervical spine bones; the spinal bones are disconnected then reconnected via a spacer to space out and allow more flexibility to the nerves.

Also, much discussed in the medical field are alternatives to spinal fusion surgery for scoliosis.

A sideways curvature of the spine that strikes both young and elderly patients (happening most frequently during the growth spurt that happens just before puberty), scoliosis is an orthopedic condition that afflicts more than 3 million people in the United States each year.  

Many cases of scoliosis can be remedied through nonsurgical means. For years, doctors have treated scoliosis in children and adults by applying therapeutic braces to remedy excessive curvatures, alleviate pressure and pain in the joints, and straighten the posture.

Exercise and nutrition options, applied through the use of specialized equipment and supplements, also has been prescribed to amend and correct curvatures; as has sensible and healthful weight loss, cold and heat packs and massage or manual manipulation, and the ‘watch and wait’ method.

It is evident that thanks to the wonders of modern technology and advances in contemporary medicine, back pain patients now have so many options when it comes to the treatment and ultimate resolution of chronic back pain. And they now have a vast plethora of alternatives to spinal fusion.

Why, then, are nearly 500,000 spinal fusion procedures still performed each year?’s complicated.

Although just about all patients (and, for that matter, a good number of physicians) do indeed favor nonsurgical and minimally invasive alternatives to spinal fusion, none of these alternatives are foolproof or applicable to every instance of severe and chronic back pain–and for many and various reasons.

Among nonsurgical alternatives to spinal fusion, some only offer limited relief in specific cases. Hot and cold packs, for example, provide great and very soothing relief for back pain caused by minor sprains and injuries; for more serious or advanced conditions, however, they often provide only supplementary comfort. The same goes for therapeutic or orthopedic massage; and IDET injections have yet to boast a long established track record of proven results.

The Wait and See method is seldom effective at all unless the back pain in question is a minor strain incurred during exercise or through a mild injury.  And speaking of exercise; although potentially very helpful, overly vigorous or poorly executed exercise could bear the potential to backfire in the end–actually leading to more back pain.

Ah, but there can’t be anything wrong with a good ol’ dose of rest and relaxation–right? Generally, no; only most doctors agree that, in order to properly heal an injured or illness-stricken joint or muscle, some degree of motion or activity is required in order to rebuild, heal and strengthen the body after a time of illness or physical trauma. And while a good night’s sleep and additional rest sessions always do a body good–especially when said body is ill, injured, or in some way ailing–few of today’s busy, active people have the time to relax away their days in a state of respite. Ultimately, rest and relaxation alone will not heal a more severe instance of chronic back pain.

Even more medicinal and intensive forms of back pain therapy do not come complete with guaranteed results and a promise of complete resolution and recovery. For example; spinal decompression, while a respected and often effective method of back pain management, might not relieve enough spinal pressure to resolve the patient’s medical issue; especially if the spine proves particularly unstable in the wake of the illness or injury.

And while cervical disc replacement surgery is indeed a revolutionary and generally successful process, it may not be advisable for those who suffer from severe arthritis or whose cervical spine is in overall poor or weakened condition. Also, it is only considered highly reliable if the afflicted disc is replaced, and the remaining discs are healthy and functional.  The disc nucleus replacement procedure, while also technically proficient and advanced in its nature, is still a fairly new pain management method and also has yet to establish a lengthy track record on the medical scene.

And if a specific case of scoliosis proves severe or painful enough and all alternatives to spinal fusion fail, then the prospect of spinal fusion becomes a real possibility. This is also true if the scoliosis curvature stands between 45 and 50 degrees, and/or when the curves are expected to worsen–affecting mobility, posture, and perhaps even lung function in the process.  

So are you sufficiently depressed–or at the very least decompressed (sorry, terrible joke) by all of this news? Well, don’t be, because–in many cases–there are indeed valued and highly effective nonsurgical alternatives to spinal fusion. And if you and your doctor do indeed determine that spinal fusion is the best option to remedy your instance of back pain, then we have some more good news for you.

When expertly and properly done, spinal fusion does not have to be a painful or particularly invasive procedure.

And when you consult Dr. Payam Moazzaz, rest assured that your back will be put in the hands of a true orthopedic expert. He has achieved a decade’s worth of experience in the orthopedic field and has become an expert in the exciting field of minimally invasive surgery and its exciting newer subset, robotic spine surgery. He ranks among the first surgeons to perform robotic spine surgery via a first-generation platform that earned FDA approval in 2011; and he stands as among the first physicians to use a robotic spine surgery platform called Mazor X–a platform introduced on a national level in 2016. Dr. Moazzaz has performed more than 500 spine surgeries using robotic technology, which is the most robotic spine surgeries in the State of California.

The process involved with this form of spinal surgery begins several days before the actual procedure when images are taken of the patient to generate a sort of three-dimensional image of the spine; an image used to create a blueprint for the spinal fusion surgery, pinpointing the specific areas that require the surgeon’s attention.

This advanced, minimally invasive form of scoliosis surgery saves the patient from an excessive degree of poking and prodding. Armed with their detailed three-dimensional images, the surgeon inserts miniature surgical instruments through smaller incisions by way of robotic arms; permitting the surgeon an unlimited range of motion and precision.

A high-definition, three-dimensional camera guides the surgeon through the surgical procedure by way of a computerized monitor and console; and by accessing this interior view of the patient’s back, the surgeon performs every move of the surgery with the able aid of their robotic counterpart.

The advanced technology of robotic spine surgery has revolutionized the entire field of scoliosis surgery, and even minimizes scoliosis surgery risks. In general, this brand of spinal fusion surgery will experience a less painful surgical procedure, one involving a smaller quantity of blood loss, fewer complications, and a much faster return to normal activities via a far more abbreviated scoliosis surgery recovery time.

Plus this singular variety of scoliosis surgery often results in less infection, along with minimized damage to skin, muscles, and tissue. These factors alone will help to ensure a shorter scoliosis surgery recovery time, and shorter hospital stays, ensuring that your experience after scoliosis surgery is far more comfortable and easier to navigate.

Moreover, Dr. Moazzaz is the only spine surgeon in the state of California to achieve a perfect, 100 percent record of patient recovery.

When investigating alternatives to spinal fusion, don’t overlook the fact that the procedure of spinal fusion is–due to the wonders of modern technology and the expertise of physicians like Dr. Payam Moazzaz–like water–and pain–off your back! Contact New Era Spine today to arrange a consultation on the subject of robotic spine surgery.