Fusing away back and neck pain

Back pain and neck pain are among the most common symptoms responsible for poor quality of life and function.

Various treatments are available to fix this issue, but fusion surgery has stood the test of time. Spinal fusion could be a viable treatment option for patients with certain spinal disorders when conservative treatment methods have failed.

Spinal fusion is a surgical procedure to decrease or eliminate the instability of the spine. Spinal decompression is done as part of fusion to take pressure off the spinal cord or nerves, which along with fusion, may result in less pain and better quality of life. Spinal fusion can be done to treat a wide spectrum of back and neck problems, including the following:

• Degenerative disc disease (space between discs narrows)
• Fracture (broken spinal bone)
• Scoliosis (spine curves abnormally to one side)
• Spinal stenosis (narrowing of the spinal canal)
• Spondylolisthesis (forward shifting of a spinal disc)
• Tumors or spine infection

The spine is composed of 33 interlocking bones called vertebrae that are separated by soft and compressible intervertebral discs. Spinal fusion can be performed at any level depending on the underlying condition of the spine: cervical (neck), thoracic (upper and middle back), or lumbar (lower back). In each segment, the vertebrae are numbered from top to bottom. For example, a C3 is the third vertebra in the neck area, while a T6 is the sixth vertebra in the thoracic area.

During spinal fusion, the surgeon places bone or a bonelike material (called a graft), often times with spacers, in the disc space between two vertebrae. This acts as a bridge between vertebrae that are next to each other. The graft can come from another part of the body, a donor, or an artificial bone substitute. Metal plates, screws, and rods may be used to hold the vertebrae together, so they can heal into one solid unit.

According to spine research, more than 2 million spine fusions were performed in 2015. That represents a 32 percent increase from 2004 to 2015, with the largest increase (73 percent) occurring among patients age 65 and older. Lumbar fusions are the most common type of fusions followed by cervical and thoracic spine fusions.

Minimally invasive spinal fusion uses a smaller incision than traditional surgery, which may lead to faster recovery times. Spinal fusion surgery may appear to cause decreased flexibility of the spine. However, most patients needing fusion may already have limited flexibility, in addition to nerve pain and poor function. Most researchers, including Johns Hopkins Medicine, believe limited motion from fusion may not be considered a major problem.