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Fusion Alternatives

Fusion alternatives



Back and neck pain can be very debilitating and can severely affect a patient’s ability to function in a normal way. The first line of treatment for both back and neck pain is often medications, therapy including chiropractic care, bracing if needed and time. For most patients these interventions are enough to resolve their back pain or neck pain. For a small percentage of patients surgical intervention might be necessary to effectively treat their symptoms. The traditional surgical treatment is often a cervical or lumbar fusion.

A fusion is a procedure in which the damaged cervical or lumbar disc is removed and replaced with bone in order to join the two adjacent vertebral bodies together. This procedure can be very effective in relieving a patient’s pain. However, there are negative affects from a fusion. The two main downsides to a fusion is that there is a loss of motion at the fused levels and there is a risk of increased stress on the adjacent levels leading to more pain.

Because of these concerns some patients are very reluctant to have a fusion. For some of these patients there are fusion alternatives in which the diseased level is fixed without losing motion. These alternatives include a disc replacement by which the damaged disc is removed and replaced with an artificial disc. For other patients with lumbar stenosis, there is an even less invasive procedure in which the stenosis is removed and a support called the Coflex device is placed to prevent the stenosis form returning.

The support is placed between the two adjacent vertebral bodies after the compression is removed from the nerves. Because a fusion is not done there is no loss of motion and therefore there is less chance of the adjacent segments becoming painful. This is a procedure that is done in an outpatient setting with the patient returning home the same day to start their recovery.  Additionally, the recovery from this procedure is much faster than that of a fusion.

In summary, for patients with back and neck pain who have failed non-surgical treatments there are fusion alternative available such as a disc replacement or a CoFlex device for those with low back pain and spinal stenosis.

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Dr. Spine

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Dwight S. Tyndall, MD, FAAOS

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