If you are considering a spinal surgical procedure, you should have plenty of opportunities to discuss the surgery with your doctor and touch upon the potential pros and cons of the operation. The specific advantages or disadvantages of spinal surgery will differ depending on the type of operation you are considering, as well as the underlying cause of your pain. In most cases, you will need to weigh the potential benefits of having the surgery, such as pain relief, and improved quality of life, with the disadvantages (often, reduced range of motion of the spine, along with recovery difficulties). In this post, we will explore some of the common pros and cons of spinal surgery, to help you understand what you should be considering when discussing the possibility of an operation.
The Pros of Fusion Surgery
Let’s look specifically at one of the most common types of spinal surgery – the spinal fusion. Spinal fusion surgery is a process that permanently connects two or more of the vertebrae in the patient’s spine. A doctor might recommend this type of procedure for numerous reasons. For instance, fusion surgery can be used to treat spinal deformities (including scoliosis, or excessive spinal curvature), to stabilize the spine after the removal of a herniated disc, or to restore spinal stability in cases where arthritis or other conditions have led to excessive and painful motion between the vertebrae.
The process of spinal fusion involves a surgeon placing bone grafts, or bonelike material, between the vertebrae and then fusing them with screws, rods, or plates. The process essentially turns these once-separate vertebrae in a solid piece, permanently.
The most obvious pros of spinal surgery are pain relief and stability. Let’s say you have recently gone through a surgery to remove a herniated disc and reduce pressure on the nerves in the spine. This surgery can reduce pain and spinal compression, but it can also remove so much bone that there is no longer enough material there to stabilize the spine. In turn, that lack of stability can lead to a great deal of motion between spinal vertebrae, causing considerable pain. To eliminate this problem, a surgeon may recommend a spinal fusion as part of the herniated disc surgery. The extra stability provided by the operation does a lot to improve the patient’s quality of life, post-surgery.
The stability provided by spinal fusion also helps reduce the risk of post-decompressive spinal deformity. When healing from spinal surgery, some patients will develop kyphosis, a spinal disorder that results in a round back or hunchback. Fusion surgery can correct both pre-surgery and post-surgery abnormalities in alignment. The fusion stabilizes the spine and helps it hold proper alignment, which can reduce future wear and tear and limit the likelihood of the patient requiring additional surgeries in the future to correct spinal abnormalities.
The Cons of Spinal Surgery
Unfortunately, there are also cons to spinal surgery. For one thing, spinal fusion is a complex and multi-step process. In addition to the surgery that needs to happen at the spinal level, the surgeon will often take a bone graft from your body—usually from the pelvis—which requires additional incisions. Reaching the spine to perform a fusion properly also typically involves more muscle dissection than simple spinal decompression does, which can lead to a longer and more challenging recovery time.
The biggest worry among most patients is that spinal fusion will limit their mobility/range of motion. This assumption is natural since the fusion of multiple vertebrae does inherently limit the body’s ability to bend and move in that area. In some cases, patients will undoubtedly experience a decreased range of motion—especially if their surgery required the fusion of more than two vertebrae. However, it’s also worth noting that patients who require spinal fusion procedures often have such severe back pain that their mobility is compromised anyway. These patients will often report than spinal fusion improves their range of motion since it reduces pain at the site of the surgery.
The type of motion the patient wishes to accomplish is also relevant when discussing whether a spinal fusion will compromise mobility. For instance, a common misconception is that spinal fusion will make it difficult or impossible for a patient to bend down to pick up something from the floor. In truth, most of this kind of bending motion is accomplished in the hips—not the spine. Fusion will not do much to limit a patient’s ability to bend or lean over. What tends to be more compromised is the patient’s ability to rotate. That’s not to say rotation is impossible for a patient with a spinal fusion. On the contrary, many patients, once healed, find they are still able to master a good golf swing, for instance. However, if you go through a fusion surgery, you might find that it takes longer for you to get used to your new range of rotational motion.
Perhaps the most oft-cited con of spinal fusion surgery is a complication called “adjacent segment disease.” When two or more vertebrae are fused, they can cause more stress on the segments of the spine (the vertebra and discs above and below the fused section) than is common with a healthy, non-fused spine. There is evidence to suggest that this additional strain will cause those adjacent segments of the spine to degenerate more rapidly, potentially bringing about the need for surgeries elsewhere in the spine. However, some surgeons argue that the risks of adjacent segment disease are overstated and that those spinal segments would degenerate with or without the spinal fusion.
Consulting Your Spinal Surgeon
Whether you are thinking about a spinal fusion or some other type of spinal surgery, consulting with your spinal surgeon and talking through your options will give you ample opportunity to explore the specific pros and cons of spinal surgery. Again, many of the pros and cons will depend on the patient, their current condition, and the particular surgery they are considering. To discuss your spinal health with a reputed expert, contact Dr. Vivek P. Kushwaha today and schedule an appointment.