The back pain won’t go away, and your most recent trip to your doctor came back with an ominous recommendation: spinal fusion surgery.
If getting surgery on your spine sounds intimidating, know that you’re not alone in feeling that way. Spinal fusion surgery sounds scary to most people, inviting questions you’d rather not think about: How long does it take? How long will my recovery time be? Are there risk factors or complications with spinal fusion? What does the procedure look like? How can I feel confident that I’m in the right hands? Maybe most of all: Is there any other way?
At Centeno-Schultz, Colorado’s leading stem cell therapy clinic, we believe there is another way. We know that spinal fusion surgery can sound scary, and we don’t believe it’s right for all patients. If you are considering spinal fusion after your doctor’s recommendation, here are five things you need to know about the spinal fusion surgery process, as well as the alternative method we believe could save you from having to undergo surgery at all:
What is spinal fusion, anyway? Why would someone need to have their spine fused?
When patients go in for continual low back pain, they could be found to have chronic pain problems or degenerative disc disease – problems that won’t go away on their own. Instead of leaving them untreated and surely allowing the pain to get worse, spinal fusion surgery is often recommended. This surgery is done by fusing certain segments of the spine together, typically with bone and/or hardware, in order to prevent motion from that spinal segment. The idea is that, with little to no motion, further erosion and increased pain cannot occur.
How well does this surgery work? What is the success rate?
This answer is a bit more complicated because the research has shown that the
success rate for spinal fusion is largely dependent on the reason someone needs
surgery in the first place. In the largest published investigation to date, researchers
looked at the results of 65 studies and more than 300,000 patients and found that the
success rates were variable; there wasn’t, in this study, a definitive answer on the
success rate of spinal fusion for surgical patients with low back pain, versus patients with
low back pain who opted out of surgery (1). Furthermore, there was no difference in pain
levels between those who underwent spinal fusion and those who did not. For patients
who had a slipped vertebra (otherwise known as spondyloisthesis), the spinal fusion
procedure did have greater success; however, most patients who pursue spinal surgery
are not in that category, but instead have chronic low back pain. The research shows
that, for these patients that make up the majority, the fusion surgery did not make any
distinguishable improvements upon their way of life.
How serious is spinal fusion? Is it considered major surgery?
In a word, yes. Because complications resulting from spinal fusion are common, this
procedure is considered major surgery. Research demonstrates that surgeons can
underestimate complications (3), and that the serious complication rate of spinal surgery
is 10-24%, according to an analysis that reviewed five larger studies on the same subject
(4). Even when minimally invasive fusions were used, which are comprised of smaller
incisions, the reported complication rate was 19%, with some studies reporting fusion
complication rates as high as 31% (10). Side effects from spinal fusion can also include
nerve damage and infection, among other problems that can lead to a need for more
How long will I be in recovery after spinal fusion surgery?
Depending upon the type of surgical method used, patients can expect to be prescribed
narcotics for lingering pain for between two and nine weeks post-surgery (5-7).
Recommended time away from work can vary from as little as seven weeks to more than
six months, depending upon the patient, the surgical method, and any potential
complications. Most surgeons tell their patients that they can expect to wait a year before
full recovery has taken place.
How will I know if my spinal fusion procedure creates complications? What are the symptoms I should look out for?
An unfortunate and major complication of spinal fusion surgery is an overall failure of the
procedure. Spinal fusion can fail, and there are a few main ways that happens, to
➜ Non-union: If the segment being fused with the bone fails to grow together,
this is called “non-union.” The rate at which non-union occurs is highly dependent upon
the type of spinal fusion surgery performed. If a procedure requires more bone, such as
a posterior-lateral fusion, non-union rates can be as high as 26 – 36% (8,9)
➜ Hardware that loosens or breaks, or pain resulting from hardware used:
These hardware-centric complications are a common reason that second surgeries need
to be performed after the initial fusion. Overall, roughly 13% of patients undergoing
fusion because of low-back problems require a second surgery (11).
➜ Adjacent segment disease (ASD): ASD is caused by excessive force on
vertebral levels above or below the fusion area, causing them to be worn out because of
the immobile fusion (12). It is estimated that as many as 12% of patients will develop
ASD within two years of their spinal fusion procedure (16), and 2 – 4% of patients will
develop this problem for every year post-fusion, for example, at 5 years from the fusion
date, 20% of patients will have developed ASD (17).
Is there a better way to do this without such a high risk of complication or additional surgery?
If this information about spinal fusion surgery has you concerned or reticent, you should know that there are alternatives to having major spinal fusion surgery. One alternative is a process whereby a surgeon replaces a disc with a moveable piece of hardware in order to retain some motion in that spinal segment, which is, in theory, better than fusing the area and losing all motion entirely. This surgery is known as an Artificial Disc Replacement, or ADR. However, the research to date hasn’t been convincing that ADR will prevent ASD (12-15), which means that
an artificial disc implant may be no better than getting your spine fused.
But there is another way. Centeno-Schultz has been using an alternative procedure for the last decade with great success (18). This groundbreaking procedure is a fusion substitute pioneered by our team at Centeno-Schultz, called the Prec-FSU Procedure.
In this procedure, FSU means the “Functional Spinal Unit,” which consists of the disc, facet joints, ligaments, and muscles that all assist in stabilizing the spine.
The Perc-FSU Procedure is injection-based, with the goal of tightening ligaments using orthobiologics such as stem cells and PRP, waking up atrophied muscles, and treating damaged joints and irritated nerves. The preciseness of the injection helps to relieve numbness, weakness, and pain for patients that have been recommended spinal fusion, and can stabilize the spine without the need for the rods, nuts, bolts, and hardware of fusion surgery. In short, the Perc-FSU utilizes the healing power of your own body – by using your own stem cells or PRP – to avoid the need for spine fusion surgery.
We know that, as we age or experience trauma to our ligaments, muscles, or joints that stabilize our spines, those pieces loosen or weaken, creating the instability that may lead to a surgeon recommending spinal fusion surgery. However, rather than bolting your spine together with a major surgery procedure, the Prec-FSU procedure is a precise x-ray and ultrasound-guided injection method. Since the injections are image-guided, the precision this procedure provides ensures best possible results for patients with chronic low back pain or disc degeneration. All of our doctors are musculoskeletal specialists with advanced training, and our Perc-FSU Procedure is backed by extensive research, as well as published patient outcome data (18).
Ready to find relief?
Life is too short to live in pain. If you’ve been recommended spinal fusion surgery, we want to provide you an alternative that minimizes complications and ensures optimal and lasting results. Take advantage of our innovative treatments that help people just like you avoid joint replacement and other invasive surgeries, allowing them to get back to doing the activities they love, faster and without surgery.