Back fusion (vertebrae fusion, spinal fusion) is generally performed to relieve back pain caused by damaged joints or discs in the back. The purpose of back fusion surgery is to stop movement at a degenerated and painful part of the spine. Most commonly this is the lumbar spine and procedures include anterior lumbar interbody fusion (ALIF) and posterior lumbar interbody fusion (PLIF). These procedures involve the insertion of screws and rods between the affected levels of the spine and generally additional bone is added as a graft to help the fusion – bone is taken from either from the hip or the spine itself. Note that in addition to the common problems of degenerative facet joints or vertebrae, back fusion may also be a type of back surgery used in the treatment of back tumours, back deformity (such as scoliosis), back infections or breaks (fractures).
Before back fusion is considered, the back pain must be typical of pain from the joints or vertebral discs of the back and a qualified specialist should review this. The same specialist should perform an examination and determine the site of the worst pain and symptoms. Finally, a scan and x-rays of the back is generally performed and the findings on this should match those from the examination.
Even if all three of the above points apply, back fusion is only a last resort. In the first instance, sufferers should try exercises, stretches, physiotherapy and perhaps a review by a chiropractic.
After the above measures have been tried unsuccessfully, it is often worth trying a good quality back brace which tries to simulate the effect of a back fusion.
When a back fusion is performed it is most effective when the condition being treated only affects one vertebral level. Movement is generally not noticeably affected when only one level of vertebrae fusion is performed, but if more than one pair of verebrae are fused then some restriction may be noticed. Fusing more than two levels is performed uncommonly and can both restrict movement and also place stress on other joints in the back – and may in fact cause further pain as a result. Back fusion is often effective when performed in a carefully selected group meeting the criteria discussed earlier, with good motivation to recover from the procedure and a healthy lifestyle. It should be noted that back surgery is general is more successful when performed after a period of alternative treatment measured but also if appropriate exercise, physiotherapy and stretching is performed after the surgery to aid recovery.