None — BACKGROUND: Spinal fusion is a surgical procedure used to correct problems with the small bones of the spine (vertebrae). The fusion is essentially a "welding" process. The idea is to fuse the painful vertebrae together, so they can heal into a single, solid bone. Spinal fusion surgery may be used to relieve pain associated with degenerative disk disease, spondylolisthesis, spinal stenosis, scoliosis, fractures, infections or tumors. There are several techniques that may be used to fuse the spine. A posterior approach is done from the back. The surgeon may also approach the spine from the side. This is called a lateral approach. Minimally invasive techniques are also used. These allow fusions to be performed with smaller incisions.
THE DOWNSIDES: Spinal fusion prevents the stretching of nerves and surrounding ligaments and muscles. According to Dr. Kenneth Light, an orthopedic surgeon in San Francisco, Calif., spinal fusion severely limits motion, and for some patients, the pain does not go away. "It puts stress on the adjacent disk levels and makes them work overtime," Dr. Light told Ivanhoe. "It causes them to deteriorate and degenerate."
FUSION REVERSAL? Spinal fusion has typically been considered a permanent procedure. However, Dr. Light recently performed the first neck fusion reversal in the United States. In a five-hour surgery, Dr. Light cut and separated the fusion at the point where the donor bone met the vertebrae above it. He then carefully fitted a disk replacement. He used a device called the ProDisc-C implant to give one patient back her quality of life. "Low and behold, we put the implant in. She woke up. She was fine. She felt fine enough to go home the next day, and four weeks later, she is doing exceptionally well," Dr. Light told Ivanhoe. The implant was designed to maintain the physiological range of motion of the spine. Dr. Light says he believes artificial disk replacement will eventually replace up to 80 percent of all spinal fusion surgeries.
SAFETY CONCERNS: While this option may seem appealing to many, critics say beware. Some are unsure if the implant will last, and there is a chance of paralysis if it fails.
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