Failed Spinal Fusion
Spinal fusion is one of the most common surgical procedures for chronic back and neck pain performed today. Nearly 500,000 people undergo spinal fusion surgery each and every year. It is often a very successful surgery, but it also has a moderate failure rate, with estimates of returning and recurring chronic pain in between 10% and 25% of all patients.
What Causes Failed Spinal Fusion?
Spinal fusion is the treatment of choice for issues such as degenerative disc disease (DDD), spinal stenosis, spinal fractures, and more. The procedure itself involves the joining of two or more vertebrae using a combination of bone grafting, pedicle screws, rods, and other hardware.
There are many different techniques that can be used to perform spinal fusion, including:
- PLIF – Posterior Lumbar Interbody Fusion is the most common type of spine surgery. The spine is accessed through an incision in the back, giving direct and immediate access to the spinal cord.
- ALIF – With Anterior Lumbar Interbody Fusion, the surgeon makes an incision in the abdomen, and then accesses the disc from the front (moving some of the organs and tissues).
- TLIF – With Transforaminal Lumbar Interbody Fusion, the patient’s spine is accessed from the back (posterior) but on only one side of the spine.
- DLIF/XLIF – With Direct Lateral Intrabody Fusion, the patient lays on their side and an incision is made on one side of their body. The procedure is also known as XLIF, or “eXtreme Lateral Interbody Fusion,” XLIF is the same procedure as DLIF.
Each of these procedures may be used to reduce pain, but not all of them share the same successes and each has potential drawbacks that could affect pain reduction. For example, most spinal fusion of the lumbar section of the spine has a high failure rate due in large part to the technique. 80% of all lumbar fusions are posterior fusions (surgery through the back).
While that may seem to be an easier, more direct route, posterior lumbar fusion requires incisions on the muscles and tissues in the back, which weakens them during recovery. It also means that the weight of the front of the body is pushing back against the pedicle screws and hardware. All of these increase complication risk, which may mean pain after surgery.
Treatment for Failed Spinal Fusion
For those that have struggled with failed spinal fusion of either the lumbar or cervical portion of the spine (back and neck), treatment first requires an accurate diagnosis. At our Atlanta or Savannah office, we need to perform a thorough analysis of your spine, in order to determine whether the issue is due to a problem in surgery, a problem with diagnosis, a problem with hardware, or something else.
Once we’ve had an opportunity to make this diagnosis, we’ll then recommend either surgical or non-surgical treatments that will help reduce pain and provide long term pain relief from FBSS symptoms. For more information, call Spine Center Atlanta today at 404-351-5812.