Treatments for Back Pain After Spinal Fusion

spinal stenosis

Failed back syndrome is a term used to define pain experienced after back surgery that is the same or worse as the pain it was meant to treat. Spinal fusion surgery is prescribed and administered en masse to treat a number of spinal problems, including disc degeneration, spinal misalignment and facet joint syndrome. The procedure carries a unique risk: adjacent segment degeneration (ASD), also called transitional syndrome.

Spinal fusion entails the use of bone grafts and often hardware to fuse two or more vertebrae together. The disc in between is removed and the bones are joined to immobilize the segment, reducing pain caused by nerve impingement, friction and/or joint instability.

When a spinal disc is removed, it changes the mechanics of the spine. The now-immobilized segment limits the range of motion of the spine and surrounding discs must take on extra pressures and stresses, since their fellow shock absorber has been removed. Transitional syndrome or ASD are terms that describes the accelerated degeneration of discs above or below the site of spinal fusion.

For people experiencing post-operative back pain caused by ASD, the recommended treatment may be shocking: another fusion surgery. The more levels of the spine that are fused, the more likely yet another operation will be needed as the stress on adjacent discs increases with every disc lost. Anyone has a right to be wary of spinal fusion surgery, especially those who have already experienced complications from it. Fortunately, there may be alternative treatments for pain after spinal fusion.

Spinal Decompression Therapy

Most fusion procedures utilize hardware to reinforce the fusion site, but some do not. If you had a fusion without hardware, you may benefit from spinal decompression treatments. Chiropractors sometimes purchase decompression machines for their offices. To receive the treatment, you lay on a table while a specially-designed belt gently pulls the vertebrae of your spine apart. These machines contain biofeedback mechanisms that monitor your body's response to the force exerted to eliminate the risk of causing harm. The pulling action increases disc space and allows degenerating discs to rehydrate. See http://www.youtube.com/watch?v=D-yJgcbg9Xk for a video that shows one type of decompression machine.

It is wise to couple these treatments with physical therapy to build muscle surrounding the fusion site. Strong muscles help the spinal discs support the spine, thereby reducing the stress experienced by the discs.

Artificial Disc Replacement

If conservative treatments don't work to remedy ASD, fusion may not be the only surgical procedure available to you. Instead of removing another disc from the spine, it may be possible to replace it with an artificial disc. It is necessary to first be certain that the pain is not being caused by a joint problem or failed fusion.

While disc replacement has not been studied for long-term effectiveness since it only became available in the U.S. in 2000, studies up to now are promising. The rationale behind this procedure rests on maintaining spinal mobility and shock absorption capacity while eliminating the disc that caused pain. A small study, found at http://www.ncbi.nlm.nih.gov/pubmed/16506474, indicates that artificial disc replacement may be a safe and effective treatment for transitional syndrome.

If you have back pain due to a fusion surgery that was meant to correct it, make sure you are aware of all possible treatments. Surgeons are quick to prescribe fusion; doing your own research will ensure that you are not misinformed about your options.