Spinal fusion is usually done when there is confirmed evidence of an unstable spine segment or segments. There is usually a massive disc herniation, severe spinal stenosis, or serious spondylolisthesis.
Spinal stenosis is a narrowing of the spinal canal where the spinal cord is located. Bone spurs, overgrowth of the spinal ligaments, and arthritic changes often cause spinal stenosis in the aging adult.
Spondylolisthesis is the forward displacement of a vertebral bone over the vertebra below it. A fracture in the supporting columnm of the vertebra allows the vertebral body to slip forward. This slippage can cause a pull or traction on the spinal nerve resulting in pain and disability.
Fusion is not usually done unless the patient has been treated conservatively without surgery for at least six months. Nonoperative treatment may include pain relievers or antiinflammatory drugs. Physical therapy to calm the symptoms and increase spinal stability may be helpful. For chronic pain patients, a team approach at a pain clinic may be needed.
A surgeon should be consulted when making treatment decisions. X-rays and other imaging tests may help identify the problem. There are pros and cons to every operation that must be considered. Your surgeon can help you sort out what your treatment options are and what's the next step.