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Patient Education: Diseases Conditions Treatments & Procedures

Back pain

Surgical Options for Back Pain

Fusion surgery is often combined with decompression surgery. Decompression for spinal stenosis may leave the spine unstable and fusion is required. With or without decompression, fusion surgery can be done from the back of the spine (most commonly), or the front of the spine. It may involve the use of pedicle screws and rods or cages. Some newer techniques include disc replacement surgery. This allows motion to be preserved at the level of surgery and may reduce the risk of adjacent level degeneration following fusion. This sounds appealing but has not yet been shown to have clinical value any greater than fusion. The downside of this lies in the absolute diagnosis of the pain generator. Longevity of disc replacements is unclear and late complications have not been established as of yet. Ask your surgeon about the various options for fusion and his success rates of fusion or disc replacement for back pain. Better still, ask him how confident he is at identifying the pain generator. If so, no matter what is done, it will be right!

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