To Fuse or Not to Fuse? Benefits and Risks of Spinal Fusion

Medically Reviewed By William C. Lloyd III, MD, FACS
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Spinal fusion surgery connects two bones in your spine—vertebrae. The procedure can help a wide range of health problems—fractures, infections, disc problems, and more. For many people, it can make them more mobile and improve their quality of life. However, spinal fusion is major surgery. It involves a very long recovery. There are also spinal fusion risks and potential complications from the procedure. For these reasons, it's important to carefully weigh the pros and cons before you decide to have this surgery.

Benefits of Spinal Fusion Surgery

There's no doubt spinal fusion surgery might really help some people. People who are candidates for this procedure often live every day with back pain that won’t go away. Some have a type of back problem that greatly affects their daily life. In such cases, the benefits may outweigh the risks.

If you fracture a vertebra, for instance, spinal fusion surgery might be a good treatment for you. This injury can cause serious pain and movement troubles. Joining or fusing the fractured vertebra to one next to it for support can solve the problem.

Another good candidate for spinal fusion surgery is someone whose spinal column is unstable. The vertebrae are moving against one another more than they should. If this continues, the moving vertebrae could damage the spinal cord itself. The result could be paralysis. Fusing the vertebrae to halt the movement can be a good solution.

Spinal Fusion Risks

All surgeries have risks. There's a small risk of bleeding, infection, blood clots, or nerve damage. This is true for any surgery. Spinal fusion risks include a chance that you may feel pain at the spot where the bones are fused. And sometimes the fusion doesn't take because there's not enough bone formation. The medical term for that is pseudarthrosis. It requires a second surgery.

Perhaps the most frustrating risk is sometimes the problems with pain and movement persist, even after spinal fusion. This is rare, but it can happen.

Other Things to Consider

There's more to consider than just benefits and spinal fusion risks. For instance, recovering from spinal fusion surgery can take a long time. You may spend four days or longer in the hospital after the operation. The first sign of bone healing might not come for six weeks or more. In the meantime, your movement will be greatly restricted.

These considerations are particularly important if you have a job that requires a lot of motion. It could be four to six months before you could return to a job like that.

You also need to consider your specific medical condition. With a fracture or spine instability, it's usually easy for the surgeon to find the area where spinal fusion should take place. With general back pain, however, it may be harder for the surgeon to find the culprit. If that's the case, the risk is greater that you could have a spinal fusion that doesn’t solve the problem.

Deciding What to Do

For any big medical decision, you should have a long talk with your doctor. This is especially true if you're thinking about spinal fusion. In the right situations, the risks and recovery period are generally worth it. Your quality of life could be much better after the surgery. Other times, though, it might be better to try other treatments first.

Find a doctor you trust and have several conversations about your situation and spinal fusion before making your decision. You may even want to consider getting a second opinion before proceeding.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Nov 13
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.

  1. Deyo RA, Mirza SK, Martin BI, Kreuter W, Goodman DC, et al. Trends, major medical complications, and charges associated with surgery for lumbar spinal stenosis in older adults. JAMA. 2010 Apr 7;303(13):1259-65.

  2. Spinal Fusion. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=a00348

  3. Spinal Fusion. North American Spine Society. http://www.knowyourback.org/pages/treatments/surgicaloptions/spinalfusion.aspx