Dr. Hooman Melamed, MD, board-certified orthopedic spine surgeon, talking to you about spinal fusion. First of all, I think spinal fusion has gotten a very bad name. And I would say yes, I think too much spine fusion surgery is being done in this country that shouldn’t be. But I will tell you, if the spinal fusion is done for the right reasons, the patient will do very well. It has to be, is the spinal fusion the right operation for that patient? And my mentors used to always say, know when not to operate is more important than doing the surgery.
There’s many different ways of doing the spinal fusion. Every section of the spine has a little angulation. The fusion has to maintain that angulation. If the angulation has been lost, the alignment, you need to restore them, because if you don’t, you’re going to increase the low, the levels above and below. If you achieve the angulation properly, maintain the disc height, decompress the nerve roots, and achieve stability, then that’s a very good goal of the fusion.
Now, I’m not here to tell you that there’s only one way, because different surgeons, different skills will do it. But as long as you achieve those goals, that is the way to go. Personally, I like to put some kind of a cage most of the time for a one or two level fusion, because I feel it gives you very good stability and you get achieved as very good surface area for the fusion. Most importantly, I love the cage because it allows to restore the proper alignment and maintain the alignment to that section of the spine.
And yes, I like to back it off with screws, because that gives me very good stability, allows to get the patient started on quick motion right away, and allows much faster, much faster healing. If you achieve alignment, decompression of the nerve, stability, and allow the patient to return very good rapid motion and their activities, that’s how you have achieved the goal for that patient, if that’s what the patient needed. Always get second and third opinions with this.
