Spinal Fusion Alternatives

Spinal fusion surgery, also known as spondylodesis, uses bone tissue to fuse at least two vertebrae.
For patients researching different treatment alternatives to spine fusion surgery, it is important to first identify the cause of the patient's symptoms to isolate the actual cause of pain. Consequently, a physician can determine which device and procedure should best address the problem.
Spinal health care is constantly changing and advancing, with more treatment options for patients. Alternatives include:

1. Intradiscal Electrothermal Coagulation(or Annuloplasty)
During IDET, a catheter passed through a needle that has been inserted into the lumbar disc space heats its outer core(annulus). The procedure cauterizes nerve endings, making them less sensitive, as well as contracts and thickens the disc wall's collagen fibers. IDET treatment is generally geared toward patients who have less severe degenerative disc disease. The procedure is minimally invasive and usually done on an outpatient basis under mild sedation and local anesthetic.

2. Disc Replacement Surgery
Artificial discs preserve normal spine motion by replacing painful discs in the spine. Disc replacement surgery has two primary theoretical advantages over spinal fusion:
-It is thought that preserving spinal motion reduces the risk that other segments of the lumbar spine will wear down prematurely.
-It is believed that artificial disc surgery may achieve better pain reduction.
However, it is important to keep in mind that any motion preservation device can fail by extrusion or wearing out with time.

3. Posterior Dynamic Stabilization
This treatment aims to preserve spinal motion while simultaneously relieving pressure from from the diseased vertebral disc. By removing pressure from the disc, Posterior Dynamic Stabilization creates a favorable healing environment and also reduces pain. The movable stabilization devices used in this approach are comparable to knee or ankle braces, which unload pressure from an injured knee or ankle in order to allow the area to heal.

4. Disc Regeneration
The regeneration process attempts to render spinal fusion surgery unnecessary. Researchers in cellular and molecular biology are exploring ways to use gene therapy to stimulate regeneration and/or to slow or cease degeneration of the vertebral disc. Thus far, the BMP-12 gene, a bone morphogenetic protein, has proven successful in regenerating cells in the nucleus and annulus of spinal discs in animals. BMP-12 is a molecule that, among other duties, promotes formation of embryonic joints.

Spinal fusion surgery is not the only option available to those suffering from vertebral disc pain. While some alternatives are still in the research stage, the possibility of eliminating spinal surgery altogether seems promising.

Photo: Copyright © 2010. Jean Henrique Wichinoski.

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