Skip to Content
216.861.6200

Dr. Rob McLain discusses spinal fusion: What is it and when is the right choice?

By Admin on 
Posted on May 22, 2015

Dr. Rob McLain discusses spinal fusion: What is it and when is the right choice?

Patients with spinal problems that result from “wear and tear” of the spine may experience back pain, leg pain, or a combination of the two.  Many patients experience back pain as their primary symptom. Sometimes this pain is severe and disabling, sometimes dull and constant, and most times it’s aggravated by activity. Less frequently, but still pretty often, patients experience leg pain, a burning or tingling sensation running down the thigh or calf towards the foot, sometimes associated with muscular weakness. Some patients are unlucky enough to have both. 

Which of these pain patterns a patient has determines more about their evaluation, treatment, and prognosis for recovery than does any other aspect of care. So, the most important question your doctor will ask you really is, “Where does it hurt?”

The Causes of Back Pain

The type of pain that any individual experiences is determined by the cause of the pain, and the location of the pain generator – the actual structure or tissue that is generating pain signals.

Back pain often results from several things happening at once. Often there is an underlying level of “wear and tear” that has been worsening for years. The disc may have degenerated, or the small facet joints may have become arthritic. Perhaps there was a direct injury to the back resulting in fracture or ligament injury. On top of these issues, the back muscles may have gotten out of shape, and can no longer do their job without going into spasm. And all of these issues are made worse by inflammation.

Now imagine trying to provide one simple treatment that will fix all of those problems at the same time. 

There isn’t one. And fusion certainly won’t cover all of these bases. If used for the wrong problem a fusion won’t help and may even hurt. So the first important rule is that fusion will only be really effective if it is used in just the right circumstances.

Which fusion is right for you?

Fusion is the cornerstone to surgical treatment of back pain. Fusion allows us to correct alignment of degenerated segments and stop abnormal motion that can trigger pain and muscle spasm. Fusion is very effective at reducing back pain if that pain is caused by deformity, disc degeneration or instability. However, (second rule), even in cases of instability fusion is never the first thing we try.

In fusion, the surgeon tries to confuse the body’s normal repair process: by removing the outer shell of bone (the cortex) and exposing the inner portion (the cancellous bone) the body is convinced that the spinal elements have been fractured. The normal healing response is triggered as the body seeks to heal the “fractured” parts.

A posterolateral lumbar fusion – an approach from behind - has been used to treat thoracolumbar and lumbar instability caused by fractures, disc degeneration, or spondylolisthesis, and has been used successfully in treating lumbar disc disease and disc-related pain. 

An anterior interbody fusion – an approach through the front - involves growing bone from one vertebral body to the next, around or through a cage placed between the two. There are several variations on these themes. So (third rule) not all fusions are the same: the approach selected depends on what your underlying problem is and what your surgeon hopes to accomplish.

The important point is that, if back pain arises from mechanical instability or specific disc-related problems, a carefully planned and performed fusion can be the best solution for you.

Hear more from Dr. Rob McLain and sign up to receive more information from our Spine and Orthopedic Institute at www.stvincentcharity.com/spine-ortho.

 

 


Recent posts

Leadership transition signals new era of Catholic health ministry from Sisters of Charity Health System

Leadership transition signals new era of Catholic health ministry from Sisters of Charity Health System

The Sisters of Charity Health System (SCHS) today announced its president & CEO, Thomas J. Strauss, will step down from his position effective December 31, 2021, after five years of dedicated service to the mission and ministry of the Sisters of Charity of St. Augustine. Janice G. Murphy, MSN, FACHE, will step into the role of president & CEO of SCHS effective January 1, 2022. Succeeding Murphy as president of St. Vincent Charity Medical Center is Dr. Adnan Tahir, currently senior vice president/chief clinical and administrative officer for the hospital. He, too, will take on his new role on January 1, 2022.
Read More
Sisters of Charity Foundation Partners with MASS Design Group to Engage Residents and Community Partners to Inform Vision for Health Campus in Central

Sisters of Charity Foundation Partners with MASS Design Group to Engage Residents and Community Partners to Inform Vision for Health Campus in Central

The Health Campus will encompass property owned by the Sisters of Charity at East 22nd Street (also known as Sister Ignatia Way) and serve as a catalyst for revitalization in the surrounding area. St. Vincent Charity Medical Center will be an anchor institution, partner and namesake in what will be known as the St. Vincent Charity Health Campus. Depending on what is recommended during the planning and engagement process, new services, programs and partners will be added to the existing services at St. Vincent Charity Medical Center’s main campus.
Read More
Northeast Ohio Hospitals Address COVID-19 Fatigue as Cases Rise in Ohio

Northeast Ohio Hospitals Address COVID-19 Fatigue as Cases Rise in Ohio

Dear Neighbors,The rise in coronavirus infections is a serious reminder of this pandemic’s strength and longevity. While many have expressed “COVID fatigue,” unfortunately we can’t wish away the
Read More