A healthy spine moves freely.

That’s what years of spinal fusion data is finally teaching us, and the reason why so many people are rethinking fusion as an option for eliminating back and leg pain. 

Why is motion preservation after back surgery so important to spinal health? And why does spinal fusion present complications that negatively impact motion, even years after surgery takes place? Keep reading to find out.

The Importance Of Motion Preservation

Pay attention to the varied movements of your spine throughout the course of a single day: How many times do you bend or twist? How often do you get in and out of a car? Do you frequently switch from standing, to sitting, to a slumped posture in front of a TV, computer, or other device? Making all that movement possible is the spine’s ability to easily alter its natural curvature—referred to as spinal lordosis.

The amount of lordosis you have in your lower back naturally changes all day long to accommodate your changing positions. When you’re standing upright, you have more of a curve in your spine than when you’re sitting. And when you’re sitting in a slumped position (like when you’re watching TV on the couch), the spine flattens out and most of the curvature is reduced. The changing spinal curvature also allows your hips to change position, and may even have an impact on your knees and ankles!

The Impact Of Loss Of Motion Preservation

So what happens when your spine loses its ability to naturally alter its curvature to accommodate your daily activities? Years of studying spinal fusion patients has given us the answer to that question.


Are you faced with the prospect of surgery—spinal fusion or any other—to alleviate back and/or leg pain? Learn more about BalancedBack® Total Joint Replacement and why it could be right for you.



During fusion surgery, your doctor removes one or more joints from your spine and fuses two or more vertebrae together. The spine is a joint just like any other joint in your body, so if you fuse it, you lose mobility. That has a negative impact on your spinal health for two reasons:

  1. It creates an unnatural change in lumbar lordosis (curvature in the lower back). To compensate for the removal of a joint, surgeons try to add lordosis to the levels that are fused. But that’s a problematic decision in itself: What position should the patient be fused in? Lying down, as they are on the surgical table? Seated? Halfway between lying down and sitting? There’s no good answer to that question, because whatever position is chosen (usually standing), that means your body will be “locked” into that position, making it unnatural for sitting and slouching. If the curvature is off, it can lead to poor posture, pain, and muscle fatigue post-surgery.

  2. It puts greater stress on the levels of your spine adjacent to the fusion. Most fusion patients do experience reduced back pain shortly after surgery. However, years of patient data show that the unnatural positioning described above has other implications, which may not arise until a few years after surgery.

The reason for this spinal fusion complication has to do with the additional stress placed on the spinal levels adjacent to the fusion. Depending on the spinal segments being fused, the levels above and below the fusion try to compensate for the missing joint by taking on the extra mechanical load of bending and changing positions. The amount of additional stress they experience depends on which spinal segments are fused. Levels L1 and L2 (higher up on your low back), for example, move far less than levels L4/L5 and L5/S1. So an L4-S1 fusion transfers a significant amount of stress to the adjacent levels, whereas an L1-L2 fusion transfers much less. The greater the burden, the greater the risk for accelerated breakdown of those segments. The net result is that fusion patients are two to five times more likely to undergo multiple surgeries compared to patients receiving spinal joint replacements. It’s becoming increasingly clear that, for the spinal fusion patient, your first surgery is not likely to be your last. In addition, we are now learning that fusion of L5/S1 transfers similarly hyper-physiologic loads to the hip joints, and may play a role in hip degeneration, the incidence of dislocation after total hip arthroplasty, and the life expectancy of total hips.

A Spinal Fusion Alternative: Motion Preservation Surgery

Most patients would like to avoid fusion surgery at all costs. As more and more data is available on fusion outcomes, it is becoming increasingly clear that fusion should be a last resort, and where there’s a viable alternative for your individual condition, it makes sense to consider it.

Today, there is an alternative to fusion—an innovative new procedure called BalancedBack® Total Joint Replacement.

Working on the same theory as total joint replacement in the hips and knees, the BalancedBack® implant is designed to eliminate the root cause of your pain and keep your spine moving. BalancedBack® replaces the function of both the disc and the facet joints, allowing full decompression for stenosis as well as relief of back pain from a damaged disc, arthritis, or muscle and/or postural issues.

With BalancedBack® you’ll not only be relieved of the source of your pain, you’ll continue to move naturally after surgery, allowing your spine to assume a comfortable, low-stress position in all postures. You can stand, sit, and sleep naturally, because the implant; the spine levels above; and the spine, pelvis, and hip below move with you. That means you’ll avoid forcing other joints into potentially damaging postures. BalancedBack® is the only solution for leg and back pain that allows the spine to rebalance itself and recreate normal lumbar lordosis.

Interested in learning more about BalancedBack® Total Joint Replacement?

If you’re concerned about spinal fusion complications and are searching for an alternative, talk to us about BalancedBack®, a motion-preservation surgery for the spine. Or, download this brochure to get more information about Total Joint Replacement and how it might help you get back to doing the things you love.

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