With any type of surgery, success rates are rarely straightforward calculations. The spinal fusion success rate is no different. That’s because “success” can be defined in a variety of ways, depending on your perspective.
From a patient’s perspective, success may simply be measured as a significant improvement in pain, so people can perform most of their daily activities without focusing on it. In addition, just about every patient prefers to minimize the amount of surgery needed. If further surgery is required within a few years, the initial surgery is considered less successful.
From a surgeon’s perspective, decreasing pain is also a priority. Some surgeons try to measure their successes objectively using a pain scale. If someone began by describing their pain as 8 on a scale of 1 to 10 and ends by describing it as 2, intuitively that seems like a success. But I’ve found that percentage measures, rather than pain scales, paint a more accurate picture. One person’s 9 isn’t another person’s 9, but a 40 percent improvement is the same across the board.
Surgeons also measure success by asking subjective questions about a patient’s lifestyle. Are they able to get back to their favorite activities without pain? Have they been able to stop using narcotics? In general, surgeons would measure the spinal fusion a success if there’s been a substantial decrease in pain—60 to 80 percent pain relief for the back, and 90-plus percent for leg pain—and revision surgery is not required.
Aside from patient and surgeon assessments of success, there’s also been data collected throughout the years about spinal fusion success rates—none of which is definitive, yet increasingly reports higher failure rates than previously thought.
Fortunately, fusion isn’t the only option for treating severe back and leg pain. Learn about an innovative new procedure called BalancedBack Total Joint Replacement.
Spinal Fusion Surgery Success Rates: What does the data say?
Numerous studies of spinal fusion have been done throughout the years in an attempt to determine the success rate. But every study has different objectives, uses different methodologies, and has different follow-up periods, which result in a wide range of data. While that makes it difficult to call out any one study as being the “most” authoritative, there is enough data to paint an overall picture of fusion outcomes:
- A study analyzing long-term outcomes (15 years) of lumbar fusion for degenerative spine disease found that fusion provides good clinical results at short-term follow-up (two years), but from two to 15 years the outcome worsened significantly, with 37.5 percent of patients requiring a new surgical treatment because of adjacent segment degeneration.
- A review of existing studies on the comparative safety and efficacy of lumbar fusion, decompression, or nonoperative care for degenerative conditions concluded that complications and the risk of reoperation limited the benefit of fusion for spinal stenosis.
- Among the results of a study that compared the effectiveness of lumbar fusion for spinal stenosis with decompression surgery was the fact that additional surgery was performed in 22 percent of lumbar fusion patients within 6.5 years.
- Another study comparing lumbar fusion with non-surgical treatment in patients with chronic low back pain showed that lumbar fusion was not superior to cognitive intervention and exercises at relieving symptoms, improving function, and return to work at four years.
- Yet another study found that the incidence of reoperation was higher following fusion than decompression alone (21.5 percent vs. 18.8 percent), and that the complication rates following fusion surgery are higher than those following decompression surgeries. It also found that patients who have undergone spinal fusion and required a second procedure had worse clinical and functional results than patients who did not undergo fusion. The rate of failure of repair was 30 percent for fusion patients; repair also infrequently led to improvement in pain.
- Another interesting piece of research focused on spinal fusion surgery success rates for chronic opioid users specifically—a group that makes up nearly 25 percent of fusion patients. The results of the study showed that these patients had a 33 percent relative increase in the likelihood of repeat spinal fusion surgery within one year, and had higher odds of other complications leading to emergency department visits and hospitalizations within 90 days of the procedure.
- One final review article noted that, when compared with other surgical procedures performed for non-life-threatening conditions, the success rates for spinal surgery (particularly lumbar fusion) are poor, lying somewhere between 30 and 46 percent. (That’s compared to a 90 percent success rate for total knee replacements.)
There are options to lumbar spinal fusion.
Spinal fusion was, for a long time, the only option for many patients experiencing low back pain. But today, some patients are able to benefit from a new procedure, similar in concept to hip and knee replacements, called decompression arthroplasty, or BalancedBack.
Rather than removing a joint from your spine and fusing bones together, BalancedBack replaces the function of both the disc and facet joints with a total joint implant. The new, productive joint allows the levels above and below it to move naturally, without additional stress on adjacent levels of your spine, reducing the need for future revision surgery. It also allows surgeons to address a wide range of problems that cause back and leg pain, including pinched nerves, spinal stenosis, arthritis in the facet joints, and sagittal imbalance. That means you’re able to solve the root cause of the problem and gain protection against adjacent segment degeneration at the same time.
We encourage you to continue doing research about your condition and your options. If you’d like to know more about BalancedBack Total Joint Replacement, click here.