Spinal Fusion Surgery
Risks and Complications
Weighing the Benefits and Drawbacks
| Benefits | Drawbacks |
|---|---|
| Stabilizes the spine | Greater surgical burden (longer surgery, more blood loss) |
| Can correct deformity | Loss of movement at the fused levels |
| Effective for back pain | Costs significantly more than decompression alone |
| Long-term stability | Return-to-work rate is somewhat lower |
| Favorable long-term results in unstable cases | Increased stress on adjacent segments |
| Implant issues (screw loosening, breakage) occur in a small percentage |
Long-Term Risk — Adjacent Segment Disease
After fusion, the levels above and below the fused segment take on extra stress, which can lead to new problems over time. This is an important consideration that you should understand before deciding on fusion.
For a detailed explanation, see Long-Term Risks of Fusion.
A Note for Patients with Obesity
From the guideline commentary:
For patients with a BMI of 30 or higher, decompression can still be effective, but the rate of symptom improvement tends to be lower compared to non-obese patients. Additionally, hospital stays for obese patients undergoing fusion are the longest among all groups.