Surgical or Non-Surgical Treatments?

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This information is provided to help you make an informed decision about your spine surgery. If you have any additional questions, please ask your physician as he or she is the only one qualified to comment on your specific condition.

A glossary is also provided to help you become familiar with medical terms your doctor may use to describe your condition and treatment.

Non-Surgical and Surgical Treatments

 There are many treatments for spine conditions and degenerative disc disease. Non-surgical treatments include rest, ice or heat, medication, steroid injections, exercise and physical therapy.

If these non-surgical treatments do not bring relief after a period of time, depending on the degree of degeneration, non-fusion and fusion surgeries are available.

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Spinal Fusion Surgery

Spinal fusion surgery takes pressure off of the nerves that are causing pain. This is done by restoring the alignment of the spine or the space between the vertebrae, and then stabilising and fusing the spine. A spinal fusion is when bone grows between the vertebra, stopping any motion in the area, which reduces pain.

Depending on the condition of the spine, the doctor may use an anterior approach, which means the incision will be in the abdomen, or a posterior approach, which means the incision will be in the back.

Sometimes the doctor may choose to use a combination of the two. If the doctor uses a posterior approach, then a pedicle screw system is used to stabilise the spine while it fuses and heals. The pedicle screw system may be used alone or it can be combined with another stabilising device.

During surgery, the doctor may relieve the nerve compression by removing the disc (called a discectomy). The doctor may also relieve pressure on the nerve by trimming or removing the roof, or lamina, of the vertebra to create more space for the nerve (called laminectomy ). The doctor then restores the space around the nerves and prepares to stabilise the spine with the pedicle screw system. There are a number of components in a pedicle screw system, and the doctor will choose the ones that will work best for your spine.
The screws are placed through each side of the vertebrae in the part of the part of the bone called the pedicle. Rods are then attached to connect the screws and hold the spine in its restored position. The pedicle screw system is now secure. In the last step of the surgery, the doctor places bone graft ( small chips of bone) alongside of the vertebrae to be fused or puts the graft in and around a device that's placed between the vertebrae. Bone graft can come from the patient's hip bone, from a bone bank, or from a combination of both.

Spinal Fusion

The pedicle screw system will hold the spine stable until the bone graft fuses with the vertebrae. Although bone fusion is a natural biological process, complete fusion can take up to one year. In some cases, people may have trouble fusing their spine. Many things, such as smoking or various medications, can interfere with successful fusion. Your doctor will discuss with you the risks associated with your specific surgery.

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Spinal Stabilisation

How can Spinal Stabilisation help?

Spinal Stabilisation uses a pedicle-screw fixation system, an implant device consisting of a spacer, cord and pedicle screw. It offers an approach to stabilisation and mobilisation of the spine and pain relief -- a "dynamic" approach -- that relies on flexible materials and preserves much of the spinal anatomy.

At rest: implant supports an intervertebral joint

Flexion: implant supports the affected joint as the spine bends forward

Extension: It also supports the joints as the spine bends backwards

Which patients are candidates for Spinal Stabilisation?

Spinal Stabilisation can be used in skeletally mature patients to provide immobilisation and stabilisation of spinal segments. It is used to treat degenerative slipped disc(s) (spondylolisthesis) in the thoracic, lumbar or sacral regions when there is evidence of resulting neurologic impairment and lumbar back pain.

When should Spine Stabilisation not be used?

Spine Stabilisation should not be used in the cervical spine or for patients that are obese, pregnant, abuse alcohol or other drugs, or who have:

  • an active or systemic infection
  • mental illness
  • severe osteoporosis or osteopenia
  • sensitivities or allergies to metals, polymers, polyethylene, polycarbonate urethane and polyethylene terephthalate
  • soft tissue deficit
  • congenital abnormalities
  • tumors
  • inadequate pedicles of the thoracic, lumbar and sacral vertebrae

Spine Stabilisation is also not appropriate for individuals with any medical or mental condition that puts them at high risk from surgery of this severity, those with a condition that will not allow them to benefit from the surgery or decrease the useful life of the device, and those who are unwilling or unable to follow post-operative instructions.

What does Spine Stabilisation surgery involve?

Spine Stabilisation is compatible with conventional surgical techniques, and in some cases can be implanted using a minimally invasive approach. On average, the procedure to implant a Spine Stabilisation implant takes two to three hours which is similar to the time required for traditional fusion procedures.

During the procedure, the surgeon removes portions of the affected disc(s) and bone from the spine. The implant is then attached to the bony extrusion (pedicle) on each side of the affected vertebrae. Once in place, the components create a dynamic push-pull relationship that stabilises the affected joints and keeps your vertebrae in a natural position.

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What to Expect Before and After Surgery

Before Surgery

There are a few things you can do to prepare for spinal surgery. Eating well-balanced, nutritional meals in the weeks before surgery will help your body as it heals. If you smoke, quitting in the weeks before surgery is also helpful.
Your doctor will tell you any other things you need to know that will help you prepare for surgery.

After Surgery Spinal Fusion

Recovery from spinal fusion surgery happens in stages as your body heals. The first stage of recovery involves the healing of the incision and soft tissues. This will happen over the first few weeks. Movement, such as walking, does a lot to help with healing. You can expect to be doing some walking as soon as the day after surgery, and you will be expected to walk every day after that. Your doctor may also have you go to physical or occupational therapy for gentle exercise in the early weeks of recovery.

Your doctor will monitor and evaluate the bone fusion throughout your recovery. This will mean visits to the doctor's office, where x-rays will be taken to see how the bone is fusing. Your doctor will tell you what things you can do to help your recovery.

It's common to have pain in both your back and your hip for a period of time after surgery. Your doctor will be able to help you manage the pain with medication. Be sure to talk to your doctor if you are having pain that is more than you were told to expect.
Most people can return to work and to many of their daily activities within six weeks of surgery.

Complete fusion takes months, and recovery is different for each patient. Depending on how many levels of your spine are fused, you may notice some changes in the flexibility of your back. Your doctor will tell you what you can expect during your recovery.

Spinal fusion surgery using a pedicle screw system is designed to stabilise your spine, giving you the ability to move more easily and with less pain. For most people, spinal fusion surgery offers significant relief and improved ability to move and function in their daily lives.

This page  is meant to help you understand spinal fusion surgery and pedicle screw systems, so you can work with your doctor to make the treatment decision that is right for you. If you have any questions, please talk to your doctor.

After Spine Stabilisation Surgery

It may take several weeks to fully recover from pain resulting from the surgery. However, you may feel almost immediate relief of any leg pain. Back pain should diminish over time now that the vertebrae have been stabilised and nerves are no longer compressed. In most cases, a short hospital stay is required to ensure you adjust to oral pain medication and can move without any problems. Most patients return home within a few days.

Following your surgery, your doctor will prescribe rehabilitation and follow-up visits as needed. It's important to follow your physician's instructions carefully to help ensure a full and quick recovery. 

Symptoms To Watch For After Surgery
As your doctor will explain, any surgery involves risk. After surgery, if you have any of these symptoms, you should contact your doctor:

  • Signs of infection (fever, chills, redness around the incision, increased pain, a feeling of pressure in the spine)
  • Bleeding or excessive drainage from the incision
  • Sudden pain, or a significant increase in your pain level
  • Loss of feeling in your hands or feet
  • Increased or ongoing shortness of breath

Are complications possible?

Surgery always involves some risk. General surgical complications may include:

  • reactions to anaesthesia
  • heart attack
  • infection
  • blood vessel damage/bleeding
  • bruise (hematoma)
  • pneumonia
  • blood clots
  • wound closure problems
  • death

Potential risks associated with the implantation of the Dynesys System are similar to those associated with any spinal fusion procedure and those risks specific to the implantation of other pedicle-screw systems. They may include:

  • tear in the outer lining of the spinal cord which may result in spinal fluid leakage
  • temporary decreased or absent intestinal function
  • implant migration
  • leg pain
  • nerve complications
  • fractured sacrum

Please consult with your surgeon for a complete list of all warnings and precautions.

The safety and effectiveness of Spine Stabilisation has not been established for indications beyond those stated here -- including spinal stabilisation without fusion.

How can I improve my chances of a good outcome?

It's well known that smokers experience lower surgery success rates than non-smokers. If you smoke, please consider stopping as far in advance of surgery as possible. In addition, poor nutrition impacts your body's ability to heal itself. Eat well-balanced, nutritional meals as far in advance of surgery as possible.

What if I have more questions?

This web site is provided to give you information about your treatment options, but it is not intended to replace professional medical care or provide medical advice. If you have any further questions or need additional information please call or see your doctor, who is the only one qualified to diagnose and treat your condition.

If you have any questions about Spinal Fusion Surgery or Dynesys Dynamic Stabilisation System, please talk to your doctor.

  1. Palmer K.T, Walsh K, Bendall H, Cooper C & Coggon D Back pain in Britain: comparison of two prevalence surveys at an interval of 10 years B.M.J. 2000 320 1577-1578
  2. Walsh K, Cruddes M, Coggon D. Low Back Pain in eight areas of Britain J. Epidemiol. Comm. Health 1992 46 277-230

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