Spinal Fusion

Overview of Procedure | Common Complications | Report an Incident


Overview

What is spinal fusion?

According to the American Academy of Orthopaedic Surgeons, spinal fusion (or laminectomy) is a surgical procedure designed to correct problems with the small bones in the spine (vertebrae). It is akin to a “welding” process, in that two or more vertebrae are joined and heal into a single, solid bone. The purpose of undergoing the operation is to restore mobility that had been compromised or eliminate painful motion.

Spinal fusion operations in the U.S. alone grew by an astounding 600 percent between 1993 and 2011, but evidence is increasing that it is not an advisable treatment for back pain. Studies now indicate that it provides few, if any, advantages to non-invasive alternatives like physiotherapy or rehabilitation therapies, or even a professionally supervised exercise program. Most telling are the results of a poll taken in 2009 at a surgical conference in Florida. A total of 100 surgeons were asked whether they would ever agree to undergo fusion surgery themselves, and 99 of them replied “absolutely not.”

Which countries are the most popular destinations for this procedure?

Costa Rica, India, Mexico, South Korea, and Spain are all very popular destinations.

What is the range of prices?

In the United States it’s $110,000

$33,500 in Israel,

$16,900 in South Korea,

$16,800 in Turkey,

$15,700 in Costa Rica,

$15,400 in Mexico,

$14,500 in Colombia,

$12,800 in Singapore,

$10,300 in India,

$10,000 in Jordan,

$9,500 in Thailand,

$8,755 in Spain,

$6,200 in Poland,

$6,150 in Vietnam,

$6,000 in Malaysia.

Complication

What are the common complications if the procedure is performed abroad?

Supposedly, the pain patients feel in their lower backs is reduced by 60% to 70% after they recover from their spinal fusion surgery three-to-six months later. But the long-term success rate is as low as 35 percent, and the vast majority of those successes are, as to be expected, reported by younger, more agile and physically fit patients. But many of them wind up on painkillers within two years anyway.  

As the popularity of spinal fusion grows, so does the number of patients who require follow-up treatments. Complications are so common that they are increasingly being recognized as medical conditions themselves, known in medical terms as Failed Fusion Syndrome (FFS) and Failed Back Surgery Syndrome (FBSS). The numbers are so large that American patients whose conditions worsened following the procedure are now eligible for Social Security disability benefits.

As with all operations, typical complications may include bleeding, infection and discomfort as a result of the anesthetic that was administered. Beyond those, however, the incisions that have to be made in the back carry with them the potential of permanent nerve damage. One rare but potentially serious (and under-reported) complication is pneumocephalus, the presence of air or gas within the cranial cavity.

The lower back is particularly vulnerable to discomfort after certain types of spinal fusion operations. That is because the lower back normally is curved, and, following surgery, the curve causes the ligaments that connect it to the spine to weaken. That, in turn, shifts more responsibility for supporting the spine to the front ligaments, which ironically exacerbates the pain in the lower back that the patient hoped to eliminate in the first place!

Horror story

In 2011 former NFL player Samari Rolle sued his surgeon Dr. Craig Brigham over what Rolle claimed was a botched spinal fusion operation that ended his football career. The lawsuit alleged permanent neurological damage resulting from the surgery. Dr. Brigham died before the suit could be settled.