Healthbeat Report: Spinal Fusion Reversal Surgery

September 10, 2010 4:34:05 AM PDT
Spinal fusion has typically been considered a permanent procedure, but there's now a challenge to that belief.

Whether to have back surgery can be a controversial decision but a new procedure to reverse it may be even more controversial.

Bobbie Jo Ramirez says she would never have attempted to jump or catch a ball. But after spinal fusion reversal surgery, she says she can do more now than she has in ten years.

"I feel great," said Ramirez.

A back injury led to the original fusion where doctors weld two vertebrae together to stabilize the spine. She says it left her stiff and in pain.

"It was excruciating. I mean just to try and roll yourself out of bed and sit upright was just excruciating pain," said Ramirez.

She had migraines three times a week, and the pain permeated throughout her body, forcing the softball fanatic to quit the game she loved.

"It started at the neck but it radiates through your shoulders to your arms to your fingertips," said Ramirez.

Orthopedic surgeon Kenneth Light says many spinal fusions shouldn't be done. He believes the surgery severely limits motion, and for some, the pain doesn't go away. Dr. Light claims to be one of the first in the U.S. to reverse a fusion. He implants an artificial disk.

"Low and behold, we put the implant in. She woke up. She was fine. She felt fine enough to go home the next day, and four weeks later, she is doing exceptionally well," said Dr. Light.

There are plenty of orthopedic surgeons who defend spinal fusion, which has been around for decades and has been a proven procedure for some people with severe back problems.

"For the vast majority, thankfully, we have a good operation in fusion that works very, very well," said Dr. Dean Karahalios, neurosurgeon, NorthShore University Health System.

Fusion is used to correct problems with the small bones of the spine. t's almost like a welding process where the painful vertebrae are fused together so they can heal into a single solid bone.

"It is not particularly difficult to reverse a fusion...but just because you can do something doesn't mean necessarily you should do it," said Dr. Karahalios.

Dr. Karahalios is a spine surgeon with the NorthShore Neurological Institute. He says he can understand why some patients who are still in pain might consider this as a viable solution. But he thinks there are too many risks with reversal, including the possibility of paralysis. His biggest concern?

"The patient will probably have the same pain or more pain after you reverse fusion," said Dr. Karahalios. "If you go in and remove the disc fusion and put in an artificial disc, those structures around the spine which haven't been moving for a time are asked to once again start moving and that is very likely to cause pain."

He also cautions that these artificial dics are meant to preserve motion, not restore it.

But Bobbie Jo Ramirez is convinced that reversing her fusion changed her painful path.

"I feel like I made a decision that's going to give me life again," said Ramirez.

ABC7 has been in touch with several orthopedic surgeons who think the idea of reversing a fusion is outrageous.

Dr. Karahalios says there are other less risky options for those still in pain. Diagnostic tests can be done to determine where the pain is coming from. He also says there are almost always other surgical and non surgical options for patients to consider.

Joan Dungo
Office of Dr. Kenneth Light
San Francisco, CA
(415) 673-4500
www.drkennethlight.com

Dr. Dean Karahalios
NorthShore University HealthSystem Neurological Institute (NNI)
For more information visit www.northshore.org/neuro

American Academy of Orthopaedic Surgeons (AAOS)
www.aaos.org


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