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MARCH | APRIL 2021

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suitable for all patients, though. People with multiple level dysfunction, who are obese or who have scoliosis, problems at the facet joints, or previous surgeries are not good candidates for disk replacement surgery. For patients who are good candidates, we see some advantages: less analgesic use and fewer repeat surgeries than for traditional fusion surgery for at least two years out from the initial procedure. 3 Posterior Dynamic Stabilization Devices This describes several pieces of hardware that can be used to help reduce hypermobility. They function as an internal brace, using combinations of screws, cords, flexible rods, and spacers. So far, posterior dynamic stabilization devices have been used in addition to traditional fusion surgery and are now being tried as a freestanding intervention. 4 POSSIBLE COMPLICATIONS FROM SPINAL FUSION SURGERY As one might imagine, the possible complications from spinal fusion surgery are serious. The same risks seen with any open surgery are present, including blood clots, excessive bleeding, and infection. But these surgeries also carry the chance of nerve damage, pain at the graft site, broken hardware, and failure of the graft to take hold. Equipment failure and poor grafting can require follow-up surgeries, which of course carry further risks. But the most common risk associated with spinal fusions is that pain may not be relieved. About 80 percent of patients get some pain relief (although most do not report being completely pain-free). But around 20 percent of patients find that the surgery did not solve their problem, even without Resources American Academy of Orthopaedic Surgeons. "Artificial Disk Replacement in the Lumbar Spine." Accessed January 2021. OrthoInfo. www.orthoinfo.org/ en/treatment/artificial-disk-replacement-in-the-lumbar-spine. Germany, Judy. "5 Spinal Fusion Facts." June 27, 2014. Accessed January 2021. www.rush.edu/news/5-spinal-fusion-facts. Machado, Gustavo C. et al. "Surgical Options for Lumbar Spinal Stenosis." The Cochrane Database of Systematic Reviews 11 (November 2006): CD012421. Accessed January 2021. https://doi.org/10.1002/14651858.CD012421. Martin, Brook I. et al. "Trends in Lumbar Fusion Procedure Rates and Associated Hospital Costs for Degenerative Spinal Diseases in the United States, 2004 to 2015." Spine 44, no. 5 (March 2019): 369–76. Accessed January 2021. https://doi.org/10.1097/BRS.0000000000002822. McAfee, Paul. "Spinal Fusion: A Quick History." SPINE-health. Updated July 22, 2008. Accessed January 2021. www.spine-health.com/treatment/spinal- fusion/spinal-fusion-a-quick-history. Montgomery, Stephen P. "TLIF Back Surgery Success Rates and Risks." SPINE- health. Updated May 7, 2003. Accessed January 2021. www.spine-health. com/treatment/spinal-fusion/tlif-back-surgery-success-rates-and-risks. Rushton, Alison et al. "Physiotherapy Rehabilitation Following Lumbar Spinal Fusion: A Systematic Review and Meta-Analysis of Randomised Controlled Trials." BMJ Open 2, no. 4 (July 2012). Accessed January 2021. e000829. http://dx.doi.org/10.1136/bmjopen-2012-000829. Sherman, J. "Spine Fusion Risks and Complications." SPINE-health. Updated September 8, 2006. Accessed January 2021. www.spine-health.com/ treatment/spinal-fusion/spine-fusion-risks-and-complications. Sivaganesan, Ahilan et al. "Oft-Maligned Spinal Fusion Surgery Can Make a Real Difference in Patients." STAT. October 14, 2016. Accessed January 2021. www.statnews.com/2016/10/14/spinal-fusion-surgery. Spivak, Jeffrey. "Artificial Disc Replacement or Spinal Fusion: Which is Better for You?" SPINE-health. Updated December 18, 2006. Accessed January 2021. www.spine-health.com/treatment/back-surgery/artificial-disc- replacement-or-spinal-fusion-which-better-you. Ullrich, Peter. "Lumbar Spinal Fusion Surgery." SPINE-health. Updated November 11, 2013. Accessed January 2021. www.spine-health.com/ treatment/spinal-fusion/lumbar-spinal-fusion-surgery. Vaccaro, Alexander R. "3 Things You Need to Know About Spinal Fusion Recovery." Rothman Orthopaedic Institute Blog. October 10, 2014. Accessed January 2021. www.rothmanortho.com/stories/blog/3-things- you-need-to-know-about-spinal-fusion-recovery. 36 m a s s a g e & b o d y wo r k m a rc h /a p r i l 2 0 2 1

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