Proper Patient Selection for Lumbar Spine Fusion Surgery
Spine fusion surgery is an intensive surgical procedure, and is best used to treat one to two levels of the lower spine. There are some important considerations before a doctor will look at recommending the procedure to ensure that it is as successful as possible.
The first consideration is to ensure that the patient is truly suffering from degenerative disc disease. There are several conditions that can mimic the symptoms of DDD, which the doctor must rule out before making a diagnosis. This includes but is not limited to Sacroiliac joint dysfunction, piriformis syndrome, facet osteoarthritis, muscle strain, and hip osteoarthritis.
Your doctor will also look to try to treat pain symptoms by using more conservative treatment including physical therapy. While these treatments may still fail, this alone will not make a patient a candidate for spine fusion. The doctor must ensure that the sections of spine to be fused will address the pain, as an incorrect diagnosis will result in further fusion surgeries later in life.
The MRI has become one of the most important tools in diagnosing true DDD, although it is not a perfect system. The differences between normal aging processes and actual disease are sometimes hard to spot, but there are some clues. DDD in a disc might be easily determined if the disc is significantly degenerated when compared to other discs of the spine, or a collapse of the disc space.
If a determination cannot be made from an MRI, the doctor may order a CT-discogram test. This works by attempting to trigger the pain by injecting dye into the disc itself. If the patient feels pain, then that disc is likely the source of discomfort. There are risks though with this procedure as it is subjective, and the procedure causes a good deal of pain itself.