Spinal fusion
For spinal arthritis, the only effective surgical treatment is spine fusion surgery to stop
movement at the painful joint. However, spine fusion surgery is generally not
recommended for spinal osteoarthritis since the arthritic condition tends to affect
multiple vertebral levels in the spine (initially or over time) and multi-level fusions are
generally not advisable. The spine is designed to move, and if motion is stopped along
multiple adjacent levels of the spine, the significantly limited motion in the spine can in
itself stress the spine and potentially cause pain. In cases where osteoarthritis of the
facet joint leads to spinal instability (degenerative spondylolisthesis) fusion
surgery can be considered to restore stability at that particular joint.
Laminectomy
If the arthritis is affecting the nerves in the spine, then surgical decompression of the
nerve roots may be an option. As mentioned earlier, spinal arthritis may lead to the
formation of bone spurs. A bone spur may then intrude into the intervertebral foramen,
which is the space where spinal nerves branch off from the spine and exit the spinal
canal. A laminectomy helps in removing the bony spurs and any thick ligaments that are
causing symptomatic nerve compression.
The majority of patients who have a laminectomy surgery to remove bone spurs
experience good relief of their symptoms that often lasts for many years, although the
bone spurs may return at any time. If a significant amount of bone is removed, then the
spine is not stable and a fusion surgery will also be required.
Dynamic Stabilization
Using rods, wires and screws on the spine appears to increase the fusion rate. However,
it puts significant amounts of mechanical stress on adjacent discs and facets. This
results in disc degeneration and/or stenosis above and/ or below the operated area that
may require further surgical intervention and extension of the fusion. Other
complications such as increased low back pain due to a rigid back with flattening of the