Top 5 Surgical Alternatives to a Spine Fusion Surgery

July 29, 2022
BY Nima Salari, M.D. FAAOS
Dr. Salari is a Board-Certified, Fellowship-Trained Orthopedic Spine Surgeon with specialized training in the operative and non-operative treatment of pathologic conditions affecting the spine. He specializes in ultra-minimally invasive endoscopic spine surgery and cervical artificial disc replacement.


Have you recently seen a spine specialist who recommended spine fusion surgery? Did you walk away from the appointment asking yourself, do I need a fusion, and are there alternative, less invasive surgeries? You may be confused with the pain’s diagnosis and cause and seeking a second or third opinion to confirm or change treatment plans.

If you are seeking an alternative to spine fusion surgery, these are a few options that you might want to explore. Living with back or neck pain can substantially affect your quality of life, sleep, work, and ability to be physically active. Choosing to have spine surgery can be difficult, especially spine fusion. Many things weigh into the decision-making process, such as: “I am not sleeping well at night because of the pain” or “how long will I be out of work due to spine fusion surgery?”

Top 5 Alternatives to Spine Fusion Surgery

Seeking a second opinion from an expert spine surgeon who specializes in fusion alternative, less invasive surgeries can help clarify your pain generator, diagnosis, and alternative options available. Many times, a spine fusion is not the best first spinal surgery to pursue. Spinal fusion is a valid and effective solution for the right indicated patients.

  • Cervical Disc Replacement (CDR)

    Cervical Disc Replacement (CDR), especially in the cervical spine, is an excellent alternative to a fusion. Like a fusion, artificial disc replacement alleviates nerve pressure from disc degeneration or herniation. Unlike a spinal fusion, which aims to prevent motion in the spine, the artificial disc preserves mobility. Cervical disc replacement is clinically proven to reduce the chance of further surgery at the levels above or below in the neck.

  • Endoscopic Lumbar Discectomy

    Endoscopic spine surgery (ESS) is an ultra-minimally invasive surgical procedure that relieves chronic low back and leg pain. This state-of-the-art spine surgery utilizes an HD camera attached to an endoscope inserted through a ¼-inch skin incision to the target pain generator in your spine.

  • Coflex Lumbar Interlaminar Device

    In the appropriate patient, the lumbar spinal canal can be enlarged to allow for more room for neural structures. The Coflex lumbar interlaminar device is inserted to provide stability while maintaining mobility. The device further helps to offload the arthritic joint structures and keep open the areas the nerves occupy.

  • Endoscopic Rhizotomy

    An endoscopic rhizotomy offered by DISC surgeons in Phoenix, AZ, is the least invasive yet most effective treatment for chronic low back pain related to arthritic joint structures. The endoscopic procedure offers patients up to 5 years of low back pain relief and is an excellent alternative to lumbar spinal fusion surgery. The procedure allows for direct visualization for ablation of small neural structures responsible only for the sensation of pain arising from degenerative joint disease.

  • Intracept Procedure (Relievant)

    Much like the endoscopic rhizotomy, this incision-less procedure targets the small neural structures responsible for the sensation of pain arising from the endplates supporting the intervertebral discs. As an ablation procedure, Intracept provides relief of chronic back pain to carefully selected individuals.

What is a Spine Fusion Surgery?

spine fusion is a surgical procedure to fuse two or more vertebrae that heals as one solid bone. Spine fusions are an effective treatment option to restore spinal stability and eliminate painful motion in a spine segment. Spine fusion surgery is performed in the neck (cervical region), middle of the back (thoracic region), and the low back (lumbar region). 

Although spine fusion surgery has about an 80-90% success rate, there is much that needs clarification. The success rate varies depending on the surgeon’s criteria for success and what patients feel is a success. For the surgeon, success may be two bones fused to the patient that there has been a significant reduction in their symptoms. The indication and surgical approach can also lead to better success rates. 

The main indication for a successful (80-90%) spine fusion surgery are:

  • Tumor – can cause fracture or instability that may require a spine fusion.
  • Spondylosis – a degenerative decline in the spine, can lead to slipped disc or instability (movement) that may require spinal fusion.
  • Scoliosis – deformed curvature of the spine which can lead to painful conditions that may improve with spine fusion surgery.
  • Fractured vertebra – A painful condition where the vertebra bone has fractured and caused pain and instability. Spine fusion or kyphoplasty are recommended.

Less common indications used for spine fusion surgery that may be candidates for fusion alternative surgery:

  • Herniated Disc
  • Spinal Stenosis 
  • Degeneration Disc Disease – pain derived from the actual disc.
  • Axial Facet Back Pain – pain due to movement in the facet joints.
  • Radiculopathy – caused by foraminal stenosis or disc herniation.

Why Do Spine Fusion Surgeries Fail?

The higher rates of spine fusion surgery success depend on a proper and accurate diagnosis of the pain generator or condition. Many times, there may be more than one pain generator. The clinical outcomes of a spinal fusion may vary from surgeon to surgeon and patient to patient.

A surgeon may stabilize and fuse a painful spinal segment that is moving, such as slipped disc (spondylosis), which can reduce pain. However, the patient may have an additional pain generator such as a degenerative disc or disc herniation causing other painful symptoms. 

Do you have the correct diagnosis, the right surgical procedure, and the right surgeon?

Our surgeons see patients daily who have seen multiple spine specialists and had many interventions, spinal injections, and even spinal surgery. Unfortunately, they are still in pain, confused about what is causing their pain, and seeking a thorough diagnosis. They come to us searching for solutions and hope that a second or third opinion will bring them relief. 

A recent study found that 88% of patients left a second opinion with a different or refined diagnosis. 

At the Desert Institute for Spine Care, we developed a precise, targeted, and personalized diagnostic approach called  Personalized Pain Mapping. This revolutionary technique accurately identifies a patient’s pain generator and spinal condition.

Our personalized pain mapping utilizes 3 Steps:

1. Get to know your pain journey

We listen and ask targeted questions so we can understand the impact it has on your daily life and your desired outcome.

2. Thorough Medical Review

We thoroughly review your medical history, perform a physical examination, and review all pertinent imaging studies. After reviewing your records, we can correlate clinically the best course of medical treatment needed. We then discuss our findings with you and customize either a conservative or personalized pain mapping to identify the pain generator further.

3. Diagnostic Pain Injections

Our surgeons then can strategically apply diagnostic injections at the appropriate spinal level to relieve or confirm the patient’s pain generator. After the pain generator is identified and an accurate diagnosis, our surgeons can customize the patient’s surgical treatment option that best fits their desired lifestyle.

A spinal fusion is often unnecessary for many spine conditions such as a herniated disc, facet joint syndrome, and spinal stenosis. With today’s modern advanced technology, there are many new, less invasive surgical techniques for spinal fusion surgery. At DISC, our surgeons pioneered and developed the new endoscopic surgical procedures that, for thousands of patients, have spared them spine fusion surgery. These patients return to work and play in as little as two weeks versus 6-12 weeks after a spine fusion surgery. In addition, new artificial disc implants are clinically more effective in the neck than neck fusion surgery.

Find Surgical Alternatives to Spine Fusion Surgery at the Desert Institute for Spine Care

The Desert Institute for Spine Care (DISC) offers innovative alternative solutions to help patients who do not want spine fusion surgery. Our surgeons treat various spine conditions, including herniated disc, stenosis, low back, and neck pain. 

We offer advanced non-surgical spine treatments and ultra-minimally invasive spine surgeries. Our board-certified surgeons hold 50 years of collective patient care experience. DISC is a worldwide leader and innovator in endoscopic spine surgery, and we provide patients with consistent results so they can enjoy life without pain. We will carefully choose the least invasive treatment method or a surgical option to help you restore your lifestyle with minimal side effects.

Take control over your pain and get back to living your life comfortably. Contact us to learn more about how we can help you find alternative solutions to spine fusion surgery. 


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