Understanding Risks of Spinal Fusion Surgery

Today’s technological advancements provide many great options for treating back pain, though all spinal fusion techniques carry the potential for risks. Prior to deciding on the best treatment option, it’s imperative to understand the risks involved with spinal fusion surgery.

These risks include:

  • Failed Back Surgery Syndrome
  • Pseudoarthrosis
  • Smoking and Spine Fusion
  • Broken Mechanics
  • Nerve Damage

Though the risks of spinal fusion surgery are present, they are much less prevalent today than in the past. In the early days, most patients undergoing any type of treatment to alleviate spinal pain died or experienced paralysis during or shortly after spinal procedures — something that is almost unheard of today. As information and technology have evolved, understanding of lower back pain and treatment for spinal injury has advanced. Today, patients are presented with a variety of options to combat lower back pain and results are more positive than ever before.

Here are some of the major risk factors encompassing spine fusion surgery:

Failed Back Surgery Syndrome

The most common risk of spine surgery is that the procedure is unsuccessful in relieving the patient’s back pain, resulting in Failed Back Surgery Syndrome. A common cause of Failed Back Surgery Syndrome is incorrect preoperative patient selection prior to surgery.


Pseudoarthrosis occurs when the vertebrae do not fuse together properly following surgery. The body discerns bone fragments as two separate bones, thus never attempting to unite them. These days the likelihood of this occurring from spine surgery is minimal.

Smoking and Spine Fusion

People who smoke have a lower rate of success with spinal fusion surgery due to decreased revascularization of the bone graft. Essentially, a lack of blood supply impedes the bone graft from getting enough nutrients, preventing it from forming a fusion. Smoking has also been found to accelerate the rate of disc degeneration, possibly contributing to continuous spine problems. Read more about the many reasons to quit smoking prior to spinal fusion surgery.


Broken Mechanics

Depending on what type of procedure is performed, pedicle screws may be used which proposes a risk that the screws may break or become loose with time. This may result in further surgery to remove or correct broken screws and rods.

Nerve Damage

Another possible obstacle includes any type of nerve damage. This can occur when the nerve root becomes irritated by the operation and swelling develops.

As discussed in a previous blog post, it’s necessary to cut through muscles and move them out of the way in order to reach the spine with traditional spinal surgery This can cause a large amount of pain following surgery, ultimately lengthening recovery time. By using a minimally invasive approach like AxiaLIF+®, many of these risks are greatly reduced. Studies have shown that such techniques can have equal or better outcomes than open spine surgery techniques by allowing the surgeon to access the lumbar spine with minimal risk of damaging vital nerves, blood vessels, muscles and surrounding tissues. (1, 2, 3)

Be sure to read our blog post “Questions to ask your surgeon before spinal fusion surgery when considering if surgery is an option for you.

1.   Bradley WD, Hisey MS, Verma-Kurvari S, Ohnmeiss DD. Minimally invasive trans-sacral approach to L5-S1 interbody fusion: Preliminary results from 1 center and review of the literature. Int J Spine Surg. 2012;6:110-4. PubMed PMID: 25694879; PubMed Central PMCID: PMC4300883.

2.   Marchi L, Oliveira L, Coutinho E, Pimenta L. Results and complications after 2-level axial lumbar interbody fusion with a minimum 2-year follow-up. J Neurosurg Spine. 2012 Sep;17(3):187-92. PubMed PMID: 22803626.

3.   Tobler WD, Gerszten PC, Bradley WD, Raley TJ, Nasca RJ, et al. Minimally invasive axial   presacral L5-S1 interbody fusion: two-year clinical and radiographic outcomes. Spine (Phila Pa 1976). 2011 Sep 15;36(20):E1296-301. PubMed PMID: 21494201.