Our Summary

This study looked at how people with the neuromuscular disorder multiple sclerosis (MS) fare after a type of spinal surgery called a “long segment fusion”. This is a procedure where four or more vertebrae in the spine are fused together. The researchers looked at two years’ worth of data from a state-wide database and compared patients with MS to those without, taking into account factors such as age, sex and race.

They found that those with MS had similar rates of medical complications and needed similar rates of follow-up surgeries as those without MS. They also spent about the same amount of time in the hospital after surgery. However, the surgery cost more for the MS patients.

This means that this type of spinal surgery can be performed on MS patients with similar safety and outcomes as those without the condition.

FAQs

  1. What is a “long segment fusion” spinal surgery?
  2. What were the outcomes for MS patients who underwent long segment fusion surgery compared to those without MS?
  3. Why does the surgery cost more for MS patients?

Doctor’s Tip

However, it is important for patients with MS to discuss their condition with their doctor before undergoing spinal fusion surgery. They should also follow their doctor’s recommendations for post-operative care and rehabilitation to ensure the best possible outcome. It is also important for patients to continue with physical therapy and exercise to strengthen the muscles supporting the spine and maintain overall spinal health.

Suitable For

Typically, patients who are recommended spinal fusion surgery are those who have severe spinal degeneration, spinal deformities, spinal instability, spinal fractures, or herniated discs that are causing significant pain and/or neurological symptoms. Patients who have not responded to conservative treatments such as physical therapy, medications, or injections may also be considered for spinal fusion surgery. It is important for patients to discuss their specific condition and treatment options with their healthcare provider to determine if spinal fusion is the best course of action for them.

Timeline

Before spinal fusion:

  1. Patient experiences chronic back pain or spinal instability that does not improve with conservative treatments such as physical therapy or medications.
  2. Patient undergoes diagnostic tests such as X-rays, MRI, or CT scans to determine the cause of their back pain.
  3. Patient consults with a spine surgeon to discuss the possibility of spinal fusion surgery and the risks and benefits involved.
  4. Patient undergoes pre-operative testing and preparation for surgery.

After spinal fusion:

  1. Patient undergoes spinal fusion surgery where the vertebrae are fused together using bone grafts, screws, and rods.
  2. Patient spends time in the hospital recovering from surgery and is monitored for any complications.
  3. Patient undergoes physical therapy and rehabilitation to regain strength and mobility in the spine.
  4. Patient follows up with their surgeon for post-operative appointments to monitor their progress and address any concerns.
  5. Patient gradually resumes normal activities and experiences improved spinal stability and reduced pain over time.

What to Ask Your Doctor

  1. What specific benefits can I expect from undergoing a long segment fusion for my spinal condition?
  2. What are the potential risks and complications associated with this type of spinal surgery, particularly for someone with MS?
  3. How long is the recovery process expected to be for someone with MS compared to someone without the condition?
  4. Are there any alternative treatments or procedures that could be considered for my spinal condition, given that I have MS?
  5. How experienced are you in performing long segment fusions on patients with MS, and what is your success rate with this population?
  6. What type of physical therapy or rehabilitation will be recommended following the surgery, and how will this be tailored to my MS diagnosis?
  7. What long-term outcomes can I expect from this surgery, in terms of pain relief, mobility, and overall spinal health?
  8. How will my MS be monitored and managed throughout the surgical process and recovery period?
  9. Are there any specific precautions or considerations that need to be taken into account for someone with MS undergoing a long segment fusion?
  10. What are the financial costs associated with this surgery for someone with MS, and are there any potential insurance coverage issues that I should be aware of?

Reference

Authors: Shah NV, Kong R, Ikwuazom CP, Beyer GA, Tiburzi HA, Segreto FA, Alam JS, Wolfert AJ, Alsoof D, Lafage R, Passias PG, Schwab FJ, Daniels AH, Lafage V, Paulino CB, Diebo BG. Journal: Spine Deform. 2025 Jan;13(1):287-291. doi: 10.1007/s43390-024-00956-2. Epub 2024 Sep 27. PMID: 39331321