The decision to have a spine fusion procedure done to treat low back pain is a very personal one, and it is entirely the patient’s decision. Degenerative disc disease is for the most part a non-crippling, non-progressive type of back condition and does not lead to neurological deficits or result in a progressive crippling condition.
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The natural history is for the low back pain to improve with time (although it may take many years) as the natural aging process leads the disc space to have less motion. With continued degeneration, bony growth around the disc will try to capture the excess motion. Therefore, continuing non-surgical treatments (such as medication, exercise) to manage the painful symptoms and living with the discomfort is always an option.
Unlike many other types of surgery, with spinal fusion surgery only the patient can decide if the pain and inability to complete one's normal daily activities is bad enough to warrant spinal fusion (or any other) type of surgery. And the best way for a patient to make an informed decision about whether or not to have spinal fusion is to fully understand the trade-offs between spinal fusion and other non-surgical and surgical treatment options.