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If you have been recommended by your doctor to have a multi-level spinal fusion, it’s something you shouldn’t take lightly. We generally recommend a second opinion for most patients and often a multi-level fusion is necessary. Typical examples include patients that have deformity of the spine that are not limited to one level, and have scoliosis and those patients will often need a multi-level fusion. Other patients with slipped vertebrae may have associated disc that have become very degenerated in time as well, but many patients purely for back pain and disc degeneration are being recommended to have long multi-level fusions and the results of this are much less clear. That’s why we recommend that anybody being recommended initially to have a multi-level fusion go for additional opinions, have discussions with their doctors about the pros and cons. If you are considering fusion of more than one level, with each level that’s done is an added risk. There’s a bigger operation that will involve more blood loss, more chance of one or more levels not healing fully, more chance of putting stress at the level above the fusion.
Multi-level fusions are often necessary for patients with spinal deformity or spondylolisthesis or other structural abnormalities of the spine, however if you are considering multi-level surgery and that’s been recommended purely on the basis of back pain and disc degeneration, this is a decision that should not be taken lightly. The results of this type of surgery are much less clear than when operating on structural deformities and so additional opinions and exhausting all types of non-operative treatment is definitely recommended before going ahead with that type of procedure.