Spinal Instability Treatment Options

Conservative treatment

The goal is to reduce pain and strengthen the core muscles that support the spine.

• Weight loss may be recommended.
• Bed rest for no more than two to three days followed by physical therapy can help with back pain. Any longer risks a detrimental effect on the muscles and is not recommended.
• Over the counter anti-inflammatory medications can help reduce pain and inflammation.
• Physical therapy is important to strengthen the core muscles that support the spine and improve flexibility.
• Activity restrictions include avoiding any activities that put stress on the spine such as heavy lifting, bending, twisting, and recreational activities.
• Bracing for additional support to the spine during movement may help temporarily reduce instability, pain and muscle spasms.
• Corticosteroid injections or nerve blocks can help reduce inflammation and pain and allow participation in physical therapy.

Surgery for spinal instability

Spinal fusion surgery

When conservative options do not improve the symptoms, spinal instability is commonly treated with a spinal fusion surgery focused on the particular area of the spine with the problem.

The procedure and results

Spinal fusion is major surgery with a long recovery period. It is a last resort for patients with severe instability. The goal of the procedure is to eliminate movement between the affected vertebrae and provide stability to the spinal column, thereby reducing pain and improving function.

The fusion is performed under general anesthesia. It may be performed as an open surgery or a minimally invasive fusion.  Fusion is typically achieved by using a combination of bone grafts (usually taken from the patient’s own body or a donor), metal screws, and rods. The bone grafts help to promote the growth of new bone between the vertebrae, eventually leading to a solid fusion which stabilizes the spine and diminishes pain. Spinal fusion is typically recommended for patients with instability due to degenerative conditions including degenerative disc disease or spinal stenosis.

How long is the recovery?

After surgery, patients typically remain in the hospital for 2- 7 days depending on the patient’ s condition and the type of fusion procedure. During the hospital stay, the patient is monitored for complications and receives adequate pain control, and physical therapy.

Patients are usually required to wear a back brace or cervical collar, depending on the location of the fusion, to help support the spine during healing.  The length of time wearing a brace may be several weeks to several months depending on the patient’s progress. The supportive device, although it will limit the patient’s range of motion temporarily, will promote healing and improve the chances of successful fusion. During recovery, physical rehabilitation is necessary to re-establish strength and mobility. Complete recovery generally takes from 3 to 6 months.