Procedure · Multiple regions
Spinal Fusion
An overview: fusion stabilizes the spine by joining vertebrae into a single solid segment. Several approaches achieve this — chosen by region, diagnosis, and anatomy.
What it is
Spinal fusion is not one operation — it is the goal of stopping motion at a painful or unstable segment so bone can grow across it into a single solid unit. Fusion is considered when motion itself is the problem: instability, spondylolisthesis, deformity, or pain from a worn disc that has not responded to conservative care.
Bone graft — the patient's own bone, donor bone, or synthetic graft — bridges the segment, and instrumentation such as screws, rods, cages, or plates holds it still while the bone heals.
Common fusion techniques
- ACDF — anterior cervical discectomy and fusion; removes a damaged cervical disc from the front and fuses the level. For arm pain or myelopathy from disc disease.
- Posterior cervical decompression & fusion — approaches from the back; for multilevel stenosis, myelopathy, or deformity.
- ALIF — anterior lumbar interbody fusion, from the front of the body; restores disc height and alignment.
- LLIF — lateral lumbar interbody fusion, from the side; a muscle-sparing corridor for selected levels.
- TLIF / PLIF — transforaminal and posterior lumbar interbody fusion, from the back; the workhorse for stenosis with instability and spondylolisthesis.
- Posterior lumbar fusion — stabilizes selected lumbar levels through a posterior approach, often paired with decompression.
Fusion or motion preservation?
Fusion trades motion for stability — the right trade when instability or deformity is driving symptoms. When the facet joints are healthy and alignment is good, motion-preserving options such as disc replacement may be worth discussing. Making that call correctly is a central part of surgical planning.
What to discuss at consultation
- Goals: stop the painful motion or correct the instability while preserving overall spinal balance.
- Alternatives: continued nonoperative care, motion-preserving options for selected patients, or a different fusion approach suited to the anatomy.
- Recovery: fusion heals over months — activity limits and follow-up imaging confirm the bone is bridging; minimally invasive corridors can shorten the early recovery.
- Risks: nonunion (failure of the bone to fuse), added stress on neighboring levels, hardware considerations, and the individual risks of surgery.
From Back Talk
Related reading: Lumbar Fusion Recovery: 3 MonthsSpinal Fusion MythsWhy I Don't Fuse Every Back
Frequently asked questions
What is spinal fusion?
Spinal fusion permanently joins two or more vertebrae so they heal into one solid segment, using graft material with screws, cages, or plates for stability while healing. It is powerful for instability and deformity — and overused when those aren't present.
When is fusion actually necessary?
Fusion earns its place for instability (spondylolisthesis), deformity, nonunion, or when decompression alone would destabilize the spine. A simple disc herniation or stenosis without instability usually does not need one — that distinction is the whole decision.
What are the alternatives to fusion?
Depending on the problem: decompression alone, cervical disc replacement (neck), motion-preserving options, or continued conservative care. The alternatives are considered first, every time — see motion preservation.
Does fusion limit my movement?
The fused segment no longer moves, but most patients adapt well — especially with one- or two-level fusions — as neighboring segments compensate. Multi-level fusions restrict more, which is part of why the indication has to be solid.
What is adjacent segment disease?
Over years, the levels next to a fusion can wear faster from carrying extra motion. It doesn't happen to everyone, and precise alignment at surgery reduces the risk — but it is the honest long-term trade-off discussed before any fusion.
Related care
Care pathway
SpondylolisthesisSpinal fusionDr. Jihoon ChoiRockwall · Garland · Forney · Greenville
Enabling technologies.
Fusion is where enabling technology earns its keep: navigation and robotic guidance support precise screw trajectories, the microscope distinguishes delicate anatomy during decompression, and neuromonitoring watches the neural elements throughout. The plan — which levels, which approach — comes from the diagnosis; technology sharpens its execution.
Computer-assisted navigation
Tracks anatomy and instruments against imaging to support precise trajectories and implant placement.
Learn more TechnologyOperative microscope
Magnification and focused illumination to help distinguish delicate anatomy during decompression.
Learn more TechnologyIntraoperative neuromonitoring
Monitors electrical signals from the spinal cord and nerves so the team can respond to meaningful changes.
Learn more TechnologyAugmented reality
Augmented reality computer assisted navigation. Enabling technology.
Learn more TechnologyRobot-assisted surgery
Supports preoperative planning and precise instrument guidance during select spine procedures.
Learn more TechnologyEndoscopic visualization
A small camera and specialized instruments access and view targeted anatomy through a minimally invasive approach.
Learn moreInitial consultation or second opinion?
If you have been told you need a spinal fusion, bring your imaging and your questions. Dr. Choi will review whether fusion is the right answer — and whether a motion-preserving option or a different approach fits you better.