UK NICE guidelines advise against spinal fusion for low back pain except within a research trial. Fusion joins two or more vertebrae so they stop moving. It is still used for instability, fractures, deformity and some cases of stenosis, but for ordinary back pain there are alternatives worth trying first.
Alternatives to spinal fusion
| Option | Notes |
|---|---|
| Combined physical and psychological programme | Recommended by NICE for persistent low back pain |
| Exercise therapy | First-line for all back pain |
| Radiofrequency denervation | NICE option for some facet-joint pain |
| PRP | Small trials for disc pain |
| Stem cell injection | Early studies for degenerative disc pain |
| Disc replacement | Selected cases, specialist centres |
Back or leg pain for more than 6 weeks? Get the free guide and a doctor review of your scan.
When fusion may be needed
- Spinal instability or slipped vertebra (spondylolisthesis) with nerve symptoms
- Fractures, tumours or deformity
- Some cases of severe stenosis
See also degenerative disc disease.
