"Fix the Problem": A Spine Physician's Take on the Fusion Debate

A Debate Worth Having Out Loud

Becker's Spine Review recently published a thoughtful discussion with a revision spine surgeon on a question the field has been circling for years: how far should surgery go to avoid a fusion? I read it closely, because it gets at something I talk about with patients every week — and because the surgeon's bottom line is one I share, even though I practice on the non-surgical side of the spectrum.

His central discipline is worth repeating: the goal is to fix the patient's actual problem. As he put it, if a smaller technique doesn't solve what's wrong because you were determined to avoid a fusion, you haven't actually helped the patient.

Where I Agree Completely

The article makes a point I wish more patients heard before any procedure: you treat the patient, not the scan. The surgeon cautioned against "treating the MRI" instead of treating the person — their symptoms, their goals, and what they actually need to get back to.

That matches how we evaluate every candidate at Emerald Coast Integrated Care. An image is a starting point, not a verdict. Two people with similar-looking scans can need completely different things, and the honest answer sometimes is that the less-invasive option in front of them is not the right one.

I also agree with the article's caution in the other direction: doing too little can be its own mistake. The piece describes revision cases where an initial attempt to limit surgery ultimately led to a larger operation down the road. That is a real risk, and any responsible clinician — surgical or not — has to be willing to say when a smaller intervention won't get the job done.

Where a Non-Surgical Option Fits

The theme running through the Becker's discussion is that spine care now lives on a spectrum — from the least invasive, motion-preserving options at one end to open fusion at the other — and that good care means choosing precisely along that spectrum rather than defaulting to one technique.

That spectrum is exactly where a procedure like Discseel® lives. For appropriately selected patients with chronic disc-related pain driven by annular tears or degenerative disc disease, the Discseel® Procedure is a minimally invasive, motion-preserving option that does not remove tissue, add hardware, or fuse a segment — and it leaves every surgical option still available if it isn't enough. For the right candidate, it belongs in the conversation before fusion, not as a replacement for it when fusion is genuinely what the pathology requires.

The key phrase there is "the right candidate." The same judgment the article calls for on the surgical side applies to ours: the procedure has to match the pathology, or it shouldn't be done.

The Standard We Hold

What I appreciated most about the article was its humility. The surgeon noted that spine care keeps evolving, and that staying useful over a long career means scrutinizing new evidence and being willing to change. That is the right posture for all of us in this field.

At our practice, that translates into a simple rule at evaluation: patient first, pathology second, technique third. If the Discseel® Procedure is the right fit for your condition, we'll tell you. If you'd be better served by a surgical consultation — including a fusion, when that's what the problem calls for — we'll tell you that, too. The point isn't to avoid any one operation or to favor our own. The point, as the article put it plainly, is to fix the problem.

Source

Eydis S. "How far should spine surgery go to avoid fusion?" Becker's Spine Review, October 2, 2026. Available at beckersspine.com.