The spine is basically a series of units, tied together with ligaments and muscles and is designed to afford the human body a semirigid platform on which to stand and to protect and conduct the nerves to various muscles and organ units.
The bones of the spine are called vertebrae (sing. vertebra). 
They are stacked on top of one another by intervertebral discs. The discs are made up of an outer band of fibers called the annulus. They criss-cross to afford strength to keep the inside of the disc contained. The interior of the disc is called the nucleus pulposus. It is gelatinous and made of a well-hydrated molecule called proteoglycans. It is this interior that gives the disc their "squishiness" but also their integral stability to the spine.
If the outer band of fibers tears or opens, the proteoglycans can get dehydrated. In some cases, pieces of the nucleus pulposus can fragment off and compress nerves. Other times, it is a slow, progressive process that can render the spine mildly unstable.
It is important to note that the spine is inherently flexible and is in constant motion. If two or more vertebrae become fused - either surgically or by its own devices (arthritis) - the other levels can become stressed or strained. The next level above and below can become worn more quickly due to them taking on more than their share of the shear stress of the entire spine.
The spine, unlike in inanimate structure -like the superstructure of a house, can react and change in response to variations in stress. Vertebral units react to additional wear and wear, such as when a disc breaks down, and the surrounding ligaments can thicken in a way to try to compensate for the loss of stability.
If left unchecked and progressing, the spine or its various byways can become stenotic or narrowed. This process can eventually lead to significant discomfort in the arm, leg, or other areas.
In some cases, the problem does not respond to different efforts like physical therapy medications, or injections. Surgery is sometimes the next step. It is important that as a patient, your description of the pain as well as exactly where it is is critical. Many times, patients are told that they need a fusion.
Fusions are performed thousands of times per month across this country. It is important to realize that fusion can lead to further arthritis down the road. Many times, a surgical procedure called a "decompression" where a portion of the bone and other overlying structures that pinch the nerve is gently sculpted away to take the pressure off of the nerve.
When spinal segments are fused, the functioning of the spine is altered, not just locally, but the entire global unit.
Fusion may be necessary in many cases, or even preferably to decompression in other situations. But they should be considered with care.
With newer technologies such as endoscopic surgery and artificial cervical and lumbar disc devices, motion preservation has become a more and more attractive guiding principle in spine surgery.
At the end of the day, we get one spine to work with and we take it with us wherever we go. When we alter the mechanics of the spine with surgery, it has to be undertaken carefully and considered alongside with techniques that preserve the integrity of the spinal unit.
We are now offering a second look service for people living in the state of California that have been told they need spinal surgery.
Head over to http://www.craniospinalcenter.com to get connected to Dr. G and have him look over your films and give you another set of options. Be safe and be well!
