Contrary to intuitive thinking though, the presence of a solid fusion does not necessarily correlate completely with the resolution of symptoms. Such factors as the correct primary diagnosis as well as technical considerations about the surgery may improve the overall results over the short term. Short term resolution of symptoms though should not be the complete criteria by which spinal reconstruction surgery is judged. Also, symptoms may be relieved for a short period of time by adequate fusion surgery and results may degrade over time if the reconstruction is not performed in a way which either recreates or corrects sagittal plane imbalance. Continued, severe low back pain necessitated revision reconstruction spine surgery.
Balance is absolutely critical in spine surgery.
The delineation between good and excellent surgery may depend on how well the surgeon balances the spine during the reconstruction. A spine which is decompensated or tilted forward, will require increased energy utilization by the various muscles which support the head, the neck, and the rest of the spine. This increased energy requirement may cause the muscles to become easily fatigued which may in fact cause pain. When choosing a surgeon for any sort of spinal reconstruction, it is absolutely critical that the question of balance be raised.