© 2018 Royal Australasian College of Physicians. Patients contemplating spinal fusion should be fully informed about the evidence base for their particular problem, including the relative potential benefits and harms of fusion compared with non-operative treatments. Better evidence is required to determine more accurately the effectiveness of spine fusion surgery for all indications. For an anterior cervical discectomy and fusion, the procedure is performed through a small incision on the front of the. Spinal fusion may be recommended when the natural disc space has decreased or the spine is unstable. The goal of a cervical fusion is to create a solid bridge of bone between two or more vertebrae. Surgical intervention for metastatic carcinoma of the spine associated with spinal cord compromise improves mobility and neurological outcome (based on a single trial). Spinal fusion is a technique used to stabilize the spinal bones or vertebrae. Benefits of spine fusion compared to non-operative treatment for isthmic spondylolisthesis are unclear (one trial at high risk of bias). The available evidence does not support a clinical benefit from spine fusion compared to non-operative treatment or stabilisation without fusion for thoracolumbar burst fractures. The available evidence does not support a benefit from spine fusion compared to non-operative alternatives for back pain associated with degeneration. We found no high-quality systematic reviews and the risk of bias of the randomised controlled trials in the reviews was generally high. We aimed to summarise systematic reviews on the effectiveness of lumbar spine fusion for most diagnoses. Lumbar spine fusion is a common procedure associated with a high cost burden and risk of serious complications.
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