In the other web page we talked about spinal fusions and why they are popular nowadays. We also talked about their shortcomings. The picture I present below is one of my favorites. This individual started out with a two level artificial disc placement at L2-3 and L3-4. Then they proceeded to have a fusion performed below that at L4-5. A subsequent surgery was done at the L5-S1 level to fuse that due to continued pain. Even after all that, the patient still had pain and then proceeded to have the levels where the artificial discs were placed fused. Of interest in this case is that each fusion is of a different variety. At L5-S1, you have a bone matrix fusion where bone and a dissolvable matrix is placed to fuse the bone. At L4-5 the fusion is a cage type with two screws placed in the L4-5 disc. At the L2-3 and L3-4 levels a lateral screw and rod system is utilized. "Amazingly" the patient still had horrible pain after all this. The important thing to realize is that fusions are not bad and they are necessary in some individuals but they should be considered after other options have failed.