I just had my two-year follow-up after a neck fusion. The X-rays show some degeneration at the level below my fusion. I'm not having any symptoms ... yet. Should I just go ahead and have that level fused, too? Why wait until it becomes a problem?

Doctors debate this question, too. When fusing the spine, should the vertebrae above and below the fused area be fused to prevent future problems at those levels? Some researchers say the next level should be fused only if there are abnormal findings on the X-ray at the time of the first operation.

Other researchers say too many levels fused puts a lot of stress and strain on the bone graft. It may not hold up even when metal plates and screws are used. Movement at the fused site can occur causing even more problems.

Most doctors take into consideration the patient's age and activity level when making this decision. X-ray findings are important, too. Many patients get better without surgery using conservative treatment. If and when conservative care fails, then further surgery can be considered as an option.