The spine gives stability and strength to our body. Additionally, the spinal vertebrae (bones) also serve as a protection for our spinal cord. Any problem in our spine is a grave matter and should be addressed by an experienced orthopedic surgeon.
To address the pain or debilitating back issues, the orthopaedist may first attempt minimally invasive methods such as pain injections. If the problem persists, then the orthopedist may perform minimally invasive spine surgery.
Spinal surgery is a viable or necessary option to treat serious musculoskeletal injuries or nerve compression. A pain management specialist will determine whether you should opt for surgery or not.
Why Do You Need Spinal Surgery?
The primary indications for spine surgery are:
Compression (squeezing) of the spinal cord, herniated disc or spinal canal stenosis
Scoliosis, (with spinal deformation more than 40 degrees)
Spinal deformation due to various etiologies, with rapidly progressing or disturbing the functions of the internal organs
Tumors of the spinal cord, spinal arachnoid, and membranes, vertebral vessel, and nerves in the spinal canal
Spinal deformation with significant defects of appearance
Injuries, the most frequent ones are compression fractures
Instability of segments of the spine due to various reasons
Refractory Chronic Pain
The inefficiency of conservative treatment for six months
Disorders of Pelvic Organs
Cauda Equina Syndrome
Sequestration of Herniated Nucleus Pulposus
Spinal Surgeries for Back Pain
1. Spinal fusion
Spinal fusion is a surgery that involves fusing two or more vertebrae to produce a single immobile unit. This surgery is most commonly associated with degenerative disc disease, congenital scoliosis, neuromuscular scoliosis, or another problem with spinal alignment. To correct alignment or a degenerative problem, this fusion is a lasting solution. The spine will stabilize into a more appropriate or straighter position by fusing the vertebrae. Spinal fusion can rectify a spinal curve by 50-70%.
Spinal fusion is traditionally performed to:
Straightening or Align the spine to reduce the spinal curve deformity
Treat side effects such as mobility issues, moderate-severe back pain, breathing issues, etc.
Degenerative disc disease
Microdiscectomy is a minimally invasive surgical procedure performed on patients suffering from a herniated lumbar disc. During this surgery, a herniated disc is removed through a small incision along with a portion of the bone covering the spinal canal to relieve pressure on the spinal nerve column.
A microdiscectomy is usually performed to:
Eliminate sciatica pain caused by the disc herniation.
Treat leg weakness, numbness
Relieve pressure on the spinal nerves or cord
3. Artificial Disc Replacement
A worn or damaged disk material is removed and replaced with an artificial spinal one when the spinal disc is damaged beyond repair. The procedure aims to relieve the back pain while maintaining normal motion.
A laminectomy is decompression surgery. A laminectomy is performed to widen the column by removing the backside of the spinal canal along with any spurs that may have formed. The lamina is the backside of the spinal canal that constitutes a cover over the spinal cord. This lamina is surgically removed along with the ligament flavum (a ligament) that helps support the spinal column. The target of the surgery is to decompress a portion of the spine and remove pressure on the spinal cord or nerves.
A laminectomy is performed to:
Gain entry to a herniated/ ruptured disc in the spine (like sciatica)
Remove bone spurs also known as osteophytes
Focus on back pain caused by nerve damage
Treat numbness and leg pain
Relieve pressure on the spinal nerves
Remove a tumor from the spine
Vertebroplasty and Kyphoplasty are similar procedures performed to treat vertebral compression fractures. In this procedure, bone cement is inserted into the vertebrae with a needle and bonds together the fractured pieces of bone. For a severe spinal compression case, kyphoplasty is performed. In this routine, a balloon is inserted and inflated to raise the compressed vertebrae back to a standard height. The bone cement is used to strengthening the vertebrae and preventing further collapse.
Vertebroplasty and kyphoplasty are performed to:
Treat vertebral compression fractures
Prevent a future osteoporotic fracture or collapse
Biopsy tumors or cancer in bone.
A foraminotomy is a surgical procedure used to relieve the pain by operating from the back of the neck to relieve pressure on one or more spinal nerves. The surgeon removes a minuscule portion of bone and joint which overlie the spinal nerve, as well as any soft tissue. This leads to the widening of the spine and reducing compression.
A foraminotomy is performed for:
Degenerative disorders or a disc prolapsed (bulge).
Treating pressure on one or more spinal nerves in the neck (caused by cervical spondylosis, foraminal stenosis, or an intervertebral disc prolapse).
7. Interlaminar implant
An interlaminar implant is a form of surgery that involves implanting a U-shaped device between two vertebrae in your lower back. This helps to maintain their space and ease the pressure on spinal nerves. This procedure helps in maintaining space between the vertebrae and opens and alleviates pressure on your spinal nerves. This implant provides stability and movement can be done normally.
This procedure is also called plasma disk decompression. This treatment is used for people suffering from prolonged and severe back pain resulting from a disc herniation (bulge). In this procedure, a needle is used to shrink a disc bulge by dissolving excess tissue with a needle that emits radio waves. This helps in reducing the pressure inside the disc and on the nerves responsible for causing pain.
Rehabilitation after Spinal Surgery
After the surgery, the recovery period is the most crucial. Depending on the spinal surgery, the doctor may recommend recovery courses:
Using braces and corsets
Physiotherapy and reflexology
It is significant to remember that all allowed physical load and procedures must be prescribed by a doctor or a physiotherapist. Rehabilitation decides the 70% success of the spine disease treatment!