All You Need to Know about Spine Surgery!

What is Spine Surgery?

Injuries, ageing, restrictive body mechanics, trauma and structural deformity, can injure the spine. In severe cases, it may further lead to chronic back pain and other problems such as numbness or immobility. In India, approximately 45% of people neglect their pain for more than seven weeks. As a result, this negligence leads to late treatment and increases the risk of spine surgery - the most common treatment to heal the problem. Spine surgery is conventionally a type of open surgery. It means that the affected area is cut open with an incision to allow the surgeon to view and access the anatomy. Most often, conditions related to the spine are easily treatable with the use of traditional medicine or physical therapy. However, when these non-surgical treatments fail to improve the condition, doctors recommend spinal surgery.

Types of Back Surgery

Depending on the area of the problem, there are different types of back surgeries, including:

• Diskectomy

Diskectomy is the most common surgical treatment for herniated or ruptured discs of the lumbar spine. This surgery involves removing part of the damaged disc. As a result, it relieves the pressure on the nerve tissue and alleviates the pain. Diskectomy is a minimally painful procedure that is highly successful for herniated or ruptured discs.

• Laminectomy

Laminectomy is useful to relieve compression on the spinal cord. Surgeons recommend this surgery to ease the effects of spinal stenosis. In this condition, the spinal column narrows and puts pressure on the spinal cord or nerves. The surgery removes the portion of the vertebral bone, lamina. The doctors remove the back muscles rather than removing them. Parts of vertebra next to the lamina are left as such. Doctors suggest Laminectomy only if the symptoms affect daily routine life. It is performed when less invasive treatments have failed. As per statistics, after laminectomy, approximately 70% to 80% of patients have a major improvement in function and mobility. Also, they markedly experienced a reduced level of pain and discomfort associated with their spinal problem.

• Spinal Fusion Surgery

Spinal fusion is useful in treating a variety of conditions, including instability of the spine and traumatic spinal fractures. This surgery is also useful in case of recurrent disk herniation, scoliosis, tumours, severe infections, or degenerative disk disease. Spinal fusion surgery may also include a laminectomy or diskectomy. This surgery involves removing the infected or damaged disk. After removal of the disk, bone grafts are placed into the empty disk space to maintain the right height between bones. Doctors use the two vertebrae on either side of the removed disk to form a bridge across the bone grafts to promote long-term stability. Spine fusion surgery is usually not suggested until a patient has tried 6 to 12 months of non-surgical care. This procedure involves fusing the painful vertebrae so that they heal into a single, solid bone.

• Artificial Discs

Artificial discs implantation is a treatment alternative to spinal fusion. This surgery involves replacing a painful disc with an artificial disc. It is performed on the lumbar spine (lower back) or the neck (cervical spine). Artificial discs are the replica of the natural spine that helps in performing the same form and function. With spine fusion surgery, there is a possibility that the fusion of one part of the spine forces the discs and vertebra above or below to carry more load and motion. As a result, more wear and tear than normal. The artificial disc surgery significantly reduces this risk.

Screaming Signs You Need a Back Surgery

Spine surgery is not advised until one has completed several months of physical therapy, and the pain has not decreased. If the physical therapy and medications recommended by the doctor do not provide relief, notice these signs that may escalate the need for back surgery.

• Slipped disc not getting better
• Bone spurs in the spine are putting pressure on the spinal cord
• A chronic spinal condition like stenosis (narrowing of the protective bony canal around the spinal cord) is causing side effects, like weakness

loss of bladder or bowel control

• Spinal infection
• Broken or dislocated bone in the back
• Tumour in the spinal cord
• Spinal deformities like scoliosis and kyphosis
• Nerve damage
• Severe injury leading to unbearable back pain
• Loss of mobility

Besides these signs and symptoms, always consult a surgeon if you feel weakness in arms and legs, or there's trouble in walking. The consultation does not imply saying a yes to surgery. Instead, it keeps one aware of the complications.

Preparing for a Spine Surgery

Surgery is a highly responsive medical operative procedure. Therefore, preparing beforehand helps the patient to make up their mind for the procedure psychologically. The week before spinal surgery, a doctor may order blood tests and spinal X-rays. The healthcare team will go over the details. Don't be afraid to ask questions in case of doubts.

• Reach the surgery centre before time. A patient may need someone to drive them and take them home.
• Ask for a list of the medicines that should or should not be taken, days before the surgery.
• Enquire, whether fasting before the procedure is mandatory or optional.
• Make necessary arrangements at home. Post surgery, a patient will require raised toilet seats, slip-on shoes, shower chairs, reachers, and other aids.

What Are the Common Surgical Risks and Complications in Spine Surgery?

All surgeries have inherent risks. Similarly, spinal surgery risks include infection, lack of fusion, pain at the incision site, as well as neurologic problems. Other common complications with this type of procedure include:

• infection
• bleeding
• severe pain
• blood clots
• risks from anaesthesia

More potential complications include:

• numbness and tingling in a leg
• back pain may reoccur

These complications are preventable. Tell the doctor right away if:

• a lot of swelling or redness by the wound
• fever over 100°F
• increased pain
• shaking chills

Is Spine Surgery a Minimal Invasive Procedure?

Over the decades, spinal surgery was known to be an open surgery meaning long incisions. Open surgeries took a long period to heal and were a bit riskier. As each case is evaluated on an individual basis, doctors, now, usually opt for minimally invasive procedures because these procedures are safer, more effective, and less painful alternative. Also, minimally invasive procedure lessens recovery time and the pain associated with surgery. This procedure uses tiny incisions and preserves the muscles and tissue surrounding the spine. The results are longer lasting and more effective than conventional surgery.

How Much Time Does It Take to Heal?

The recovery period from the spine surgery may vary from person to person. For example, if the surgery involves a minimally invasive procedure, the doctor may discharge the patient in a day or two. However, even then, doctors advice a week to 10 days of rest. In severe cases, the time off is much more important, 2 – 6 weeks. In rare cases, it may be even more.