Back Surgery

Surgery: Not a First Option for Back Pain

Surgery is often an option for back pain. There are many things you should know before you consent to surgery, since often the surgery can cause irreversible changes in your body. Although surgical procedures often may go right, there are many people’s lives who have changed for the worst – and you don’t need to be one of the ones in that category.

Surgery for back pain can be performed for one of two reasons:  procedures that decrease pain and ones that fix the problem.

Surgical Procedures that Decrease the Pain

Medical doctors can also perform surgeries where painkillers are injected into the spine in the area that is causing the back pain. These injections have done wonders for many patients, especially those with intractable pain. However, it does have some risks associated with it that do not make it ideal for everyone. You can talk with your doctor to see if this technique is right for you.

Surgical Procedures that Fix the Problem

Spinal fusion is one of the primary surgical procedures that is performed for back pain, fractures, severe scoliosis, and spondylolisthesis. Spinal fusion may also be used in cases where an infection has eaten away parts of the vertebrae and the vertebrae are no longer able to support itself.

In spinal fusion surgery, actually two surgeries may need to be done:

  1. Bone fragments are removed from the pelvis bone
  2. The actual spinal fusion

The bone fragments help the area heal in time and prevent the motions that cause back pain. Both surgeries are quite painful.

Spinal Fusion for Herniated Disc

In the spinal fusion surgery for herniated disc, the herniated disc is removed first. Then bone fragments are added the area where the two vertebrae will fuse together. This is located immediately above and below the herniated disc. The fragments will make the two bones grow together to form one bone. Titanium screws, strips or rods may hold the vertebrae together for support during the bone growth period.

Spinal fusion surgery depends on a lot of assumptions that things will go right, such as:

• The bone from the hip will grow the bone without complications
• The motion of the rest of the spine will be intact.
• The patient’s pain will be reduced.

However, in a lot of cases, the person has a long rehabilitation period and then has restricted motion – for life. His range of motion is decreased permanently. Unfortunately, this happens more often when the surgery involves multiple fusions in the spine.

New Medical Ideas Replacing Spinal Fusion

Luckily, medical science has progressed rapidly in the last decade. Although spinal fusion is still performed for disc herniations and some cases of pinched nerves, there is no lack of innovative doctors trying to perfect better techniques.

For example, using a genetically engineered protein, doctors can create a new disc. Here’s how the procedure is done:

  1. First a sponge made from collagen is soaked with bone proteins and sterile water.
  2. The sponge is then inserted inside a titanium cage that resembles a vertebrae
  3. New bone then grows on the sponge and fills the space of the cage. The process takes about five months.

What a pretty incredible idea! And so far, doctors like this new surgical procedure because they see that it can immediately make a patient feel better. The titanium cage allows separation of the two vertebrae that have collapsed on top of each other, which has created all the back pain symptoms in the first place. The new bone grows and the patient feels like he’s brand new. This technique is very early it is development and is not widely available.

Another new surgical technique involves first the suction of the herniated disc through a very small one-inch incision in the back. A needle is guided into the area where the disc needs to be replaced. Then a rubberized silicon material is injected which hardens in about 10 minutes. Now the patient has a new disc. It’s not exactly like the original but it may be a great substitute.

What You’ll Need to Know about Surgery Before The Operation 

Don’t ever just take a surgeon’s word for it that you need surgery. Even surgeons will tell you this. Get a second opinion. For both consultations, make sure that you ask these 8 questions. Be informed and prepared, not desperate and ready to jump for the knife.

• What exactly will be done. Get a complete description of the surgical procedure.
• The chances of success. Find out what influences the chances on your part and if there’s anything you can do to improve the chance of a successful outcome.
• Recovery details. What is involved in the recovery process? What will you not be able to do after the surgery for the first week? The first month? Permanently?
• What types of things can go wrong with the surgery (complications) and what are their remedies?
• Who has undergone this procedure that you can speak with? (Because of confidentiality, you will have to ask them to call you.)
• How experienced is the surgeon with this particular surgery?
• What type of tests will be done before and after the surgery to determine its effectiveness?
• Ask if the surgery will be performed the conventional way or if minimally invasive techniques will be used. Here’s the difference:

Conventional Way of Surgery

In the conventional surgical procedure, an incision is made into the body and the surgeon looks directly at the tissues (either with or without a microscope). This method involves long recovery times and painkillers in the narcotic category.

Minimally Invasive Surgery

This method is becoming more and more common here in the U.S. and in Europe. Very tiny incisions are made which heal quickly, and mini cameras, microscopes and screens in the operating room image what is happening during the surgery. Tubes or needle-like devices may be used to decompress the nerve.

The surgery is may be done on an outpatient basis and may not require narcotics for pain control. There are fewer chances to develop an infection and lose blood while the patient returns quickly to work and normal daily activity.

Remember that surgery is always a big decision to make and the body must have its much needed recovery time, no matter which type of surgery is done.

Surgery Can Relieve Nerve Compression

Nerve compression may be relieved with different types of surgical procedures:

  1. Fusion. This is where the vertebrae above the nerve that’s compressed and the vertebrae below the nerve that’s compressed are joined together to form one spinal vertebrae. This decreases the movement that is causing the back pain symptoms.
  2. Disc Removal. When the offending herniated disc is removed, so are the symptoms.
  3. Laminectomy. This is when part of the bone of the vertebrae that covers the nerve root is removed. In some cases, some of the herniated disc will also be removed.
  4. Arthroplasty. The joints that connect vertebrae to each other can become calcified which can create bony spurs called osteophytes. This surgical procedure repairs the joints between the vertebrae.

It’s possible that your surgeon will use multiple procedures during the surgery, so do get the details before you go under the knife.