• Rukmani Birla Hospital,Gopalpura Bypass Road, Near Triveni Bridge,Gopalpura,Jaipur – 302018.

SPINE SURGERIES – AN OVERVIEW

The spine is a critical part that holds the entire body in one place and you should be glad if you can sit upright because it is those stacks of little bones known as vertebrae at the center of the back that are functioning well, allowing you to move and function properly. The spine supports the head, neck, shoulders and the entire upper body. Most importantly it also helps to link the brain to most of the other body parts through a tunnel of nerves. However, sometimes the spine becomes sore to everyday life because of the pain it causes, restricting movement. This pain could be because of several reasons such as age, improper body mechanics, trauma, injury or structural deformities. Well, sometimes the pain can be eased from conservative treatments and there is a need for surgery to ease back and lower body weakness.

Types of Spine Surgeries

  • Spinal Fusion: The most common surgery for chronic unspecified back pain – Spinal fusion involves attaching two or more vertebrae together to make one immobile unit. The surgery restricts the natural movement between the vertebrae and how far they can stretch which in turn reduces the pain increased or caused by bending, lifting, twisting, etc. The surgery can also be used in cases where the spine has been affected by tumour or infections causing damage. It controls spinal deformities such as scoliosis and can also treat vertebrae injuries.
  • Laminectomy: The most common surgery to treat the spinal column that has been pressurized on the nerve roots due to narrowing/stenosis of the spine. Laminectomy involves enlarging the spinal column and removing the lamina, as well as parts of bones, projections, ligaments, and spurs that may have formed over time – to relieve the pain or weakness. Though the procedure can make the spine less stable sometimes and in case that happens, a spinal fusion may be required.
  • Discectomy: The vertebrae in the back are separated by cushions which can move out of place sometimes, causing severe back pain. Discectomy involves removing all or part of the disc to relieve the pressure from the spinal nerves, thereby easing pain. There can be two types :
  • Percutaneous:This surgery involves removing a part of the disc via a laser device inserted through small incisions on the back.
  • Microsurgical:This surgery involves removing damaged portions of the disc, as well as a small part of the bone covering the spinal cord by using a microscope through incisions made on the back.
  • Foraminotomy: This surgery relieves back pain caused because of a compressed spinal nerve. The surgery involves removing the bones at the side of the vertebrae to increase the space to allow the nerves to exit the spine, easing the pressure of the nerves.
  • Disc Replacement: This surgery involves replacing thedamaged spinal disc with an artificial disc, allowing normal movement. The recovery time of the surgery is relatively lesser than others.
  • Interlaminar Implant: A minimally invasive method which involves placing a u-shaped implant between the two vertebrae in the back, creating space and easing pressure from the spinal nerves.
  • Vertebroplasty and kyphoplasty: These two surgeries ease pain and other issues caused because of compression fractures of the vertebrae. These surgeries bolster fractured bones by a cement-like material injected into the vertebrae. Though similar, kyphoplasty involves placing a balloon-like device in the vertebrae (before injecting the binding material) and inflating it to restore height.

When to consider spine surgeries

Excessive pain in the back that is not healed by conservative and non-surgical methods indicates the need for surgery. Moreover, the following conditions increase the chances of surgery:

  • Herniated or Ruptured discs
  • Spinal stenosis
  • Spondylolisthesis
  • Slipped disc
  • Vertebral fractures
  • Degenerative disc diseases
  • Damage to spinal discs due to age
  • Osteoarthritis
  • Sciatica
  • Tumor
  • Scoliosis
  • Kyphosis
  • Ankylosing Spondylitis
  • Spinal cord injury
  • Cauda Equina Syndrome
  • Syringomyelia (Cyst full of fluid)

Benefits of Spine Surgeries

While the most basic and important benefit of spine surgery is relief from pain, though it also provides additional advantages such as:

  • Better movement
  • More physically fit
  • More productive
  • Strengthening of lower muscles
  • Ease from pain killers
  • Improves the quality of life

Risks of Spine Surgeries

While the chronic back pain might make surgery appear as a most beneficial option, one should still evaluate and consider all risks involved before going ahead with the surgery. Some of the common risks associated with spine surgeries include:

  • Adverse reaction of anesthesia
  • Bleeding
  • Infection
  • Blood clots
  • Nerve damage
  • Paralysis
  • Heart attack

The surgery can have higher risks because it is closer to the nervous system. Moreover, the recovery time may be long. That said, the surgery can also have additional risks depending on the health conditions of the person such as high blood pressure, diabetes, etc.

That said, the surgery is a viable option to relieve pain when all other non-surgical methods fail, though proper precautions and considerations must be discussed with the doctor before the surgery.

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