Back Surgery

Back pain affects so many people around us, and so often surgery fails to help. There are many different reasons as to why your back hurts and these usually determine whether or not surgery will help. Some of these include:

  • Pressure on the nerves in the spine (this can cause many other symptoms as well as back pain)
  • Trauma
  • Poor posture
  • Ageing

When Back Pain Persists does Back Surgery come to Mind?

The percentage of people that need back surgery is very small, and a lot of the time non-surgical treatments, such as gentle massage, anti-inflammatory medication, heat, ice and physical therapy can be used to take care of the problem. It is only really when these treatments do not help that back surgery could offer the relief you need.

Back Surgery is an Option when:
  • There are fractured vertebrae (broken bones) from an injury that causes damage to the spinal column and tends to leave your spine in an unstable condition.
  • Your spine is unstable and there are vertebral fractures that are related to osteoporosis.
  • Your spinal nerves are being compressed, causing excessive pain in your back as well as numbness along the backs of your legs.
  • There are ruptured disks. These separate the bones in the spine.
  • You have tried non-surgical measures and they do not help to relieve your pain.

Various Types of Back Surgery

Pressure can be relieved on the spine if portions of the bone are removed. This helps to widen any narrowed areas within the bones of your vertebrae. If a disc is ruptured, removing these gel-like portions may help to relieve any pressure that has built up on pinched nerves. In some cases the entire disk has to be removed and the remaining vertebrae need to be fused together.

There are many different types of back surgery. It will all depend on what your symptoms are as to what type of surgery you have.

Surgeries include:

  • Spinal disc replacement – this is suitable in a small percentage of people who have worn or slipped discs. The procedure aims to restore movement between the vertebrae and disc height. The surgeon removes the discs that are affected and replaces these with artificial discs.
  • Discectomy – this procedure can be used in cases of slipped discs. It relieves any inflammation and irritation of a nerve. The lamina, which is the back portion of a vertebra, is removed so that the ruptured disc can be accessed.
  • Laminectomy – this can be used when the spaces in your spine are narrowed (otherwise known as spinal stenosis). The procedure is performed to relieve pressure and enlarges the spinal canal. The surgeon removes the lamina then shaves back any bone spurs, joints and ligaments that have thickened. A bone spur is an overgrowth of bone.
  • Vertebroplasty – this is only suitable for a few types of fractures on the back bone. The surgeon makes a small incision on the back and with the help of X-rays to guide him slowly injects a cement-like type of mixture into the vertebrae. This stabilises the spine.
  • Foraminotomy – this is usually used when a vertebral disc has been thickened, or the disc is bulging. The surgeon performs the keyhole procedure in which the foramina are widened. The foramina are bony holes from which the spinal nerves all branch out of the spinal cord.
  • Spinal Fusion – this procedure is common for people who have degenerative disc disease (this is when the discs become worn) or when a back bone slips out of position (otherwise known as spondylolisthesis). The surgeon joins two (and sometimes more) of the vertebrae together by using a specialised metal scaffolding that is made of plates, rods or screws and bone graft.

What to Expect after Back Surgery

Following back surgery, you will be required to rest until the anaesthetic has worn off. You might need some pain relief in helping with the discomfort that might be felt while the anaesthetic is wearing off. If open surgery has been performed, a catheter might be needed for draining your urine from the bladder. Fine tubes might also be running from your wound. These tubes will help to drain excess fluid and are normally taken away after one or two days.

Although you will need to rest quite a bit, you should be able to walk around a bit a day after the surgery. You might also have to wear a corset that will help in supporting your back. This depends on how the operation that was performed, though. Physiotherapy might also be given to help you with your recovery and mobility.

Your nurse will give you further information about bathing, hygiene and back care before you leave the hospital.

Are there any Risks Associated with Back Surgery?

In general, back surgery is safe and is a commonly carried out procedure. However, a person needs to know about the risks of the surgery and about any complications that can occur.

Back Surgery Side Effects

Side effects are unwanted but usually temporary effects from a successful operation, such as feeling sick after the anaesthetic. Some pain might be felt in the back and also the legs. Back pain or stiffness after surgery is usually felt by most patients.

Back Surgery Complications

Complications can occur during the operation and after. Most people however, will not be affected. There are possible complications with any kind of operation. These could include unexpected reactions to an anaesthetic, developing a blood clot (usually a leg vein as in deep vein thrombosis), infection, or excessive bleeding. Complications might need further treatments such as having to go back into the theatre so as to stop any bleeding, or to go on antibiotics for dealing with any infections.

General complications of a back surgery could include nerve or spinal cord damage. Although rare, this could lead to pain, numbness, impotence, loss or paralysis of muscle, or loss of bowel or bladder control. There might also be complications to the specific operation that was performed, such as implants or screws coming loose in the back and needing further surgery. Your doctor should always be consulted if any unexpected problem is experienced such as leg or arm weakness or on-going pain. Each risk of back surgery is specific to each patient and will differ for each person.

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