back surgery

How to Decide to Have Back Surgery? Determining if Back Surgery Is Right for You

Is back surgery right for you? The answer is rarely simple. The decision of whether or not to have back surgery depends on several factors, from the severity of your condition to your age and risk factors. 

A spinal specialist can evaluate your unique situation to help you determine if back surgery is right for you. But, to help you make an educated choice, keep reading to learn about who may need back surgery, spine surgery success rates, and more. 

Who Needs a Back Surgery?

People with chronic back pain and/or neurological symptoms that don’t respond to non-surgical treatments may need back surgery. 

Examples of spinal conditions that may eventually require back surgery include:

• Ruptured spinal discs can, in severe cases, require back surgery. Also known as a slipped or herniated disc, ruptured spinal discs often heal on their own with physical therapy, lifestyle adjustments, and pain management. However, if the disc is severely damaged and causes chronic pain, surgery may be necessary for symptom relief. 
• Spinal stenosis is a condition involving abnormal narrowing of the spinal canal. Especially if it’s treated in the early stages, spinal stenosis usually doesn’t require surgery – conservative treatments are sufficient for pain relief. However, if it causes chronic or debilitating pain that doesn’t respond to other treatments, surgery may be recommended. 
• Spondylolisthesis occurs when a vertebra is unstable and slips onto the vertebra beneath it. If the unstable vertebra compresses spinal nerves, it may require surgery to restore spinal stability and alleviate pain. 
• Spondylolysis is a stress fracture in the pars interarticularis of the vertebra. The pars interarticularis is a small segment of bone that links the two facet joints of each vertebra. It can fracture as a result of excessive impact on the spine, particularly in young athletes.  

What Is the Success Rate of Spine Surgery?

The success rate of spine surgery is around 50%, although statistics vary depending on the procedure. 

Spine surgery is considered “failed” if it:

• Doesn’t resolve or improve the patient’s back pain
• Results in new pain
• Leads to hardware failure
• Doesn’t fuse the targeted vertebrae (for spinal fusion)

Failed back surgery syndrome, or FBSS, is the term used for continued pain, poor mobility, and neurological symptoms after spine surgery. Its prevalence ranges from 20% to 40%, making it a serious concern among patients and physicians today. Risk factors for failed back surgery syndrome include:

• Smoking and other forms of nicotine use
• Mental health conditions, including anxiety and depression
• Obesity and overweight
• Pre-existing medical conditions, including diabetes, fibromyalgia, and hypertension
• Previous back surgeries
• Surgical errors
• Older age

While some of these risk factors can’t be averted, like older age and pre-existing medical conditions, you can take steps to prevent failed back surgery syndrome. Quit smoking and adopt a balanced, nutrient-rich diet before the surgery. Try a gentle, low-impact exercise routine to reach a healthy weight, and find a highly qualified spinal surgeon with years of experience in the procedure you plan to undergo. 

What Is the Most Popular Spine Surgery?

The most popular spine surgery is spinal decompression and fusion for many spinal conditions, including herniated disc, spinal stenosis, and spondylolisthesis. 

Spinal decompression surgery encompasses several different procedures, including:

• Laminectomy is the most popular spine surgery used for degenerative spinal stenosis. It involves surgically removing some or all of the lamina, which is a section of bone that covers the back of the spinal canal. In removing part of the lamina, your surgeon can create more space in the spinal canal and alleviate nerve compression from spinal stenosis. 
• Discectomy and microdiscectomy are spinal decompression procedures used to remove damaged spinal discs in the case of herniation or rupture. In a discectomy, an incision is made in the back to reach and remove the disc. In microdiscectomy, the surgeon uses magnification with a smaller incision to remove the damaged tissue in a less invasive procedure. 
• Foraminotomy involves widening the foramen, which are bony openings where the nerve roots exit the spinal canal. Surgically opening up the foramen can ameliorate spinal nerve compression.

Vertebroplasty is another type of spine surgery that may be used to alleviate back pain. Unlike the spinal decompression procedures listed above, it involves injecting a cement material into a broken vertebra. This procedure is generally used for spinal compression fractures from osteoporosis. 

What is Spinal Fusion?

Spinal fusion is often performed after spinal decompression to stabilize the spine. This prevents instability resulting from removing spinal tissues during a laminectomy, discectomy, or foraminotomy. 

During the spinal fusion procedure, bone graft material is positioned between two or more vertebrae. Over several months, this material stimulates your body’s bone regeneration process, causing the treated vertebrae to fuse into a single bone. 

Spinal fusion is a very common spinal procedure, with over 300,000 fusions performed in the U.S. in a single year. While this procedure effectively prevents instability after spinal decompression, it can lead to limited spinal mobility, as all motion is eliminated at the fused segment.

Additionally, the surrounding vertebrae must undergo extra day-to-day impact to accommodate for the fusion, potentially leading to adjacent segment degeneration (ASD). This can lead to ongoing pain and may require reoperation. 

Is L4 L5 Surgery Safe?

L4-L5 surgery is generally safe if performed by a qualified surgeon on a generally healthy patient. However, as with any surgery, it comes with certain risks. 

Risks that come with any surgical procedure, including L4-L5 surgery, include:

• Excessive bleeding
• A severe drop in blood pressure, known as shock
• Surgical site infections
• Pulmonary embolism
• Deep vein thrombosis
• Adverse reactions to anesthesia

Your physician will talk to you about these risks before the procedure and provide pre-operative instructions to prevent them. 

Is Spinal Surgery a High-Risk Surgery?

Spinal surgery can be high-risk, as it’s done close to the spinal cord and spinal nerves. Though rare, this can lead to permanent nerve damage. 

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If the spinal cord is injured during spinal surgery, serious complications like paralysis and incontinence are possible. However, spinal cord injuries from spinal surgery are rare, with an incidence of less than 1% for most procedures. 

Another risk of spinal surgery is a dural tear, which can lead to cerebrospinal fluid leakage. The dura is a layer of thick, fibrous membrane that encloses the spinal cord. If it’s damaged in surgery, cerebrospinal fluid can leak into other areas of the body, leading to symptoms like headaches, nausea, vision changes, ringing in the ears, and loss of taste or smell. 

Minimally-invasive forms of spinal decompression have been developed in recent years to reduce the risks of spinal surgery. Minimally-invasive techniques allow for smaller incisions, less tissue disruption, less blood loss, less postoperative pain, and a lower risk of infection. 

The TOPS System is a revolutionary spinal implant device used in conjunction with minimally-invasive spine surgery to decompress and stabilize the spine. It’s used in place of spinal fusion to stabilize the spine while preserving your full range of motion. 

If you’re suffering from chronic back pain, a physician can help you determine if back surgery is right for you. Schedule a consultation with a specialist in your area to get on the path to relief. 

How Long Does It Take for Nerves to Heal After Back Surgery?

Back surgery is commonly used to treat pinched or damaged spinal nerves from conditions like spinal stenosis, spondylolisthesis, and herniated disc. However, the process of nerve recovery after back surgery can be lengthy and uncomfortable. Nerve tissue takes a notoriously long time to heal.

In this article, we’ll explore the healing process for nerves after back surgery and offer strategies to improve your recovery. 

Table of Contents

• Does Nerve Pain Ever Go Away After Back Surgery?
• How Do You Know If a Nerve Is Healing After Back Surgery?
• Nerve Healing Signs
• What Helps Nerves Heal Faster?
• What Is the Fastest Way to Recover From Back Surgery?

Does Nerve Pain Ever Go Away After Back Surgery?

Nerve pain goes away after back surgery in most cases. However, it can take a year or even longer after the surgery for the nerves to completely heal. Nerves heal slowly when compared to other types of tissue.  

If nerve pain doesn’t go away after back surgery, it may be referred to as failed back surgery syndrome. With this condition, the spinal procedure fails to resolve the patient’s symptoms, which may include nerve pain. While the reason for failed back surgery syndrome is often unknown, possible causes include:

• A surgical error, such as nerve damage during surgery
• An incorrect diagnosis, with which the spinal procedure may not address the root of the patient’s pain
• Scar tissue formation, which can occur around a nerve root and trigger lasting nerve pain
• Adjacent segment disease, or ASD, which is a possible complication of spinal fusion and occurs when the spinal segments surrounding the fused segment degenerate at an accelerated rate
• Hardware failure, which occurs when the spinal hardware (i.e. screws) breaks, potentially leading to nerve pain

How Do You Know If a Nerve Is Healing After Back Surgery?

Your nerve is likely healing after back surgery if you experience gradual relief from radiating pain, no pain with movements that used to cause flare-ups, and restored sensation in the treatment area. Other signs of nerve healing include:

• Reduced numbness and tingling
• Improved mobility and range of motion in the spine
• Greater muscle strength in the affected area

Confusingly, some patients experience a tingling sensation while a nerve is healing. This occurs because the nerves fire sporadically as they regenerate, and the nervous system tends to kick into overdrive during the recovery process. This tingling, pins-and-needles sensation is temporary and simply indicates that the nerves are regaining their normal function. 

Your physician or surgeon can help you differentiate between tingling that indicates nerve damage and tingling that indicates nerve healing. 

Nerve Healing Signs

Nerve healing signs may include:

• Reduced pain and inflammation; improved mobility and muscle strength; and reduced neurological symptoms, as discussed above
• Greater sensation in the area supplied by the nerve
  • Some people experience hypersensitivity to touch in the affected area as the nerve heals. 
• Itching 
• Tingling
• “Electric” sensation

Some individuals don’t experience notable signs of nerve healing. So, if you don’t have the symptoms above, your nerve may still be healing properly – experiences vary from patient to patient. 

Why Does Nerve Healing Cause Itchiness?

Though it may sound strange, itching is a normal sign of nerve healing. This occurs because as nerves heal, they’re stimulated by activity at the site of the injury. The brain construes this stimulation as itchiness and gives you the urge to scratch. 

Tingling and Nerve Regeneration

Though tingling in the extremities is a symptom of a pinched spinal nerve, tingling is also a known sign of nerve regeneration. Specifically, tingling can suggest that young axons are present in the affected area and are actively developing. 

Axons are thin fibers that link nerve cells (also known as neurons) together, allowing them to communicate through electrical impulses. Axonal regeneration is the second key phase in nerve regeneration, preceded only by Wallerian degeneration, which involves removing the end of the injured neuron. 

Electric Shock Sensation Due to Nerve Repair

As a nerve heals, some individuals experience an electric shock-like sensation. This can be uncomfortable but indicates that the nerve is effectively recovering. 

It can be hard to differentiate this sensation from the burning, shooting pain of nerve damage. However, when a nerve is healing, the “electric” feeling will likely move as the nerve grows, then subside. In cases of nerve damage, the burning sensation tends to worsen over time.  

If you can’t tell whether an electric sensation is a sign of nerve healing or nerve damage, contact your physician. 

What Helps Nerves Heal Faster?

Cardiovascular exercise, physical therapy exercises, getting plenty of sleep, and eating a nutrient-dense diet can all help nerves heal faster. These natural therapies support nerve regeneration and promote the body’s healing process. 

Cardio for Nerve Healing

Cardiovascular exercise can benefit nerve recovery by boosting the release of growth factors and neurotrophins in the spinal cord. While you shouldn’t push through pain during exercise or stray from your surgeon’s aftercare instructions, gradually adding low-impact cardio to your routine can encourage healing after back surgery.  

Examples of low-impact cardio include:

• Brisk walking
• Water aerobics
• Using a stationary bike or elliptical machine
• Yoga 
• Resistance exercises

PT for Nerve Healing

Your physical therapist can provide stretches and strengthening exercises that promote nerve healing. In strengthening the muscles that support the spine, PT exercises can limit impact on the spinal structures with day-to-day motions, helping to prevent further nerve damage. Additionally, PT exercises can promote blood circulation to the spine, ensuring that the irritated nerves have the oxygen and nutrients required to heal. 

Sleep for Nerve Healing

If you miss out on high-quality sleep at night, your pain threshold may suffer. As a result, nerve pain after back surgery may feel worse. So, try to prioritize sleep after the procedure by:

• Sleeping on your side with a pillow between your knees or on your back with a pillow under your knees, which helps reduce pressure on the spine after back surgery
• Wearing satin pajamas to easily change positions during the night
• Keep your bedroom at a consistent temperature (ideally between 60 and 68℉)
• Invest in a supportive mattress, ideally firm to medium-firm
• Avoid naps during the day, which can make it difficult to sleep at night
• Consider wearing an eye mask or earplugs to limit disturbances while you sleep

Nutrition for Nerve Healing

A variety of dietary nutrients are crucial for nerve regeneration, including B vitamins, vitamin A, vitamin C, and antioxidants. Foods that are rich in these nutrients and can support nerve healing include:

• Antioxidant-rich fruits like cherries, cherries, peaches, and grapes help fight inflammation after back surgery by preventing free radical damage. 
• Leafy and green vegetables like spinach, kale, broccoli, and asparagus are rich in B vitamins, which support nerve regeneration. Many of these veggies also contain alpha-lipoic acid, which is known to improve nerve function.
• Potassium-rich foods, including avocados, bananas, beets, and squash, promote healthy nerve transmission.    
• Sweet potato is rich in vitamins A and C, as well as natural anti-inflammatory compounds that can help with nerve recovery. 

What Is the Fastest Way to Recover From Back Surgery?

The fastest way to recover from back surgery is to closely follow all of your surgeon’s instructions, safely engage in low-impact exercise, and adhere to a healthy lifestyle. This should involve:

• Avoiding smoking and excessive alcohol consumption
• Eating a nutrient-dense diet with plenty of fiber, low-fat protein, and antioxidants
• Avoiding excessive bed rest 
• Sleeping for at least seven to nine hours each night
• Avoiding activities that could strain the spine, such as lifting objects and twisting the spine

Low-impact exercise is considered a key component to a fast recovery from back surgery. Walking will be the recommended exercise in the first few months after the procedure, so aim to walk regularly. This will promote circulation to the spine, prevent muscle atrophy, and increase your spinal mobility. 

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The TOPS System significantly reduces patients’ back surgery recovery time when compared to spinal fusion. By creating a controlled range of motion within the spine, it’s an ideal spinal fusion alternative for patients with lumbar spinal stenosis or spondylolisthesis. 

Contact a spinal surgeon in your area to learn more about nerve recovery after back surgery. 

What Are The Risks of Back Surgery?

With any type of surgical procedure, there are risks and possible complications to consider. So, if you’re a candidate for back surgery, you likely have many questions surrounding its risks. 

This article will cover the key risks, complications, and side effects associated with back surgery so that you can make the best decision for your medical needs. 

Table of Contents

• Signs You Need Back Surgery
• Is Spinal Surgery a High-Risk Surgery?
• What Percentage of Back Surgeries Are Successful?
• What Are The Chances of Back Surgery Going Wrong?
• What Are The Risks Associated With Back Surgery?
• What Are The Chances of Getting Paralyzed From Back Surgery?
• How to Decrease the Risks of Back Surgery?
• Are You Awake During Back Surgery?
• What Is The Most Common Back Surgery?

Signs You Need Back Surgery

You may need back surgery if:

• You have persistent back pain that hasn’t improved after six to 12 months of non-invasive treatment. 
• Your back pain is progressive, meaning that it continues to worsen over time. 
• Your back pain radiates to the extremities and is accompanied by numbness, weakness, or tingling. This is known as radiculopathy. 
• Your mobility is declining as a result of your back pain. You may struggle to participate in physical activities that you used to enjoy, or walk for long distances. 
• Your quality of life has diminished due to back pain and reduced mobility. 
• Your back pain is caused by a degenerative spinal condition (such as spinal stenosis or degenerative spondylolisthesis) that isn’t responding to non-surgical therapies. 

Is Spinal Surgery a High-Risk Surgery?

Any type of surgery involves a risk of complications. Given that spinal surgery is performed close to the spinal cord, which is responsible for carrying nerve signals between the brain and body, it can cause severe complications. 

With that said, all surgeries are thoroughly tested, reviewed, and regulated for safety and effectiveness before being performed on patients. Additionally, your doctor will weigh the benefits and risks of spinal surgery before recommending it as a treatment option. It’s worth noting that back surgery risks for elderly patients are more likely to cause complications than in younger patients. 

What Percentage of Back Surgeries Are Successful?

One study conducted by the Asian Spine Journal estimated the success rate of back surgery to be approximately 50%. However, many factors influence this rate, including the patient’s health, any underlying conditions, and the type of back surgery performed. You can ask your surgeon about the probability of success in your case.

What Are The Chances of Back Surgery Going Wrong?

The chances of back surgery going wrong depend on many factors. However, up to 40% of people who undergo back surgery experience continued pain after the procedure. 

Factors that may increase the chances of back surgery going wrong include:

• Obesity
• Diabetes
• Anemia
• Cardiovascular disease, kidney disease, and heart issues
• Osteoporosis and other forms of metabolic bone disease
• Long-term use of corticosteroid medications
• Smoking and tobacco use
• Chronic pain from other conditions (i.e. fibromyalgia)
• Intraoperative risk factors, like the surgeon not creating enough space around the nerves or not creating enough space around the nerves

Ways in which back surgery can go wrong include:

• Failed spinal fusion, meaning the bone graft fails to fuse the targeted vertebrae
• Surgical complications, such as wound infection, reactions to anesthesia, blood clots, or shock
• Recurrent back pain after the procedure
• Accidental damage to the spinal cord or spinal nerves
• Spinal fluid leakage (known as incidental durotomy)
• Bleeding inside the spinal cord

What Are The Risks Associated With Back Surgery?

Anesthesia Risks

For one, back surgeries present the risk of complications associated with anesthesia. The risk of these complications is higher for procedures that are done under general anesthesia, rather than local anesthesia. 

Potential complications of anesthesia include:

• Nausea and vomiting
• Sore throat and damage to the larynx
• Teeth damage
• Nerve injury
• Allergic reactions
• Hyperthermia
• Aspiration pneumonitis
• Stroke
• Hypoxic brain injury
• Malignant hyperthermia
• Cardiac arrest
• Cardiovascular collapse
• Embolic event

Infection

For most patients, the risk of infection is low after back surgery. However, it’s crucial to follow all of your surgeon’s wound care instructions to prevent infection following the procedure. 

Blood Loss

Blood loss is another key risk of back surgery. Your spinal surgeon will take many steps to reduce blood loss through the advanced incision and wound closure techniques. 

Blood Clots

Blood clots are a considerable risk in all surgical procedures. Following a surgical procedure, the body actively tries to stop the bleeding caused by the operation. This can cause clotting, as can injured blood vessels around the area affected by the surgery. 

In the first couple of weeks following surgery, blood clots may appear. The symptoms of a blood clot to look out for include inflammation in the calf, foot, or ankle, tenderness or redness in the leg, and calf pain.  

Laser Back Surgery Risks

Additionally, laser back surgery can involve different risks. One of the key laser back surgery risks includes damage to the surrounding tissue. 

What Are The Chances of Getting Paralyzed From Back Surgery?

Paralysis is one of the fusion back surgery risks. Although it’s rare, this complication is very serious and can permanently limit patients’ mobility following the procedure. 

To help you understand the odds of developing paralysis from back surgery, let’s consider a few key statistics: 

• Approximately 1 in 10,000 patients who undergo herniated disc surgery will develop paralysis. This makes it one of the rarest herniated disc back surgery risks and complications. 
• Out of 11,817 adult spinal surgeries, 21 patients experienced a new onset of major neurological deficit immediately after the procedure. The incidence of this complication was 0.178% overall. 

How to Decrease the Risks of Back Surgery?

While there’s no way to make back surgery entirely risk-free, you can reduce the risks of back surgery by making certain lifestyle adjustments. By adopting healthy habits well in advance of the procedure, you can also improve the procedure’s chance of success. 

• Quit smoking several weeks before back surgery. 

Smoking cigarettes and using any type of nicotine product greatly increases the risks of any surgery. Nicotine inhibits circulation, which hinders the recovery process and increases the risk of infection after an operation.  

• Get your blood sugar under control. 

If you have diabetes, make sure that your blood sugar is successfully managed before undergoing surgery. High blood sugar increases the risk of infection after surgery. 

• Get your blood pressure under control. 

Hypertension, or high blood pressure, can increase the risk of complications from anesthesia, including heart attack, stroke, and congestive heart failure. If you struggle with high blood pressure, talk to a physician about getting it under control before undergoing surgery.  

• Reach and maintain a healthy weight. 

Though it’s far easier said than done, reaching and maintaining a healthy weight will positively impact your recovery from back surgery. Obesity is a risk factor for infections and complications relating to the heart and lungs after surgery. 

If you’re not able to reach your ideal weight before undergoing back surgery, shedding even a few extra pounds will support your body’s healing process. Patients who are struggling with weight loss should consider talking to a physician about effective weight loss strategies. 

• Eat healthily. 

Sticking to a healthy diet goes hand-in-hand with maintaining a healthy weight before and after back surgery. But, beyond helping you shed extra pounds, a healthy diet provides the nutrition that your body needs to effectively heal after surgery. 

Are You Awake During Back Surgery?

No, most patients are put under general anesthesia for back surgery. This means that you’ll be fully asleep for the entirety of the procedure.

What Is The Most Common Back Surgery?

Spinal fusion is the most prevalent surgery for chronic back pain in patients with spinal degeneration. In spinal fusion, the surgeon places bone graft material in between the affected spinal bones, called vertebrae. Over several weeks following the procedure, the bone graft will fuse the vertebrae into one bone. 

The key risks of back fusion surgery that patients must consider include:

• Normal surgical risks, including the risk of bleeding, blood clots, infection, and nerve damage
• Pain at the location of the fusion
• Pseudoarthrosis, meaning that the fusion doesn’t stimulate adequate bone formation, necessitating a second surgery
• Adjacent segment disease, or ASD, develops when the vertebrae on top of and below the fused segment degenerate more rapidly as a result of the fusion

Additionally, spinal fusion can require a lengthy recovery period. The patient may need to remain in the hospital for up to four days following the procedure. Additionally, it can take six weeks (or even longer) for patients to notice signs of bone healing. 

To completely heal from fusion, patients may require six months to a year. During this recovery period, patients’ mobility and range of motion are generally very limited. 

Can I Lower The Risks of Spinal Fusion Surgery?

Many of the risks of lower back fusion surgery can be reduced or eliminated with fusion alternatives including the TOPS System from Premia Spine. This non-fusion spinal implant allows for a minimally-invasive procedure, which limits surgical risks and complications. 

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Additionally, by eliminating the need for fusion, the TOPS System preserves the independent motion of the vertebrae. This allows the patient to retain his or her complete range of motion in the back. 

Medical innovations like the TOPS System continue to reduce the risks and complications associated with back surgery. So, make sure to talk to your spine specialist about all of the chronic back remedies available today before deciding on a treatment plan. 

5 Ways To Avoid Spinal Fusion Surgery

Table of Contents

• What to Expect After Spinal Fusion Surgery?
• Risks of Spinal Fusion Surgery
• What Are The Alternatives to Lumbar Fusion?
• 5 Ways to Avoid Spinal Fusion Surgery
• Future Complications From Spinal Fusion

When back pain from a spinal condition becomes chronic, physicians may present the option of spinal fusion surgery to patients. However, few patients want to undergo spinal fusion unless it’s the last resort. Spinal fusion involves all of the risks of other surgical procedures, along with the prospect of significantly reduced spinal mobility. 

Thankfully, medical advancements in recent decades have made way for spinal fusion alternatives. This article will discuss strategies for avoiding spinal fusion surgery while obtaining relief from persistent back pain. 

What is Spinal Fusion Surgery?

Spinal fusion surgery is a medical procedure that involves fusing two or more spinal vertebrae so that they can heal and become a single bone. This procedure eliminates motion between the targeted vertebrae while preventing irritation to the surrounding nerves and ligaments.

To perform spinal fusion, the surgeon extracts a bone graft from the patient’s pelvis or uses a synthetic bone graft. The graft is then positioned and secured between the affected vertebrae. Metal plates, screws, and rods are sometimes used to hold the two spinal vertebrae together while the bone graft heals. This surgical procedure improves stability and corrects spinal deformities. 

How Long Does It Take to Recover From Spinal Fusion Surgery?

Usually, it takes about 4 to 6 months to return to gentle activities after spinal fusion surgery. It can take between 6 and 12 months to make a full recovery from the procedure.

Keep in mind that the healing process can differ from person to person, and several factors can influence recovery. Diet, weight, age, and lifestyle can go a long way in determining how fast the patient will recover from the surgery. 

Patients are advised to undergo physical therapy, avoid strenuous activities, and maintain a healthy diet after spinal fusion surgery to enhance the recovery process. You’ll likely need to take four to six weeks off of work after fusion surgery, or longer if your occupation is physically demanding.  

What to Expect After Spinal Fusion Surgery

Just like any other spinal surgery, spinal fusion surgery comes with several risks; a nerve could get damaged, there could be infection, bleeding, blood clots, poor wound healing or pain in the pelvis area where the bone graft was harvested, loss of bowel or bladder control may occur too. 

Spinal fusions can also put pressure on the bones that are above and below the fusion, which can cause them to break down and degenerate more quickly. Subsequently, this leads to an increased likelihood of further surgery in the nearest future. 

Spinal fusion is a surgery that risks leaving patients in pain or needing the procedure again in the future.

The only time you should think of undergoing spinal fusion surgery is when you know that you are capable of taking a long time from work without your finances being affected, say 4 to 6 months. Or you have good insurance that can cater to you and your family. 

If you can not confidently boast of any of the above then it is advisable for you to avoid spinal fusion surgery. 

Risks of Spinal Fusion Surgery

Just like any other spinal surgery, spinal fusion surgery comes with several risks, including:

• Nerve damage
• Infection
• Bleeding
• Blood clots
• Poor wound healing
• Pelvic pain at the area where the bone graft was harvested
• Loss of bowel or bladder control, in severe cases

Spinal fusion can also place pressure on the bones located above and below the fusion. This may cause them to break down and degenerate more rapidly. Known as adjacent segment disease, or ASD, this spinal fusion complication leads to an increased likelihood of future revision surgery. 

Patients should generally only consider undergoing spinal fusion surgery if:

• Several months of non-surgical treatments have failed
• They’re capable of taking a long time off of work (around 4 to 6 months) without their finances being affected, say 4 to 6 months
• They have good insurance that can cover the cost of the procedure 

Additionally, patients should speak at length with a spinal specialist before considering fusion to ensure that they’ve exhausted every other available treatment option. 

What Are The Alternatives to Lumbar Spinal Fusion?

In addition to non-surgical treatment approaches, advanced non-fusion spinal implants present an alternative to lumbar spinal fusion for many patients. One such implant is the TOPS System from Premia Spine. 

The Premia Spine TOPS System is a non-fusion spinal implant that provides a genuine alternative to spinal fusion. It’s a mechanical device positioned between two titanium plates that offers stability while retaining spinal mobility in all directions. It replaces the spinal structures, such as the lamina or facet joint, that are removed during lumbar spinal decompression surgery. 

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The TOPS System is designed to be used between the L2 and L5 spinal segments, which are often affected by lumbar spinal stenosis and spondylolisthesis. It re-establishes a controlled range of motion within the lumbar spine to alleviate pain without limiting the patient’s activities. 

In a 7-year clinical study, the TOPS System was found to maintain clinical improvement and radiologic stability over time in patients with spinal stenosis and degenerative spondylolisthesis. 

Get in touch with a medical professional to discuss your treatment options today.

5 Ways to Avoid Spinal Fusion Surgery

1. Physical Activity and Targeted Exercises

Many people believe that taking enough rest from physical activity is the best way to care for back pain. There’s no denying that rest can prevent you from overstressing the spine. Additionally, rest is essential to the healing process for many back injuries, namely acute back injuries and sports injuries. 

However, many spinal injuries and conditions benefit from physical activity. Exercise increases blood flow and, as a result, the flow of oxygen and nutrients to the spine. This stimulates the healing process while helping to alleviate stiffness that can worsen back pain. 

Despite the benefits of physical activity for spinal pain, certain precautions will ensure that your exercise routine doesn’t do more harm than good:

• Avoid high-impact activities, like running and weightlifting, which can cause further injury. Low-impact activities, such as walking and water aerobics, are safe options. 
• Talk to your doctor before starting any new exercise routine, and ease into it. 
• If you experience spinal pain (not muscle soreness) while exercising, stop and rest. 

Additionally, targeted exercises can benefit your recovery from spinal conditions. Exercise can strengthen the muscles that support the spine, namely those in the back and abdomen. By strengthening these muscles, you can reduce the impact exerted on your spine with day-to-day motions. 

Here are a few simple exercises to try at home: 

• Lie on your back, bend your knees, and place your feet flat on the floor. Gently lift your buttocks a few inches off the floor toward the ceiling. Complete three sets of 10 repetitions.
• Lie on your back and hug your knees to your chest. Gently roll side to your side, just a few inches, to massage and stretch your lumbar back area. Return to the starting position and repeat to the other side. 
• From a standing position, bend at the waist with your fingers reaching for the floor. Go only as far as your body naturally permits. Now, just hang there and breathe naturally for one minute. With each breath, let your back and legs relax and stretch. Repeat three times.

2. Physical Therapy

Physical therapy is almost always recommended for patients struggling with chronic back pain from spinal conditions. While your physical therapist may recommend exercises for muscle development like those listed above, they can offer unique insight and recommendations for your recovery process. In general, physical therapy improves strength, mobility, and stamina for patients with spinal pain. 

Your physical therapist can specifically target the problem areas of your spine. They may correct abnormalities in your gait, posture, and lifting techniques to reduce spinal compression. Paired with targeted training and pain management strategies, these methods work to alleviate symptoms of spinal conditions. 

It may take several months for physical therapy to improve your back pain and other symptoms. However, patients often find that physical therapy allows them to exercise with less frequent and less severe pain. PT also frequently improves patients’ ability to comfortably complete day-to-day activities, like grocery shopping and gardening. 

Talk to your doctor before scheduling an appointment with a physical therapist. Your doctor can likely refer you to a PT that specializes or is highly experienced in your condition.

3. A Healthy Diet and Weight Loss

As the saying goes, an apple a day keeps the doctor away. While an apple might not keep your back pain at bay, maintaining a healthy weight is crucial to your spinal health. 

Being overweight increases the strain on all of your joints, as well as your spine. Each extra pound adds to the impact exerted on your spine with every stride or repetition at the gym. 

Clinical research has supported the claim that body weight is related to back pain. A 2010 review in the American Journal of Epidemiology found that the risk of lower back pain is directly linked to body mass index or BMI. 

Additionally, a 2017 study conducted at the University of Tokyo Hospital found that after reviewing 1,152 men’s medical histories from 1986 to 2009, a patient’s BMI and body fat percentage correlated to the risk and incidence of back issues. 

Eating a diet rich in vegetables, fruits, whole grains, and lean protein can help you maintain a healthy diet. Avoid consuming foods that are high in sugar and cholesterol, as well as trans and saturated fats). These foods can contribute to inflammation throughout your body and in your spine, which may worsen spinal pain while inhibiting your recovery process. 

Additionally, eating a nutritious diet and maintaining a healthy weight will support the health of your entire body. With greater overall health, patients can often recover from spinal conditions more rapidly.

4. Spinal Manipulation

Spinal manipulation is a technique typically performed by chiropractors to restore spinal alignment. It can help resolve back pain and nerve compression caused by spinal misalignment. Additionally, by realigning the spine, spinal manipulation can improve the flow of blood (and, as a result, oxygen, and nutrients) to the injured spinal tissues.

There’s a range of different techniques that chiropractors may implement for spinal manipulation. However, the most common technique is the high-velocity low-amplitude (HVLA) thrust.

The HVLA thrust often causes a “pop” that patients can hear. When using this method, the chiropractor will apply an abrupt force to a joint with their hands while the body is in a specific position. 

In some cases, chiropractors may opt for a gentler method known as spinal mobilization or low-force methods. These techniques don’t require twisting the body or applying a sudden force to the body. They may be implemented to suit the patient’s comfort level, preferences, or size, or for specific conditions (like osteoporosis, for example. 

Many spinal conditions can be exacerbated by spinal misalignment and, therefore, benefit from spinal manipulation. The most common of these conditions include spinal stenosis, spondylolisthesis, and herniated disc.

When combined with other treatment options listed here, spinal manipulation and other chiropractic methods may help patients avoid spinal fusion surgery. However, if your back pain has resulted from a traumatic injury, like a spinal fracture, this treatment likely won’t work for you. 

5. Epidural Steroid Injections

Epidural steroid injections can help calm pain caused by an irritated or compressed spinal nerve. These injections contain powerful anti-inflammatory medication that can offer relief within just a few days.

While steroid injections are quick and accessible, they’re not generally used as a long-term solution. Undergoing more than three to four injections per year can lead to tissue damage. Additionally, make sure to consult your doctor about the benefits and drawbacks of steroid injections for your particular spinal condition. 

Future Complications From Spinal Fusion

Given that spinal fusion surgery may be correlated with accelerated degeneration of the joints surrounding the fused vertebrae, many professionals believe that fusion can lead to future spinal issues. This is especially true for patients who undergo spinal fusion relatively early in adulthood. 

This implies that the longer you live after undergoing spinal fusion surgery, the higher your chances are to experience future spinal problems. 

According to a study published in the Journal of Spine Surgery, revision spinal surgery after the initial spinal fusion procedure takes place in 8% to 45% of cases. The reasons for revision include non-union, implant failure, recurring spinal stenosis, adjacent segment disease, infection, and flatback syndrome. 

Complications from spinal fusion may contribute to chronic back pain in the future. Whether caused by adjacent segment disease, spinal muscle injuries, hardware malfunction, or graft site pain, pain after spinal fusion can be debilitating. 

With these risks in mind, it’s generally recommended to avoid spinal fusion whenever possible and opt for safer options. Thankfully, medical advancements have paved the way for spinal fusion alternatives that can provide lasting stability and pain relief, like the TOPS System. These alternatives can improve your quality of care, alleviate your back pain, and give you a greater overall quality of life. 

Thromboprophylaxis in Spinal Surgeries – Common Complication or Rare Condition?

If you’ve been recommended to undergo spinal surgery for chronic back pain, the risk of complications is an important factor to take into account. In surgery, including spine surgery, deep vein thrombosis is a possible complication and area of concern for many patients. 

Surgical treatment for conditions like spinal stenosis and spondylosis presents a far lower risk of complications like DVT when compared to joint replacement surgery. However, thromboprophylaxis in spinal surgeries may be required in some cases. 

Here, we’ll discuss the prevalence of DVT in spine surgery and when thromboprophylaxis may be needed. 

Thromboprophylaxis Definition

Prophylaxis is defined as any action that’s done to prevent disease. So, thromboprophylaxis refers to the treatment implemented to prevent thrombosis. There are three possible ways to perform thromboprophylaxis: chemical (pharmacological), mechanical, or a combination of both. 

Chemical Thromboprophylaxis

Chemical thromboprophylaxis generally involves the use of medications called blood thinners or clot busters. Aspirin (which prevents platelet aggregation), warfarin, and heparin are the most commonly used blood thinners for thromboprophylaxis, others may also be used.

Blood thinners are also called anticoagulants. These medications can prevent blood clots from forming in the first place. For patients who have experienced a blood clot, blood thinners can help keep the clot from returning. 

Also called thrombolytics, clot busters are medications that are administered via IV or a catheter that’s placed into the clot. They work by dismantling blood clots. Common clot busters include alteplase, anistreplase, reteplase, and streptokinase, among others. 

Mechanical Thromboprophylaxis

Mechanical thromboprophylaxis is another option for preventing thrombosis in spinal surgery and other settings. There are two key types of mechanical thromboprophylaxis: static systems and dynamical systems. 

• Static systems

Static systems for mechanical thromboprophylaxis typically involve compression stockings. Also referred to as anti-embolism stockings or elastic stockings, these garments prevent thrombosis by gently encouraging circulation in an upward direction. 

• Dynamical systems

Dynamical systems for mechanical thromboprophylaxis include a venous foot pump and intermittent pneumatic compression.

Deep Vein Thrombosis

Deep vein thrombosis (DVT) is a possible complication of spinal surgery, as well as a variety of other surgical procedures. DVT is a condition that results from a blood clot that develops in one of the body’s deep veins. In most cases, DVT arises in the leg. 

A lack of physical motion for an extended period after surgery can trigger DVT. A long stay in the hospital following spine surgery can also contribute to this medical complication. 

Signs of thrombosis include:

• Sharp chest pain
• Swelling in the feet and affected leg
• Rapid shortness of breath
• Dizziness and fainting
• Rapid pulse
• Coughing up blood

Risk Factors For DVT

Along with a lack of motion (muscle atony), certain factors can increase your risk of developing thrombosis after surgery, including:

• Older age
• Previous surgeries
• Smoking
• Being overweight
• Pregnancy
• Oral contraceptives and hormone replacement therapy
• Genetics, including genetic disorders like factor V Leiden
• A family history of DVT
• Cancer
• Heart failure
• Bowel conditions, including inflammatory bowel disease, Crohn’s disease, and ulcerative colitis

How Common is Thrombosis in Spinal Surgery?

Without thromboprophylaxis, an estimated 15% of patients who undergo posterior spinal surgery experience deep vein thrombosis. This may be influenced by the prevalence of venous thromboembolism, or VTE, among patients with degenerative spine conditions. 

Thromboprophylaxis can significantly decrease the rate of DVT among spine surgery patients. If you’re at a heightened risk of blood clots or have a severe spinal disorder, your doctor may recommend blood-thinning medications (chemical thromboprophylaxis) for a period to lower your DVT risk. 

Patients who don’t need to go on blood thinners may instead use mechanical thromboprophylaxis to prevent thrombosis. Wearing stockings or using a pump to compress your legs can effectively reduce your DVT risk. Standing and moving around as much as possible after surgery is also crucial to warding off postoperative blood clots. 

Lowering Your Risk of DVT in Spine Surgery

Spine Surgery Preparation

Effectively preparing for spine surgery can help reduce your risk of developing DVT. Surgery preparation tips to follow include:

• Quit smoking.

Smoking increases the risk of all surgical complications, including DVT. But, in relation to blood clots, nicotine alters the surface of the platelets in the blood. As a result, the platelets become more prone to clumping, potentially leading to blood clots.  

• Discuss medications with your doctor. 

Before undergoing spinal surgery, make sure to talk to your doctor about all of the medications that you’re currently taking. Your doctor can advise you to stop taking medications that may compromise your recovery and/or increase your risk of complications. 

• Eat a healthy diet. 

Taking extra care of your nutrition leading up to spinal surgery can help reduce your risk of complications. In particular, make sure to eat plenty of fiber-rich foods, such as vegetables, berries, beans, and whole grains. Fiber can prevent intestinal inflammation and the risks that it poses. 

Minimally-Invasive Spine Surgery

Traditional spinal decompression surgery involves spinal fusion. In fusion, two (or more) vertebrae are fused into a single bone using bone graft material. 

Unfortunately, spinal fusion greatly increases patients’ recovery time and post-operative pain. Fusion is also associated with a higher risk of medical complications, including DVT. 

When compared to fusion, minimally-invasive spine surgery comes with a much lower risk of DVT. So, for spinal stenosis, spondylolisthesis, herniated discs, and other spinal disorders, minimally-invasive surgery (MIS) is an optimal choice to reduce your risk of DVT.  

Spinal implants like the TOPS System can allow for minimally-invasive spine surgery. As a spinal fusion alternative, the TOPS System stabilizes the spine while preserving the patient’s range of motion. 

Wrapping Up

Deep vein thrombosis is considered a rare complication of spinal surgery, especially among otherwise healthy patients. But, along with pre-operative preparation and thromboprophylaxis, minimally-invasive spine surgery can largely reduce your risk of developing a blood clot.

Advanced spinal implants like the TOPS System can make it possible to achieve back pain relief and correct spinal deformities without fusion. Talk to your doctor to learn more about the minimally-invasive spine surgery options available to you. 

Spinal Conditions That Require a Surgery

The back surgery conversation is one that no one wants to have. Even with no medical background, people understand the potential implications of any damage to or compromise of the spine. So, it is not uncommon for people to start intensely worrying when lumbar back pain presents itself. 

Some back pain treatment options are non-surgical, and these may include anti-inflammatory drugs, physical therapy, rest, or even exercise. Sadly, not everyone has situations that can be handled in this way, and for those people, back surgery may be in the cards.

You are going to have to speak with your orthopedic doctor to get an evaluation of exactly where you are and the treatment options that are available to you. These doctors typically have your best interests at heart, so they are not going to jump at surgery the first chance they get.

It is usually after the non-surgical alternatives seem to be showing no improvement that the surgery step is considered. Below is a look at some back surgery conditions that fall under this umbrella.

Spinal Stenosis

Spinal stenosis is a blanket term that can speak to one of several different situations. The first is far lateral recess stenosis, which is a condition that involves narrowing of the lateral part of your spinal canal. Second, you could be dealing with central stenosis, which denotes a narrowing of your spinal canal’s central area.

Finally, there is foraminal stenosis, and this means that there is pressure on your existing nerve root thanks to a narrowing of your foramen. Your foramen is the hollow bony archway that adjacent vertebrae create. All spinal nerve roots run through it. 

Regardless of which kind you are dealing with, there is typically a narrowing effect that tips your orthopedic doctor off. Of course, you are not going to just get up and immediately realize that you have spinal stenosis. So, what kind of symptoms would you be looking for? Well, pain is a giveaway, but that is the case for several different back conditions whether you have it on one or both sides of the body. 

However, you also tend to get some numbness and unrecognizable sensations in your legs, thighs, buttocks, and back. There is likely going to be a three-to-six-month nonsurgical treatment period before you are advised to do surgery.

Degenerative Disc Disease (DDD)

While Degenerative Disc Disease is typically associated with an aging body, it is not impossible to see it in younger people. Its symptoms make it hard for you to differentiate from other potential issues since you mostly feel pain in your lower back, buttocks, or both areas.

As is usually the case, you start by being given non-surgical treatment over an evaluation period. For DDD, this is not normally any less than six weeks. Once the said period has elapsed and you are not seeing any improvement, back surgery is likely going to be in the cards.

Herniated Nucleus Pulposus

This condition can appear like DDD since it is also characterized by progressive disc degeneration. In this case, the said degeneration tends to be the result of a traumatic event. Eventually, your orthopedic doctor may diagnose you with herniated nucleus pulposus (HNP).

The kind of treatment that you receive for the condition depends on the extent of the herniation that has occurred. That state is also going to have a tremendous impact on the types and severity of the symptoms you experience. Should your symptoms be mild, surgery is rarely ever called on for this condition. You are way more likely to end up getting nonoperative treatment.

Only after this has not worked for several months would your doctor even begin to consider lumbar spine surgery. Some of the symptoms you may find yourself experiencing with this condition are numbness, loss of or abnormal sensations, or back and leg pain.

Cauda Equina Syndrome

Here is yet another condition that is associated with herniation. When you have a central disc herniation, it can result in the cauda equina syndrome. Unlike the other conditions that have been discussed up to now, the process of starting with nonsurgical treatment, waiting, and then trying surgical options does not apply here.

If cauda equina syndrome is in the mix, you are likely going to need some urgent attention. While the symptoms that you experience are not unique to this condition, they stand out enough for you to know that something is likely seriously wrong. These symptoms are anal sphincter weakness, a loss of feeling in the perennial area, bladder paralysis, and leg pain that affects you on both sides of your body.

Should you find yourself experiencing a combination of the symptoms highlighted, it would be in your best interest to reach out to and visit an orthopedic doctor immediately. The chances are if your condition is something else, you are unlikely going to require spinal surgery for it.

Spondylolisthesis and Spondylolysis

Spondylolisthesis is a spinal issue that causes one of your lower vertebrae to slip out of place. The said vertebra moves forward and makes contact with the bone that is directly beneath it. The result of this is intense pain, but thankfully, it is treatable in most instances. Note that you can almost reliably avoid having to deal with this condition by practicing a proper and consistent exercise regimen. Be that as it may, overstretching and straining from activities, such as weightlifting, gymnastics, track and field, and football could lead to spondylolisthesis. 

The kind of symptoms that you would see if you have this illness are pain that goes away when you lean forward or sit, legs that have weird sensations or are often numb/tired, pain that seems to get worse during standing and walking, plain low back pain, and thigh or buttock pain. 

When you have spondylolysis, there is a stress fracture or crack that develops in the pars interarticularis. This is a very thin and small vertebral area that connects the joints of the upper and lower facets. The said crack or fracture tends to occur in the lower spine’s fourth or fifth vertebra. The fifth one is typically where it happens, and you can experience the fracture on both sides of the bone. 

The pars interarticularis is the weakest vertebra area, hence it tends to be very vulnerable to injury from repetitive stress and strain. The symptoms you may encounter here include stiffness and pain in the lower back, pain that gets worse whenever you bend forward, or pain and other associated symptoms that seem to get worse when you engage in activity.

Your orthopedic doctor may attempt non-surgical courses of treatment to get you past your spondylolisthesis or spondylolysis. However, if none of this works, either condition may require back surgery.

What Are the Main Types of Back Surgery?

Depending on whatever unique situation may present itself, back surgery may be unavoidable. In this case, one of the four main types below is typically required. Do not get the idea that only four back surgery variations exist. Instead, view these as categories under which many kinds lie.

Discectomy

Whenever there is a material present that may be putting pressure on your nerve root or spinal column, it needs to be removed. The procedure that allows an orthopedic surgeon to do that is called a discectomy. Note that there are other names for this back surgery type, including decompression surgery, lumbar discectomy, percutaneous discectomy, etc.

The idea is to remove the intervertebral disc’s herniated portion, which relieves whatever pressure may be on the spinal cord. Doing so can help to address mobility, balance, weakness, pain, or numbness issues. Note that there is also a microdiscectomy, in which the process is a lot less invasive.

Laminectomy

Like the discectomy, the laminectomy is a decompression-type surgery. During this surgery type, your spinal column gets exposed as your lamina gets cut away. Notre that the lamina is the reverse side of the spinal canal, which farms a spinal cord cover. When this surgery is recommended, the goal is to get rid of pressure on the spinal cord or nerves by decompressing the lamina portion of the spine.

The ligamentum flavum is also cut and removed, though its purpose is to support the spinal column. That is because the said ligament is often the thing causing the nerve or spinal cord compression. Central stenosis is an example of a condition that is most effectively treated with a laminectomy, assuming surgery is needed.

Spinal Fusion

Whenever there is instability because of spinal alignment issues, such as DDD or scoliosis, a spinal fusion tends to be the recommended surgery. Here, a healthy bone graft harvested from your bone or a bone bank is fused with two or more vertebrae. They are then locked in place with metal plates, rods, or screws.

The procedure is a permanent solution that helps to mitigate degenerative problems or correct improper spinal alignments. If you want an idea of how effective this can be, there is a 50 to 70% correction in the spinal curve when such a surgery is complete.

Kyphoplasty/Vertebroplasty

Kyphoplasty and vertebroplasty are common and similar procedures that doctors use to address compression fractures. People end up with a hunch and even excruciating pain whenever vertebrae compress, fracture, and remain untreated. Both osteoporosis and injuries can cause the problem, and either case may reduce your comfort and mobility.

During vertebroplasty or kyphoplasty, a long hollow needle is used to insert bone cement into affected vertebrae. The kyphoplasty tends to be used when this compression is more severe.

In this case, the compressed vertebra gets lifted to a normal height after a balloon is inserted into it and inflated. When the lifting process is complete, the bone cement gets put in. Not only does bone cement improve pain, but it provides strength to the vertebrae and prevents further collapse.

Back Surgery Recovery Time

Back surgery recovery is a vital consideration to people who may need to get a procedure done. While persons want to know how long the surgery is going to run, they also are interested in knowing what the recovery period and process looks like. Are you going to be able to move around on your own? What does this mean for your job? Are you going to be in pain? Are you going to need someone to look after you?

The thing is there is no singular template for back surgery recovery time. Some patients make a full recovery in two to six months, but that still depends on the kind of surgery you do and the condition you had. 

Instead of trying to guess, your best bet is to speak to your orthopedic surgeon to get an idea of the timeline you are looking at.

Spinal Implants and Back Surgery

Where do spinal implants fit into all this? While you may not know what your recovery time is going to look like after back surgery, spinal implants can help you to lessen it by providing the required support. 

Implants are very effective at spine stabilization, strengthening, and even positioning. The result is benefits, such as fusions being more effective and healing happening in an optimal context. Whether you have one of the conditions discussed above or another that requires back surgery, consider spinal implants to reduce the traumatic impact of the procedure.