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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 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.
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.
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.
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 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.
What is spinal fusion surgery?
Spinal fusion surgery is a medical procedure whereby two or more spinal vertebrae are fused together so that they can heal and become one single bone. This procedure eliminates motion between the two vertebrae and prevents the stretching of nerves and surrounding ligamen.
It involves the use of a bone graft that is cut out from a patient’s pelvis or alternatively a synthetic bone graft is used. 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 deformities.
How long does it take to recover from the surgery?
Usually, it takes about 4 to 6 months to recover from the surgery. Although the healing process of all individuals differs and there are several factors that can influence recovery. Diets, weight, age, and the lifestyle of the patient go a long way in determining how fast the patient would recover from the surgery.
Patients are advised to undergo several physical therapy activities (such as rehabilitation), avoid strenuous activities, and maintain a very healthy diet after the surgery to enhance the recovery process.
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 at 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.
5 tips that could help you avoid spinal fusion surgery and relieve you of your back pain
It is best to avoid spinal fusion surgery and there are a few alternatives to it. The decision to consider spinal surgery should always come after trying non-surgical options.
Some medical alternatives to spinal fusion surgery, intradiscal electrothermal coagulation (or annuloplasty), disc replacement surgery which involves replacing the painful disc in the spine with an artificial disc, posterior dynamic stabilization, and disc regeneration.
It is widely perceived that undergoing spinal fusion surgery when you are young can lead to further health problems in your spine areas as you grow older. This is because undergoing a spinal fusion surgery may be correlated with experiencing accelerated degeneration of the joints above or below the area where the fusion took place as earlier stated.
This implies that the longer you live after undergoing spinal fusion surgery, the higher your chances are to experience related health problems in the future.
Undergoing this surgery can also lead to other health issues such as suffering from chronic pain of the neck or back. There is also the rare possibility that another joint will require an operation and trigger the same negative physical response in the next joint as well, creating a domino effect that can leave a person in a great deal of pain.
Overall, it is more advisable to avoid spinal fusion surgery and opt for safer options. These alternatives can lead to you getting better care, relieving your back pain, and having a better quality of life.
Get in touch with a medical professional and discuss your options today. Health is wealth!