Back Surgery Types

The Latest Advances in Spine Surgery

New Technology and Instrumentation

Multiple Spine Surgeries

Spine Surgery Recovery

There is a lot to think about when you have exhausted every other treatment and the time has come for surgery to relieve your back pain. The best part is that it can sometimes provide you with very fast relief from the pain you’ve been suffering. Recovery time can be significant, however, and there are cases when it doesn’t work and more than one operation may be required. But there have been some remarkable advances in back surgery techniques, not to mention new technologies involved.

Some of the reasons that back surgery may be required are talked about in the chapter called Back Problems & Surgery .

Back Surgery Types

The type of surgery performed to relieve back pain depends on the cause of that pain. See the chapter called Back and Neck Pain Causes for a description of many common causes of pain that can be helped with surgery.

· Discectomy – A discectomy is most commonly performed to remove the part of a herniated disc that is putting pressure on a nerve and causing pain. The part of the disc that is not damaged is left in tact to act as a shock absorber for the spine. This type of surgery requires general anesthesia and a three-inch incision.

· Microdiscectomy – This is a type of discectomy that can be performed with the aid of a microscope. If the herniation is in a certain area, only a small incision may be required through which the spine surgeon can pick out the portion of the disc that is herniated. However, quite often this part of the disc is hidden from view by the vertebrae and this type of surgery isn’t possible.

· Percutaneous Discectomy – This type of surgery to remove the herniated piece of a disc is even less invasive than a microdiscectomy. This is a relatively new procedure and is discussed in more detail in the chapter called “The Latest Advances in Spine Surgery”.

· Vertebroplasty – This surgery is used to stabilize fractured and compressed vertebrae and relieve the pain. A special type of bone cement is injected into the affected vertebra. Vertebroplasty is a fairly new procedure and is discussed in more detail in the chapter called “The Latest Advances in Spine Surgery”.

· Laminectomy – This surgical procedure is performed to relieve spinal stenosis. It removes the part of the bone in the spinal canal that is putting pressure on the nerve by widening the opening.

· Spinal Fusion – Spinal fusion is used to relieve pain caused by the motion between vertebrae that may be caused by an injured disc or one that is degenerated. It is also used to connect two bones in the spine and to stabilize a spinal break.

· Artificial Discs – Another way besides spinal fusion to relieve pain from movement between vertebrae is to implant artificial discs. This up and coming technology will be discussed further in the chapter called Fusion Alternative – The Artificial Disc .

· Spinal Implants – The practice of spinal implants and its advancements are discussed in “The Latest Advances in Spine Surgery” and “New Technology and Instrumentation”.

The Latest Advances in Spine Surgery

Because of advancements made in spinal surgery, surgeons are able to more effectively treat spinal disorders. Some of these advancements are:

· Treatment of spinal fractures – The best way to treat unstable spinal injuries like burst fractures and fracture dislocations is to stabilize them as soon as possible. When these fractures occur in the lumbar segment of the spine, new developments in vertebroplasty are being used, especially for wedged compression fractures since these are the most common spinal fractures. A wedge compression fracture means that the vertebra has been crushed or wedged leaving spaces within the bone.

Verterbroplasty is used to correct this type of injury. While the patient is under local anesthesia and light sedation, a needle is guided into the vertebra that is fractured with the guidance of an x-ray. Once the needle is in place an acrylic bone cement made especially for this type of procedure is injected into the vertebra. The cement fills those spaces in the bone caused by the fracture and the needle is then removed.

Within 10 minutes the cement hardens, holding the bone fragments together, thus stabilizing the bone.

· Treatment of herniated discs – One of the newer methods of removing the herniated disc material that is pressing on the nerve or the spinal cord is called percutaneous microdiscectomy. It is sometimes referred to as “band-aid” back surgery because the incision is only one-half inch long and can be covered with a band-aid when the surgery is over.

This type of procedure is known as endoscopy and there are several different ways to perform percutaneous procedures. They each involve the insertion of small instruments between the vertebrae and into the center of the injured disc. X-rays are used to monitor the surgery and guide the surgeon’s movements of the instruments being inserted into the disc. Once the instruments have reached the damaged disc material, the surgeon has the option to cut the material out, suck it through the center of the disc, or to use lasers to evaporate or burn the disc material.

· Spinal Implants – This is a technique that is gaining popularity for getting rid of back pain. But because the surgeries are quite intricate and the fact that a lot of muscle tissue needs to be cut to insert the implant, this is usually considered one of the last option. Recovery time can be quite long and painful, sometimes longer than 6 months.

Spinal implant procedures are based on the normal spine surgery techniques, but the new spinal implant procedure can offer a permanent solution to your chronic back pain. The devices used in spinal implants are made to keep normal function and flexibility in the spine.

Spinal implant devices are discussed further in the next chapter called “New Technology and Instrumentation”.

New Technology and Instrumentation

The goal these days is to come up with minimally invasive procedures for spinal surgery. These means small skin incisions that cut down on the possibility of damaging large muscles when they are retracted. The idea is to leave the body as close to the way it was before the procedure. Examples of these procedures are microdiscectomy and vertebroplasty, which are described in the “Types of Back Surgery”.

With these procedures, surgeons hope to make recovery time quicker, reduce post-operative pain, and to leave behind a small, unobtrusive scar.

Some of these procedures involve implanting instruments in the spine like screws and rods to stabilize it. As part of the less invasive techniques used to do this, surgeons use computer-assisted image guidance making it easy for them to “see” the spine without making a large incision. The x-ray machine used to do this is called a fluoroscope and it has been combined with computer technology that helps the surgeon locate and navigate to the part of the spine to be worked on. The technology is called FlouroNav Virtual Fluoroscopy System.

With the help of the FlouroNav system, doctors can use a variety of different devices in the spine to reduce pain. Some of these are:

· Pedicle screws and rods – The pedicle is a part of the vertebral bone that is very strong and it connects the front part of the spine to the back of the spine. The spine has a pedicle bone on each side. Implanting a screw into the pedicle bone stabilizes the spine.

Screws of all sizes are used and are called pedicle screws. When these screws are attached in several different locations along the spine, a rod can then be inserted that connects them all together on each side of the vertebrae. This gives quite a bit more strength to the spine.

· One of the more popular pedicle screws is made of titanium. It has a rotating head so that it can accommodate different conditions and positions in the anatomy. It is known as a polyaxial. A new instrument called a SEXTANT is used to place the screws and rods straight through the skin, fat, muscle, and right into the bone without long incisions. The screws are implanted with damaging or the connections of tendon and muscles to bone. Then the rod is passed through the path formed by the SEXTANT directly into the heads of each screw.

Multiple Spine Surgeries

Unfortunately, some people end up enduring more than one spine surgery. More often than not this occurs because of technical problems during the surgery rather than a recurrence of the original injury. An example of this is the microdiscectomy and percutaneous discectomy that were discussed in the chapter called Types of Back Surgery.

With discectomies using either one of these methods it is often difficult to actually observe and get to the portion of the disc that is herniated. This can lead to an unsuccessful discectomy, making it necessary to perform another surgery.

Recovery after Spine Surgery

No matter which of the surgical options you have had performed to ease your back pain, a period of recovery will be required for your body to heal the damaged tissues and get you back to normal. There will be pain and recover will take time, so a positive attitude can be a big help during this period. Here are some things to keep in mind about recovering from back surgery.

Take Your Time

Follow your doctor’s instructions explicitly and don’t try to rush things. If you push yourself beyond what the doctor recommends, you are more likely to cause a setback.

A lot of time should be spent resting while the pain from the surgery decreases. If you start to feel more energy and are able to be more active, that’s a great sign that your recovery is progressing.

Determining the time it takes to recover is not an exact science. It is different for everyone, depending on things like age and what type of physical condition the patient was in before the surgery. Simple things like a good attitude, healthy diet, and lots of rest really do work to shorten recovery time.

Pain After Surgery

Some pain after spine surgery is natural. The surgery can cause achiness because of an inflammation or muscle spasms. There is likely to be pain at the incision site for a while after surgery. Your doctor will likely prescribe medication for the pain and something to stop the muscle spasms. Eventually, you should begin to cut back on the pills you take and start using light exercise, moist heat, and massage.

Post-Operative Recovery in the Hospital

Generally, patients remain in the hospital for two days after back surgery unless it has been a less invasive procedure. The hospital staff will have you up and walking within a few hours after the procedure. This is not like the old days when bed rest was considered the best cure.

Return To Back Pain Complete Guide