Many questions might arise when it comes to spine surgery such as – Is surgery
compulsory to treat the problem or conventional treatment be more appropriate?
If surgery is necessary, which is better one – traditional spine surgery or keyhole surgery (minimally invasive spine surgery)? Back surgery can help to treat spine problems and relieve from back pain, but surgery is rarely necessary. Most back pain problems resolve on its own or can be treated with conventional treatments.
When Do You Need Spine Surgery?
When a person suffering from symptoms associated with spine problems, first
they need to get evaluated with a primary care physician. In case of back pain or
neck pain, a spine doctor would suggest them to maintain stable physical
activity, proper weight and diet to see if the issue resolved. If the problem
persists physical therapy, OTC medicines or anti-inflammatory medication is the
next step of treatment suggested by a doctor.
Patients who are suffering from spine problems are treated initially to manage symptoms as your body may fix naturally. If they don’t settle, then surgery will be a good option. The type surgery depends on the spine problem you are experiencing.
In open spine surgery, a large incision is made and involves the complete
exposure of the anatomy to treat the damaged area. In minimally invasive spine
surgery, smaller incisions and tiny surgical instruments used to treat the
damaged part of the spine. Whether it is minimally invasive surgery or traditional surgery, the goal is to see an overall improvement in symptoms or to halt the degeneration.
Types of Spine Surgery Procedures
There are various types of spinal procedures that are meant to treat severe spinal conditions surgically.
Decompression procedures intended to relieve symptoms caused by pressure or to decompress the compressed spinal cord or nerve roots. Bulging discs, thickening of joints, loose ligaments, and new bone growth can narrow space of the spinal canal and the spinal nerve openings, causing pain. In severe conditions, the pressure created on spinal nerves can lead to paralysis and problems related to bladder or bowel movements.
Some of the Spinal decompression procedures such as laminotomy or laminectomy, foraminotomy or foraminectomy, osteophyte removal and corpectomy help to relieve pressure on the nerve roots. These procedures are successful in reducing pain by about 80% to 90% of patients.
Only Fixation (spinal instrumentation) Procedures
This is a procedure where various types of devices or implants are used during spine surgery. This surgical procedure involves implanting titanium or titanium-alloy, steel or non-metallic devices in the spine. There are different types of medical implants specifically designed to treat spinal disorders in people of all ages. Spinal instrumentation procedure cannot provide a permanent solution to spinal instability unless spinal fusion is also done along with this. Stand-alone spinal instrumentation without spinal fusion is rarely done in practice.
Spinal Fusion Procedures
Spinal fusion is a procedure used to fuse two bones with the help of a bone graft to grow the bony surfaces together. Medically spinal fusion is called arthrodesis. A bone graft is taken from the patient called autologous or from others called allograft bone during the primary surgical procedure. Bone morphogenetic protein (BMP) is being used in some foreign centres instead of bone graft.
It is still under evaluation. Spinal instrumentation is a useful adjunct and often accompanied by the spinal instrumentation and is discussed below.
Both Spinal Fusion And Spinal Instrumentation Combined
Successful correction of spinal deformities often requires spinal fusion along with spinal instrumentation. The instrumentation provides stability and helps to maintain the correction during the fusion of bones. Internal fixation of devices in the spine increases the rate of solid arthrodesis. Without successful spinal fusion, the mechanical devices induced in the spine fail due to repeated stress. The first spinal fusion was performed successfully in 1911, and initially, the spinal instrumentation procedure was developed to decrease the rate of pseudarthrosis after spinal fusion.
Spinal Correction Procedures For Deformities Like Kyphosis And Scoliosis
A deformity is simply a change in the structure of the spine when compared to the standard shape. A spinal deformity may develop due to any condition causing curvature and twisting of the spine — however, various procedures designed to correct moderate to severe spinal deformities. The main procedures of deformity correction include – osteotomy, vertebral column resection, pedicle subtraction osteotomy, and spinopelvic fixation. These procedures vary from person to person based on the volume of correction they provide.
Osteotomy is a procedure involve removing some bone from the deformed vertebral column. It is performed at various levels, and about 10-20 degrees of correction is made at each level. Therefore osteotomy is often used to correct the long curves of kyphosis or ankylosing spondylitis conditions.
The pedicle subtraction osteotomy is similar to the osteotomy procedure. It is primarily used to treat the cases of ankylosing spondylitis, flatback syndrome, angular kyphosis and some C-shaped scoliosis.
The vertebral column resection (VCR) involves correction and stabilization by removing the entire vertebra. This is a more complex operation needing more expertise and experience.The vertebra is restored with bone grafts, and other implants called cages. A system of screws and rods implanted in the spine restores stability while healing the bone graft. This procedure can provide nearly a correction of 80 degrees or more.
These are done in all the regions of the spine (cervical, thoracic, lumbosacral) for various congenital, infective, inflammatory, Post Traumatic, Neoplastic and degenerative conditions if you or an individual is known to you suffering spinal deformities or any other spinal conditions consult Dr Surya Prakash, one of the best spine doctors in Hyderabad.