Most pain in the lower back can be treated without surgery. Nonetheless, there are times when back surgery is the most viable option to treat serious musculoskeletal injuries or nerve compression. A pain management specialist can help you decide whether surgery is an appropriate choice after making sure you have exhausted all other options.
How Do You Know When You Need Spine Surgery?
When someone is experiencing extreme symptoms, we at Ventura Orthopedic almost always suggest they first get an evaluation with their primary care physician. If the patient is experiencing low back pain or neck pain, we will usually watch them over time and encourage them to maintain good, stable physical activity to see if the issue resolves on its own. If the issue is not resolving with physical activity, over the counter treatments, or pain management and anti-inflammatory medication, the next step would be to see a doctor for an evaluation.
Many patients with spinal pain or injury can be treated non-surgically. Physical therapy, home exercises, medication and oftentimes spinal injections are recommended prior to considering surgery. The next step would be surgery if these treatment options do not do the trick.
A surgery may be the recommended course of action if:
- All non-operative treatment options have been exhausted, including physical therapy, injections, acupuncture, massage, and all other non-surgical treatments your physician has recommended.
- Your symptoms match medical findings such as physical exam, x-rays, or MRI.
- You have a treatable deformity such as degenerative scoliosis.
- You are in relatively good health, meaning you are not overweight, do not smoke, or have any conditions that put you at greater risk of complications or poor recovery.
- The pros outweigh the cons.
4 Main Types of Back Surgery
Here are the 4 main types of back surgery. Under each of these surgery umbrellas, there are many variations to treat the individual patient.
- Spinal Fusion
- Vertebroplasty/ Kyphoplasty
A discectomy (sometimes called a microdiscectomy, percutaneous discectomy, lumbar discectomy, herniated disc surgery, decompression surgery) is performed to relieve pain caused by pressure on the nerve root or spinal cord, often the result of a herniated disc. A discectomy involves removing the portion of the disc that has caused damage and is putting pressure on the spinal cord or nerves.
In this procedure, no material is used to replace the removed disc tissue. In certain cases, a discectomy can be performed arthroscopically, which is a minimally invasive procedure.
A discectomy can be performed on various parts of the spine. For instance, a lumbar discectomy is performed to remove the herniated portion of the lumbar disc (lower back).
A discectomy is performed to:
- Address leg and/or buttock pain caused by nerve compression from a herniated/ ruptured disc
- Treat leg weakness, numbness
- Relieve pressure on the spinal nerves or cord
A laminectomy is a type of back surgery used to relieve compression on the spinal cord. During the procedure, your doctor will remove the lamina. The lamina is part of the bone that forms the vertebral arch in the spine. Your doctor will also remove bone spurs. These structures can put pressure on the spinal cord or nerve roots.
A laminectomy is performed to:
- Gain access to a herniated/ ruptured disc in the spine (like sciatica)
- Remove bone spurs also known as osteophytes (“spondylosis deformans”)
- Address back pain caused by nerve damage
- Treat numbness and leg pain
- Relieve pressure on the spinal nerves
- Remove a tumor from the spine
3. Spinal Fusion
Spine fusions are used to treat injuries to the vertebra, protrusion and degeneration of the disk between the vertebra, abnormal curvatures of the spine and weakness or instability of the spine caused by infections or tumors. This procedure stops motion at the painful vertebral segments, decreasing pain in that joint. Spinal fusion permanently connects two or more vertebrae to strengthen and stabilize that segment of the spine, and it reduces or eliminates pain that is emanating from that part of the spine.
This procedure eliminates movement between the damaged vertebrae. However, because the surgery usually focuses on a very small section of the spine, any loss in range of motion is minimal. Plates, rods, and other tiny tools may be used to enable the vertebrae to naturally fuse together as it heals.
A spinal fusion is performed to:
- Reduce spinal curve deformity by straightening or aligning the spine
- Treat scoliosis, spondylolisthesis, spondylosis, spinal stenosis, spinal disc herniation, fractures, infection and tumors.
- Treat side effects like moderate-severe back pain, mobility issues, breathing issues etc.
- Degenerative disc disease
4. Vertebroplasty/ Kyphoplasty
Vertebroplasty and kyphoplasty are minimally invasive spine procedures designed to treat the pain and other symptoms of vertebral compression fractures. Vertebral compression fractures (compression fractures of the spine) most often are caused by osteoporosis, which is a weakening of the bones.
The procedures are almost always done on an outpatient basis. Patients are numbed with local anesthetic, and conscious sedation is used to keep the patient relaxed and comfortable. The bone cement strengthens the vertebrae, helps prevents further collapse, and improves pain.
A vertebroplasty and kyphoplasty are performed to:
- Treat vertebral compression fractures (VCF) of the spine.
- Prevent future osteoporotic fracture or collapse (which are common after an initial fracture)
- Improve osteoporosis (calcium broken down in bones)
- Biopsy tumors or cancer in bone.
What are the risks of back surgery?
Back surgery can carry higher risks than some other types of surgery because it is done closer to the nervous system. The most serious of these risks include paralysis and infections.
Even with a successful surgery, the recovery time can be long. Depending on the type of surgery and your condition before the surgery, healing may take months. And you may lose some flexibility permanently.
How Can I Get Started?
The experienced and dedicated orthopedic surgeons at Ventura Orthopedics are here for you. If you need spinal or back surgery, it may be time to consult a medical professional. The experienced and dedicated orthopedic surgeons at Ventura Orthopedics are here for you. We are committed to helping you through any procedure until optimum health, strength and mobility are restored.
Call us today at 800-698-1280 to schedule an appointment.