Back Surgery: When is it a Good Idea?
Back surgery offers a wide variety of advantages that have the potential to change your life completely. There are many different types of procedures to choose from, each of which offers a different approach that can help put an end to chronic back pain. While many advantages come along with each procedure, they all have disadvantages to consider.
The spine consists of 33 individual bones known as vertebrae that interlock. The vertebrae are categorized into five regions:
The primary function of the vertebrae in the lumbar region of the spine is to bear the weight of the body. To support that weight, lumbar vertebrae are larger in size as compared to the other vertebrae.
Intervertebral discs sit between the vertebrae and act as shock absorbers for the spine. They are flat, round, about half an inch thick and are made up of two components—the nucleus pulposus, and the annulus fibrosus. The nucleus has a jelly-like consistency and can be found in the center of the disc. The “jelly” allows the disc to be flexible and strong. The annulus is the flexible outer ring of the disc and consists of several layers. When moving or standing, weight is put on the nucleus, causing it to expand while the annulus holds it in place. Together, the nucleus and annulus allows for movement to take place while simultaneously maintaining the strength of the spine. Many nerve endings supply the annulus and, as a result, an injured annulus can cause pain.
Back surgery can provide more than just a decrease in pain. It is proven back surgery can lead to:
- Better movement.
- Increased physical fitness.
- Improved mood.
- Less pain medication.
- Increased productivity.
While most people who get back surgery experience no complications, any operation has a degree of risk. These risks include:
- A negative reaction to anesthesia or other drugs necessary for the procedure.
- Blood clots.
- Heart attack.
- Herniated disk.
- Nerve damage, resulting in weakness, paralysis, pain, sexual dysfunction, or loss of bowel or bladder control.
Even though most people have no complications, the chances of having complications increase with certain health conditions and the type of surgery. Your Florida Orthopaedic Institute physician will help you determine your risks and if back surgery is the right treatment option for you.
TYPES OF BACK SURGERIES
There are several different types of back surgeries designed to treat a variety of different conditions. These surgeries include:
- Spinal Fusion. This is the most common surgery for back pain. During this procedure, spinal bones, called vertebrae, are joined together. While this limits the motion between them and how far your nerves can stretch, it will typically not limit your activity. There is a chance the bones will not fuse together completely, resulting in the need for another procedure. Luckily, this condition is rare, but the chances are increased in patients who smoke.
- Laminectomy. In this procedure, parts of the bone, bone spurs, or ligaments in the back are removed, relieving pressure on spinal nerves which eases pain and/or weakness. While this may alleviate pain, it can make the spine less stable. Spinal fusion may be required if this occurs.
- Foraminotomy. The bone at the sides of the vertebrae is cut off to widen the space where nerves exit the spine. The extra space can relieve pressure on the nerves and ease pain. Like a laminectomy, this procedure can also decrease stability in the spine, resulting in the need for a spinal fusion.
- Discectomy. Sometimes a disc, the cushion separating the vertebrae, can slide out of place and press on a spinal nerve, resulting in pain. In this procedure, either all or part of the displaced disc is removed. This procedure is sometimes part of a larger one, such as laminectomy, foraminotomy, or spinal fusion.
- Disc replacement. The damaged spinal disk is removed, and an artificial one is inserted between the vertebrae. Unlike spinal fusion, this allows the spine to move normally. While recovery time may be shorter than for a spinal fusion, there is a slight change the new disc could slide out of place and need repair.
- Interlaminar implant. A U-shaped device is implanted between two vertebrae in the lower back which helps keep the space between them open, easing pressure on the spinal nerves. Additionally, this procedure can be done at the same time as a laminectomy. Unlike spinal fusion but similar to disc replacement, the implant provides stability and allows the back to move normally.
Talk to your Florida Orthopaedic Institute physician to decide if back surgery is right for you. All FOI physicians are fellowship trained and up-to-date on the latest back surgery techniques, including minimally invasive back surgery.