Spine Surgery Overview

Spine Surgery Overview

If you have had back pain for awhile, you may wonder if spine surgery is the only thing that may help you. In some cases, spine surgery is the only option. But there's good news. Most back disorders can be helped with treatments that don't involve spine surgery. These are referred to as conservative therapies or non-surgical treatments.

Trauma, aging, improper use of body mechanics and structural abnormalities can all damage your spine. These lead to back pain and other symptoms like pain in your legs or numbness and even weakness in your legs. Chronic back pain may often require a team of professional health care providers to diagnose and treat your condition. Before deciding to have spine surgery, consider obtaining the opinion of a few different spine specialists. The time you invest gathering information will help you make a decision that best supports your desired level of physical activity and lifestyle.

What is the last resort?

As with all non-emergent surgeries, a trial period of conservative treatment should be attempted before spine surgery is considered. Conservative treatment may include interventions like bracing, physical therapy and the use of pain medications, preferably using anti-inflammatory drugs. The length of the trial period of conservative therapy may vary, but from six weeks to six months is a typical time frame.

Your physician may recommend spine surgery if conservative methods like physical therapy and anti-inflammatory medications fail to relieve your symptoms. Surgery is usually only considered when the exact source of the problem can be identified, such as in the case of scoliosis, spinal stenosis or a herniated disc.

Minimally Invasive Surgery

Spine surgery is traditionally performed as "open surgery." This means the operative site is opened with a long incision enabling the surgeon to view and have access to the spine and its various parts. But today's technology allows more spinal conditions to be treated with techniques that are minimally invasive.

Since minimally invasive spine surgery (MISS) does not require the surgeon to make a long incision, the muscles and tissues surrounding the spine do not need to be manually manipulated. This leads to shorter operations, less pain following spine surgery and a quicker recovery.

Imaging During Surgery

During spine surgery procedures, surgeons can view the structures of the spine with much more clarity using computer-assisted image guidance techniques than is possible using traditional techniques. Surgical implants, such as screws and rods can be placed with higher accuracy than is typically possible with conventional surgical techniques.

Using computer-assisted image guidance, pre-operative images are merged with those taken while the patient is undergoing spine surgery. This creates real-time images of the operative site during the procedure. Prior to surgery, computed tomography (CT) images and real-time x-ray are most often used during the procedure as these give surgeons the ability to operate with high levels of safety and precision.

MISS procedures are not appropriate for every patient. The surgeon needs to be relatively certain that the same or even better results will be achieved if MISS techniques are used as would be possible with open spine surgery.

Surgical Approaches

The spine can be accessed by the surgeon using different approaches, whether a minimally invasive procedure or a tradition spine surgery is being performed. The various approaches include:

  • Anterior approach: In this approach, the spine is accessed through the abdomen or the front side of the body
  • Posterior approach: In this approach, the surgeon gains access to the spine through the back
  • Lateral approach: In this approach, the surgeon accesses the spine through the side of the body

Common Surgical Procedures

Many different conditions can lead to the need to have spine surgery. Different spinal procedures include:

  • Discectomy or Micro-discectomy: This procedure is commonly performed to remove a herniated disc in order to relieve pressure from a spinal nerve. A Micro-discectomy is a minimally invasive spine surgery procedure.
  • Laminectomy: This procedure relieves pressure on the spinal cord or nerves by making more room in the spinal canal. It is the removal of the lamina, which is the bony plate-like arch on the back of a vertebra.
  • Laminotomy: This is similar to a laminectomy, but only a portion of the lamina is removed in this spine surgery.

Decompression procedures take pressure off a spinal nerve. The laminotomy and laminectomy are both decompression spine surgery.

  • Foraminotomy: This procedure is also decompressive. It removes bone or other tissues from the passage where the nerves exit the spinal column to provide more room.
  • Disc replacement: In this spine surgery, a disc that has been injured is replaced with an artificial disc.
  • Spinal fusion: This is a procedure in which two bones of the spinal column are joined together to form one long piece of bone. It may involve the use of instrumentation, for example, surgical screws and plates or rods. A bone graft is placed where an injured disc is removed and the fusion is accomplished using different approaches:

The following spine surgeries are all related to fusion of the lumbar spine to add stability to the spine of the lower part of the back. They eliminate movement between the vertebrae:

  • ALIF: Anterior Lumbar Interbody Fusion
  • PLIF: Posterior Lumbar Interbody Fusion
  • TLIF: Transforaminal Lumbar Interbody Fusion. This procedure is done approaching the vertebrae through the foramen.
  • LIF: Lateral Interbody Fusion. This is minimally invasive spine surgery.

Spinal Instrumentation

Spinal instrumentation involves the use of bone screws, plates, interbody devices, and rods as examples, but there are other types of surgical devices a surgeon may recommend using in specific types of disorders. The goal of instrumentation performed during spine surgery is to provide stability for the spine until fusion is complete.

  • An interbody cage: This prosthetic device is left in the body following spinal decompression surgery to maintain the height of the space between two adjacent vertebrae.
  • Interspinous process devices (ISP): These devices take the load off of the vertebral joints, maintain the height of the space between the vertebrae, and make the spine more stable. They are used in minimally invasive spinal surgeries because they do not require a large incision be made in order to insert them.
  • Pedicle screws: These are used in spine surgery with instrumentation to provide stabilization for the vertebrae until they fuse together.

If spine surgery recovery is your only treatment choice, minimally invasive spine surgery has multiple benefits. Patients who are still young and active, as well as those who are elderly or have major problems with their spine many times reach a higher level of functioning after their symptoms are relieved.

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Questions & Answers
Q:
What is the best way to treat permanent back and neck pain and stiffness?
A:

Here are some tips:

Neck Pain Tips: Sleep with a cervical pillow

Orthopedic or cervical pillows are made with special contours to support the space beneath the neck and head. They are also more concave for the head and provide more support to the neck.

Neck Pain Tips: Sleep on your back

The best position to lie to sleep is on your back. If you sleep on your stomach or on your side, make sure your pillow is not too thick. It should raise your head no more than 4 to 6 inches. This will keep your neck and head from turning to either side.

Neck Pain Tips: Position your computer screen at eye level

While you are working at a computer, sit comfortably in your chair with your computer in front of you. Close your eyes and then open them. When you open your eyes, you should see the middle of the computer screen. If your gaze is not in the middle of the screen, adjust the height of the screen using items like books.

To keep your head from gradually drifting forward, take frequent breaks to stretch. Getting up to walk around at least once every half-hour is one of the best neck pain tips.

Neck Pain Tips: Use a telephone headset

Never hold a phone between your shoulder and your ear. Use a headset or other hands-free system to talk on the phone and avoid abusing your neck and spine.

Neck Pain Tips: Exercise your neck muscles

One of the best neck pain tips is using the chin tuck. You can do this often throughout the day. In addition to helping strengthen the muscles that hold the head in alignment over the shoulders, it also helps strengthen the scalene and sub-occipital muscles.

Read more tips here: Neck Pain Tips: Sleeping, Posture, Exercising, Hydration & Prevention

Read more
Temed Holdings
4 answers
Q:
What is the best treatment for neck pain and shoulder Pain?
A:

One of the best treatment for neck pain and shoulder pain is exercises:

Neck Pain Exercises: Neck Extension

  1. To begin this neck pain exercise, sit up straight in a chair with your feet flat on the floor.
  2. Looking straight ahead, tuck your chin slightly (starting position)
  3. Place the palm of your hand on the back of your neck, at the base of your head
  4. Apply slight forward pressure with your hand, while resisting the forward motion of your neck and head
  5. Hold for a count of 5 and return to the starting position and relax
  6. Repeat the neck pain exercises 5-10 times

Neck pain exercises: Side bend

  1. Sit up straight in a chair with your feet flat on the floor.
  2. Looking straight ahead, tuck your chin slightly (starting position)
  3. Place your left hand, palm down, on the left side of your head (around your ear)
  4. Slightly push your head to the right side with your hand, while resisting the sideways motion of your neck and head
  5. Hold for a count of 5 and return to the starting position and relax.
  6. Repeat 5-10 times
  7. Repeat the neck pain exercises with the other side.

Neck pain exercises: Neck flexion

  1. Sit up straight in a chair with your feet flat on the floor.
  2. Looking straight ahead, tuck your chin slightly (starting position)
  3. Place the tips of your fingers on your forehead
  4. Slightly push your head backward with your fingers, while resisting the backward motion of your neck and head
  5. Hold for a count of 5 and return to the starting position and relax.
  6. Repeat the neck pain exercises 5-10 times

More exercises here: Neck Pain Exercises

Read more
Temed Holdings
4 answers
Q:
How do I reduce the shoulder and neck pain?
A:

Here are some tips:

Neck Pain Tips: Sleep with a cervical pillow

Orthopedic or cervical pillows are made with special contours to support the space beneath the neck and head. They are also more concave for the head and provide more support to the neck.

Neck Pain Tips: Sleep on your back

The best position to lie to sleep is on your back. If you sleep on your stomach or on your side, make sure your pillow is not too thick. It should raise your head no more than 4 to 6 inches. This will keep your neck and head from turning to either side.

Neck Pain Tips: Position your computer screen at eye level

While you are working at a computer, sit comfortably in your chair with your computer in front of you. Close your eyes and then open them. When you open your eyes, you should see the middle of the computer screen. If your gaze is not in the middle of the screen, adjust the height of the screen using items like books.

To keep your head from gradually drifting forward, take frequent breaks to stretch. Getting up to walk around at least once every half-hour is one of the best neck pain tips.

Neck Pain Tips: Carry weight evenly

Many people make the mistake of carrying a heavy briefcase or their purse on their shoulder or on one side of their body. Doing this causes strain in the muscles and leads to pain.

Remove non-essentials from your briefcase or purse. Consider using a backpack to evenly distribute the weight across your shoulders. If you choose to carry a purse or backpack, keep your shoulders level while carrying it.

Neck Pain Tips: Maintain a proper posture

The most common posture contributing to neck pain is the “head-and-shoulders-forward” posture. In this position, the neck slopes forward, putting the head in front of the shoulders.

In this position, the head pulls the upper back forward also in a slumped position. This places a strain on the entire spinal column.

More tips here: Neck Pain Tips: Sleeping, Posture, Exercising, Hydration & Prevention

Read more
Temed Holdings
4 answers