How is a diagnosis conducted before spine surgery?
The doctor conducts a physical examination to assess the spinal issues. S/he may ask you a few questions to understand the condition better. Commonly asked questions may include:
Do you have any pain in your back or neck?
Did you suffer any injury on your back or had to undergo any surgery on your neck or back?
Do you feel weakness and balance loss in your legs?
Once the physical examination is done, some diagnostic tests are also recommended to get a clear image of the spinal abnormality. The following are diagnostic tests that are commonly recommended-
X-ray: X-rays can help study the structural anatomy of the hard tissues of the spine to diagnose spine dislocation, kyphosis, scoliosis, bone spurs, disc space narrowing, vertebral body fracture, spinal collapse, or erosion.;
Magnetic resonance (MR) imaging: MRIs help diagnose aberrations of the soft tissue components of the spine, such as the spinal cord and nerves.;
Computed tomography (CT) scan: CT scans provide a detailed view of both hard and soft tissues of the spine to diagnose abnormalities of the vertebrae, spinal cord, spinal nerves, and other soft and hard tissues.
How to prepare for spine surgery?
Preparation before a spine surgery includes both physical and psychological aspects. Depending upon the condition of the injury, the doctor is likely to guide the patient with everything necessary. However, here are a few points that may come in handy for anyone planning spine surgery.
Gather all necessary information about spine surgery The key to preparation for any surgery is being well informed about it. Talk to the doctor, and the medical staff, and acquire all important information about the procedure, medicines, the cost, and anything else that comes to your mind. The more well-informed a person is about the surgery, the better he/ she is likely to do postoperatively.
Don’t stop moving We understand it is tough to live with constant back pain. Even then, it is recommended to be physically active as much as possible. Going stagnant may add to complications during the surgery. Stay physically active, and try to achieve a healthy weight. This can speed up the recovery process and enhance blood circulation too.
Don’t take any anti-inflammatory drugs – You should stop taking drugs like ibuprofen, naproxen, and aspirin before the surgery. Blood thinners can increase the risk of complications during the surgery. If you are taking any over-the-counter pills, it is essential that you inform your doctor.
Keep realistic expectations – Don’t expect the surgery to fix everything. The surgery is not a guaranteed cure for the condition. Although it improves the injury symptoms to a great extent, a lot also depends on the person’s dietary and lifestyle habits too.
What can you expect during endoscopic spine surgery?
Endoscopic spine surgery is a medically-advanced, minimally invasive spine surgery designed to provide the patient with a quicker recovery time and less recurring pain compared to any traditional spine surgery methods.
Almost all kinds of endoscopic spine surgeries are performed using general anesthesia. This is considered to decrease any medical risks in patients who are older or who have any co-existing medical disorders. During endoscopic spine surgery, the doctor makes a small incision of approximately ¼ inch, guides a spinal needle, and inserts a guided wire through it. A metal dilator and a cannula are guided to the spinal disc. The doctor removes the wire and the dilator once the surgical portal is established. Through the endoscope, the doctor places micro-instruments to decompress the affected spinal nerves. The doctor then targets and resects the bone spurs and the herniated disc with precision.
After the surgery, the doctor injects a steroid medicine at the spinal area to relieve the patient of post-operative pain and discomfort. The cannula and the scope are then removed. Following this, the patient is moved to the recovery ward and monitored for a day
When is spine surgery required?
It is difficult to pinpoint the exact reason behind spine surgery, however, the most common causes are back and cervical pain. The pain can result from a variety of degenerative bone and muscle conditions. The following are a few reasons for which an orthopedic surgeon may recommend spine surgery-
Degenerative disk disease, like spinal arthritis, spinal stenosis
Herniated disc with associated complications like sciatica
Spinal instability
Bone spurs and tumors
Scoliosis
Benefits of Minimally Invasive Spine Surgery (MISS)
Advanced and minimally invasive surgery is a faster and safer surgical approach as opposed to conventional spine surgery. The method reduces the extent of trauma that might be caused to the muscles and soft tissues. The common benefits of minimally invasive spine surgery are:
Less blood loss during the surgery
Better and finer cosmetic results because of reduced skin infections
Reduced risk of muscle damage since no cutting of muscle is involved in the procedure
Reduced risk of infection
Reduced postoperative pain
Ensures a faster recovery and shorter rehabilitation period
Lower reliance on medicines after the surgery
What to do during recovery after spine surgery?
Once you are home from the surgical center, it is time to focus on your recovery. Allowing the spine to heal properly, taking ample rest, and eating healthy foods are the keys. The best advice, however, is to follow the after-care tips by the spine surgeon for a speedy and safe recovery.
Take good care of the spine. Begin with short walks and gradually increase the distance and time. Moderate exercise enhances muscle toning and builds strength. Avoid twisting, lifting, and bending. If you have had a spinal fusion, avoid lifting weights.
Eat a well-balanced diet rich in fruits and vegetables. Since you will be less active physically, do not load the body on high calories and fatty foods. Healthy eating is crucial for smooth recovery.
Follow the advice of the doctor for bathing and incision care. . Typically, doctors recommend keeping the surgery site clean and dry for 3-4 days. Avoid getting into the bathtub or the swimming pool until the doctor deems fit.
Take medicines for pain management after the surgery as directed by the doctor and make sure there are no gaps. Do not take any medicine without informing your doctor.
\Wear a post-operative braceif the surgeon prescribes one. The brace provides support to the neck and back and limits movements of the spinal levels.
Ask your surgeon what is thebest position to sleepin without hurting the back, and try to follow it. Ideally, the following tips help relieve the stress from the back and the adjacent body parts.
– Place a pillow under the knees or the back to keep the hips slightly bent.
Don’t get up suddenly from the bed. Use the ‘log roll method.’
– While getting up, push your arms and legs rather than exerting pressure on the waist or back.
Ask your doctor if you may require physical therapy after the surgical treatment. Physiotherapy helps gain and build bone and muscle strength, and increase physical endurance. Ask your doctor if you need to include any form of exercise in the recovery regime.
The post-operative routine you adopt as part of your recovery from spine surgery can help prevent future or additional spine/health-related problems. So, it is important to maintain an active life, practice exercising, eat well, and get plenty of rest to stay on that recovery road for a long time!
Are there any long-term complications involved in spine surgery?
Minimally invasive spine surgeries are typically safe. However, as spine surgeries are major, there are some complications associated with them. Spinal fusion surgery and laminectomy are among the most commonly performed MISS surgeries.
However, some complications that often associated with these surgeries are:
Non-union of the spinal bones that were fused together;
Implants breaking due to excessive forces on the spine;
Spinal instability and pain due to implant screws loosening;
Injury and degeneration to the facet joints ;
Spinal muscle injury
Types of Spine Surgery
Spinal laminectomy/ spinal decompression
It is generally performed for spinal stenosis patients. The surgeon removes bony spurs or walls compressing the spinal column to relieve the nerve pressure.
Vertebroplasty/Kyphoplasty
Vertebroplasty and kyphoplasty are performed to fix compression fractures due to osteoporosis. The surgeon injects a glue-like bone cement that hardens and strengthens the vertebrae.
Discectomy (or Microdiscectomy)
It is a slipped disc surgery that is performed to remove a herniated disc compressing the nerve root and spinal cord. It is often performed in conjunction with laminectomy.
Foraminotomy
This is performed to widen the spinal column where the nerve root exits the spinal canal in case it has narrowed due to aging.
Nucleoplasty
Nucleoplasty, also called plasma disk decompression is a minimally invasive laser surgery in which the surgeon uses a plasma laser device to reduce the disk size and treat mild disk hernia.
Spinal fusion
The surgeon removes the spinal disc and fuses the adjacent vertebrae together using bone grafts or metal implants to allow the fusion of vertebrae together via the bone grafts, for example, ACDF surgery (Anterior cervical discectomy and fusion), TLIF surgery (Transforaminal Lumbar Interbody Fusion).
Artificial disk replacement
For people with severely damaged vertebral discs, the surgeon removes the disc and replaces it with a synthetic implant to help restore vertebral height and movement.
