If you’ve struggled with back pain for any length of time, you may be wondering if spine surgery is your only treatment option
Spine
Surgery Overview
Sometimes, surgery is the only
treatment. However, there’s good news. The vast majority of back problems can
be remedied with non-surgical treatments—often referred to as non-surgical or
conservative therapies.
Aging,
improper body mechanics, trauma and structural abnormalities can injure your
spine, leading to back pain and other symptoms such as leg pain and/or numbness
or even leg weakness. Chronic back pain is a condition that generally requires
a team of health professionals to diagnose and treat. Before resigning yourself
to surgery, consider getting opinions from several spine specialists. This
investment of time and information-gathering will help you make an informed
treatment decision that will best support your lifestyle and desired level of
physical activity.
What
about conservative non-surigcal treatment?
As
with all non-emergency spinal surgeries, a trial of non-operative treatment,
such as physical therapy, pain medication—preferably an anti-inflammatory, or
bracing should be observed before surgery is considered. The trial period of
conservative treatment varies, but six weeks to six months is the general
timeframe.
Spine
surgery may be recommended if non-surgical treatment such as medications and
physical therapy fails to relieve symptoms. Surgery is only considered in cases
where the exact source of pain can be determined—such as a herniated disc,
scoliosis, or spinal stenosis.
Open
surgery vs. minimally invasive spinal surgery
Traditionally,
spine surgery is usually performed as open surgery. This entails opening the
operative site with a long incision so the surgeon can view and access the
spinal anatomy. However, technology has advanced to the point where more spine
conditions can be treated with minimally invasive techniques.
Because
minimally invasive spine surgery (MISS), does not involve long incisions, open
manipulation of the muscles and tissue surrounding the spine is avoided,
therefore, leading to shorter operative time. In general, reducing
intraoperative (during surgery) manipulation of soft tissues results in less
postoperative pain and a faster recovery.
Imaging
during spine surgery
Computer-assisted
image guidance allows surgeons to view the operative site in far finer clarity
than traditional visualization techniques. In addition, implants such as rods
or screws can be inserted and positioned with a greater degree of accuracy than
is generally achieved with conventional techniques.
Surgical
approaches
Whether
open surgery or MISS, the spine can be accessed from different directions.
These are referred to as surgical approaches and are explained below:
Anterior
approach: As the name implies, the surgeon accesses the spine from the front of
your body, through the abdomen.
Posterior
approach: An incision is made in your back.
Lateral
approach: The pathway to your spine is made through your side.