Chronic back pain is a byproduct of our primarily sedentary lifestyles and prolonged working hours. And while most cases can be resolved via targeted physical therapy, injections and/or acupuncture, a certain number of individuals are unable to find permanent relief with traditional treatment methods. In such cases, spinal surgery may be considered. The most common types of spine surgery are as follows:
1- Spinal Fusion
Primarily used to correct spinal instabilities resulting from a spinal curve deformity, disc protrusion, fractures, infections, herniations (displaced vertebrae), and spinal disk degeneration, the procedure involves ‘fusing’ two or more vertebrae (small bones forming the backbone) in the affected area using a healthy bone sample extracted either from elsewhere in the patient’s body, or from a bone bank and locking them in place via metal rods, screws, or plates.
While bendability is only slightly compromised in most patients, it is usually recommended as a last resort treatment. Spinal fusion may also be performed in conjunction with Foraminotomy, Laminectomy, and Discectomy; procedures requiring partial or complete removal of spinal components that may cause instability.
2- Laminectomy
Back pain, and sometimes leg pain and numbness, resulting from compressed spinal nerves is often relieved via laminectomy. As its name suggests, the procedure involves removing the bone, or ‘lamina’, along with the spinal column supporting ‘ligamentum flavum’ covering the spinal canal to ease spinal pressure and pain. Other nerve-compressing causes include bone spurs, overgrown joints and herniated discs (cartilage cushion between two vertebrae).
3- Discectomy
Discectomy is employed exclusively for relieving spinal nerve compression and back pain caused by spinal discs herniating, or ‘slipping’, inwards over the spinal nerves from their normal positions. The procedure involves making an incision and removing the pressure-inducing disc either in whole or in part and can be performed anywhere on the spine.
● Microdiscectomy: Partial herniated disk removal either directly via a laser or through suction from a comparatively smaller incision of 1-1.5 inches.
● Disk Replacement: Removal and replacement of an irreparable disk with a synthetic alternative. While the recovery time is comparatively faster than all other surgical options, the disk may become dislodged or the body may reject the unfamiliar material, in rare cases.
4- Foraminotomy aka Laminotomy
Yet another type of decompression surgery like laminectomy and discectomy, the main purpose of this procedure is to relieve spinal compression by allowing the nerves to exit easily from the spine. This is achieved by creating a larger opening as opposed to that in laminectomy for extracting or shaving off parts of the lamina.
5- Vertebroplasty and Kyphoplasty
‘Hunchback’ deformities caused by untreated fractured and compressed vertebrae can be corrected through these fairly recent surgical procedures that involve sealing and strengthening the fractured vertebrae by inserting bone cement into the damaged areas via a long hollow needle in case of a vertebroplasty.
In kyphoplasty, however, the compressed vertebrae are first elevated to normal height by inserting and inflating a balloon prior to filling in bone cement for vertebral strengthening and avoiding further damage.
Both procedures can also be used to perform biopsies for bone cancer detection.
6- Foraminotomy
This surgery is used to relieve pain associated with a compressed nerve in the spine. The surgeon cuts away bone at the sides of your vertebrae to widen the space where nerves exit your spine. The extra room may relieve pressure on the nerves and ease your pain. Like a laminectomy, this procedure can also make your spine less stable. So the surgeon may do a spinal fusion at the same time. That’ll increase the amount of time you need for recovery.
7- Interlaminar implant
This is a minimally invasive alternative to more invasive laminectomy or laminectomy plus fusion surgery. The surgeon implants a U-shaped device between two vertebrae in your lower back. It helps keep the space between them open and eases pressure on your spinal nerves. It can be done at the same time as a laminectomy. Unlike spinal fusion, the implant provides stability and lets you move your back almost like normal. You may not be able to bend backward as easily in that area.
In addition to a small likelihood of re-slippage following a discectomy, all of the above surgical procedures also present the risk of blood clot formation, rare allergic reactions, instrument malfunctions (in case of laser, etc.), damage to the surrounding tissue, neurological damage, paralysis, and complications caused by already present or undiagnosed medical problems.
Surgical treatment must be considered carefully. If you experience chronic back pain and/or numbness, consult with your doctor on suitable treatment options and remember to get thoroughly checked for any underlying medical condition prior to a surgery. You can also book an appointment with top Orthopedic Surgeons in Lahore, Karachi, and Islamabad through oladoc.com, or call our helpline at 042-3890-0939 for assistance to find the RIGHT doctor for your spinal concerns.
