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Oh My Aching Back!

Oh My Aching Back!
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As we get older we sometime confront the inevitable back surgery.  Here’s a few thoughts to ponder if back surgery is in your future 

Back surgery is typically focused on a procedure that affects the spine. It’s a cause for concern for anyone confronting this type of surgery, and it should be.

Back surgery is serious 

Any surgical procedure has its risks but surgery on the spine is significant given that it’s the delivery point for our central nervous system. Typically, a doctor will explore other options for treating back-related aches, pains and problems but some conditions can worsen or be aggravated by injury and require surgery sooner rather than later.

There are no guarantees 

In some instances, back surgery on the spine results in immediate relief and continuing improvement over time. In other instances, the surgery will not relieve the condition and in rare instances make the condition worse.  The key is to consider options, your general health and the competence and surgical record of your surgeon and hospital.

There are benefits to consider 

Back surgery can help you to move around better, allow you to be more physically fit and improve your overall mood. In addition, you may need to take less pain medicine and you can go back to work and perhaps be more productive as your condition improves.

There are also risks 

While most people who have back surgery have no complications you or a loved one may suffer from the following:

  • Infection
  • Bleeding
  • Reaction to anesthesia
  • Reaction to drugs
  • Difficulty swallowing if the surgery was performed from the throat
  • Blood clots
  • Stroke
  • Heart attack
  • Herniated disk
  • Nerve damage

Many of these risks are common with other types of surgical procedures but nerve damage leading to paralysis, weakness, sexual dysfunction and loss of bladder and bowel control are often associated with surgeries related to the back and spine.  These risks vary by the general health of the patient, the type of surgery and the ability of the surgeon to accurately assess risks.   The type of surgery has the greatest impact.

  1. Laminectomy.  This procedure involves the removal of parts of the bone, bone spurs or ligaments in your spine.  This relieves pressure on spinal nerves and eases any weakness or pain.  It sometimes leaves the spine less stable and that could lead to a second procedure called “spinal fusion.”
  2. Spinal fusion. This is a more complex procedure and is often done through an incision through the neck.  The throat is moved aside and the spinal bones are joined together with a one implant that must grow and fuse the spine.  Smoking cigarettes can inhibit this bone growth so anyone considering this kind of surgery should cease smoking at least a month before and for three months afterwards. 
  3. Foraminotomy. This procedure involves cutting bones at the side of the vertebrae to widen the space where nerves exit the spine.  The idea is to relive pressure on the nerves.  This procedure can also make your spine less stable so spinal fusion may have to be performed at the same time.
  4. Diskectomy. This procedure is directly related to the disks that act as a cushion in the spinal cord and gives it flexibility.  When the disk slips out of place or presses on a spinal nerve, back pain can result.  This procedure is done through the back but can also be a part of a more complex set of procedures including laminectomy, foraminotomy, or spinal fusion.   It sometimes leads to disk replacement which involves the insertion of an artificial disk between vertebrae.
  5. Interlaminar implant. This involves the insertion of a U-shaped device between the two lower vertebrae in the lower back.  This keeps the space open and eases pressure on spinal nerves.

What’s up with Laser Spine Surgery? 

The jury is still out on Laser Spine Surgery. It’s been around since the 1980’s but there are no clinical trials to evaluate its effectiveness from more traditional approaches.  It is usually used for lower back surgery but no specific benefits have been identified beyond conventional methods to date.

Think and ask twice before pursuing back surgery

According to the Mayo Clinic most back pain resolves on its own within two months. Lower back pain is the most common but conditions associated with the upper spine and neck often need an MRI and other tests to evaluate the potential for the condition.

If traditional treatments are not working a surgical solution is a consideration but the recovery from surgical procedures on the spine are typically significant.

Recovering from back or spinal surgery 

Recovery from any spinal procedure is not easy. It requires careful discipline that a surgeon and their staff will recommend.  Many people who have upper spinal surgery around their neck will need to wear a hard neck-brace for up to a month and a soft neck-brace for two months following.  Activities will need to be carefully managed and while walking and simple exercise is recommended, many motions and activities should be avoided depending on the type of procedure and doctor’s recommendations.

Medications particularly pain medications will be prescribed and a log should be kept of time and dates when any medication is taken by both patient and caregivers.

The Prognosis 

The good news is that many procedures including the most complex have been vastly improved and most people who follow their instructions before and after back surgery make a good if not full recovery. The key is to explore all of your options and know that surgery is a last resort and possibly the best solution to a serious problem related to back pain in certain instances.


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