What are the types of spine surgeries?

Surgeries are of varied types. Sometimes these are complete procedures in themselves; other times, these may be one of the steps in bigger surgery. The procedures commonly performed are:

• Laminectomy – Here spinal cord and nerves are released by removing parts of bones
• Microdiscectomy - Removal of herniated discs under microscope
• Fusion – this procedure is performed in case of spinal instability. Metallic screws, plates and rods are used in these type of surgeries.
• Disc replacement surgeries - Here, after removal of disc, artificial disc is implanted to preserve normal movements
• Other complex procedures like scoliosis surgeries, tumor surgeries, surgeries for TB and other infections, Spinal cord stimulation, Pump implantation

What are the lifestyle changes required after spine surgery?

• Avoid bending
• Avoid weight lifting
• Avoiding driving in initial period
• Continue wearing of lumbar or cervical belt
• Avoid smoking
• Continuing Core strengthening exercises
• Healthy food
• Weight reduction in case of obesity
• Control of diabetes mellitus

How often revisit to hospital is required?

After the discharge, we encourage first follow up after one week so as to monitor skin healing and curtail the drug list according to requirement. Next visit is usually after one month and probably thereafter 3 months. Usually fourth visit is not required.

How is recovery after surgery?

During the Initial few days of surgery the pain induced by surgery requires drugs. Antibiotics are continued. The patient is encouraged to walk as much as possible. Usually there is no restriction on climbing stairs case. Rehabilitation and physiotherapy us continued. The patient may feel occasional crampy sensation and numbness in limbs for about 6 months, which usually subsides.

What is Intraoperative Neuromonitoring System (IONM)?

IONM is a machine which gives indication of proximity to nerve when pedicle screws are placed in spine. This provides assurance to the surgeon regarding correct placement of screws in bone and prevents inadvertent injury to nerves. This makes the surgery very safe and effective.

What makes spine surgery less risky?

• Correct Diagnosis
• Thorough preoperative evaluation
• Sugar control
• Advanced equipment like use of Operating Microscope, Intraoperative Neuromonitoring system, High speed Drills

What are the risks involved in spine surgery?

Apart from the usual risks of any surgery in any part of the body like infection and bleeding, the specific risks are the following:

• Weakness of limbs
• Numbness of limbs
• Partial relief from pain
• Associated risks like heart related risks in elderly cardiac patients

What are the benefits of undergoing spine surgery?

• Pain relief
• Recovery from neurological deficits if any
• Prevention of fresh neurological deficit
• Improvement in Quality of Life

What is done before and after spine surgery?

The patient with spine related disease is evaluated by spine specialist and diagnosis is made. If required a trial of conservative management is provided. In case there is failure of non-surgical treatment or impending neurological deficits, a surgery is planned. After discussing the benefits and risks of the proposed surgery, patient is admitted one day prior to the procedure. Anesthesia fitness is obtained. Night prior to the surgery, the patient will be fasting. After the surgery, observation shall be performed in ICU for pain relief. The next day of surgery, patient is shifted to the wards after mobilization by physiotherapy team. Further antibiotics and pain killers are administered. Usually postoperative day 4 the patient is discharged from hospital.

Does every lumbar disc prolapse (slipped disc) require surgery?

More than 90% of lower back pain and leg pain due to a lumbar disc prolapse can be treated conservatively without surgery. A thorough assessment will help in making the decision.

What are common degenerative disorders of spine?

• Spondylosis – This is an umbrella term, which is used to signify the age related degeneration of the spine. This can be cervical spondylosis or lumbar spondylosis.
• Slipped Disc – It is a condition when, the disc in between two vertebrae gets displaced and causes compression over one of the nerves. This is most of the time due to age related degeneration, but at time it has been seen in youngsters lifting very heavy weight without any adequate back support, and trauma.
• Listhesis – It is a condition when, one of the vertebrae slips forward or backward over adjacent vertebra. This also can be due to fracture or degeneration.
• Scoliosis – It is a condition when, the spine has abnormal bending to one side.

Can spine surgery be an emergency?

Yes, spine surgeries can be an emergency in certain circumstances like:

• Sudden development of limb weakness
• Sudden inability to pass urine
• Sudden onset of erectile dysfunction
• Fracture of spine

When do we require to undergo spine surgery?

• Any spine related pain, which does not get relieved with recommended lifestyle changes and conservative treatment
• Spine ailments associated with weakness and numbness of body parts
• Spine ailments wherein there is impending neurological deficits
• Difficulty in passing urine
• Difficulty in holding objects, imbalance while walking, progressive difficulty in walking, pain radiating to upper or lower limb

What is spine surgery?

Any procedure on spine which is aimed at relieving pain and preventing neurological problems are collectively known as spine surgery. These procedures are also aimed towards infections of spine and tumors of spine and spinal cord.

What does a spine specialist do?

Spine specialist is a surgeon, who is trained in treating spine related disorders. These surgeons are best in deciding requirement of medical and surgical intervention on the spine.

Should we wait till 10 years of age to operate on spine deformity in children?

Surgery for spine deformity depends on the cause for deformity. Spine deformity that starts by birth or early childhood (before the age of 5) and increases consistently has to be addressed early to prevent long-term breathing problems.

Does spine surgery lead to long-term disability and pain?

Every surgery has complications. A minimally invasive approach and thorough assessment to decide on the need and type of surgery along with improved expertise to handle these issues has brought down the incidence of complications significantly. Today, spine surgery is safe provided adequate care is taken.