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Neurosciences | Posted on 05/12/2020 by Dr. Amit Chakrabarty
Back surgery is advised by doctors for patients who experience chronic back pain because of several reasons such as injury, trauma, disease, or stress/exertion of certain body structures. The intensity and type of pain may vary per muscle, bone, or nerve pain but no matter the type of pain, back pain is highly undesirable, and painful and hampers everyday normal functioning.
Back pain can feel like an ache, burning, stabbing, or tingling sensation and can be sudden, sharp, slow, dull, intense, long, etc. The pain can be caused due to several conditions which may include disease, injury, or stress/pressure on different structures including bones, muscles, ligaments joints, nerves or the main spinal cord. The impacted structure signals the brain through nerve endings moving up the spinal cord, and the brain then registers the message as pain.
The treatment for back pain depends on the cause of the problem, the type, and the source of the pain. However, in cases where the exact cause of the pain is not known or cannot be identified, the symptoms of the problem are treated. The goal of each treatment aims to improve the quality of life by easing movement and relieving pain. Some treatment options for people suffering from back pain include physical therapy, medication, and surgery – when other non-invasive methods fail. The type of surgery is dependent on the cause and the intensity of the problem.
Some common types of back surgeries include:
Spinal Fusion: This is one of the most common surgeries to treat chronic back pain without a specific cause. This kind of pain also causes degenerative changes. In this surgery, the doctor will join the vertebrae – spinal bones – to improve functionality. Although this restricts the motion between these spinal bones, which simultaneously limits the stretching ability of the nerves it does not hamper the activity and reduces pain. However, patients advised for spinal fusion would need to quit smoking since that causes complications.
Laminectomy: This surgery is recommended for patients who suffer from lumbar spinal stenosis – narrowing of the spinal canal that causes the nerves of the lower back to be compressed. In this surgery, the surgeon aims to relieve the pressure on the nerves by removing the parts of the bone, bone spurs, and ligaments. By removing the pressure on the spinal nerves, the surgeon relieves the patient from the pain, although the procedure can make your spine less stable.
Foraminotomy: For patients, who experience back pain due to compression of a spinal nerve, are advised to opt for a foraminotomy. In this type of surgery, the bone at the side of the vertebrae is cut to increase the room where the nerves exit the spine. This extra space reduces the pressure on the nerves, reducing overall back pain. However, this procedure is risky because this can make the spine less stable and the surgeon might need to do a spinal fusion, which will increase the recovery time.
Diskectomy: In many cases, the back pain could be caused due to the disk slipping out of its place; the spinal disk is a cushion that separates the vertebrae. When the disk slips out of place, it causes immense pressure on the nerves which leads to chronic back pain. In a diskectomy, the surgeon makes an incision on the back to remove a part of the entire disk. In recent advancements in the procedure, the surgeon can perform a diskectomy by only making a small cut; this kind of procedure is known as microdiscectomy which uses an operating microscope. In many cases, a diskectomy is performed as a part of a larger procedure such as spinal fusion, laminectomy, etc.
Disk Replacement: For patients who suffer from back pain due to displacement of risk or damage, etc. – a disk replacement surgery is the optimal method of treatment. In this surgery, the surgeon removes the damaged spinal disk and replaces it with an artificial disk. This surgery is more effective than other surgeries such as spinal fusion, as well as involves lesser recovery time relatively.
Interlaminar Implant: This is non-invasive surgery in comparison to other more invasive surgeries. In this procedure, the surgeon places a U-shaped device between the vertebrae in the lower back. This provides more space between the two vertebrae and eases pressure on the spinal nerves, which reduces pain. This implant provides more stability to the spine and improves functionality.
The recovery time for back surgery depends on the type of surgery. In the case of a laminectomy, the recovery takes approximately 3 to 4 months post-surgery, while complete healing may take up to a year. In the case of spinal fusion surgery, the recovery period will be approximately 4-6 weeks provided the patient is healthy and young. In the case of older patients, the recovery can take 4-6 months.
In the case of diskectomy and foraminotomy, the patient may continue to experience some pain, weakness, and numbness in the affected nerve. However, these symptoms tend to get better in a few weeks.
The major risk of back surgery is that there is no guarantee that the pain will be gone. On the other hand, there are minimum complications involved in back surgery, these include:
Other than relieving back pain, back surgery also provides the below benefits:
Overall, back surgery is a very beneficial alternative for patients who have not responded well to physical therapy and medication.
