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Spine Treatment

Spine Treatment

Back pain is one of the most common health problems faced by a large number of people especially with increased weight, improper body mechanism, trauma, age and structural abnormalities leading to other symptoms such as leg pain, numbness or leg weakness. Generally, back pain can be treated with simple medications or physical therapy. But if the person is struggling with prolonged back pain and all other treatments fail to provide any relief from pain, doctors recommend surgery as a treatment option. Surgery is specifically considered in case of severe pain that occur from the problems like herniated disc, scoliosis or spinal stenosis. Conservatively, spine surgery is performed as open surgery that requires a large incision on the area to be treated so that surgeon can view and access the spine. But now, with the advancement in technology, spine problems can be treated with minimally invasive techniques which don’t require a long incision, can prevent damaging the muscles and tissues surrounding the spine, requires shorter operative time and faster recovery time.
Doctor will perform several tests for spine surgery such as CT scan, MRI, intra-operative fluoroscopy that enables surgeons to operate with a high level of precision and safety. Computer assisted image guidance allows surgeon to see inside the part to be treated with finer clarity than other traditional visualization techniques. Not all patients are good candidates for minimally invasive spine surgery procedures. There are different surgical approaches to access the spine such as:
• Anterior approach - the surgeon accesses the spine from the front of the body through the abdomen.
• Posterior approach - spine approached through the incision made in the back
• Lateral approach - approach to the spine made through the side of the body.
There are different kinds of spinal surgeries that the doctors may recommend after evaluating the medical conditions of the patient. Some common procedures include:
• Discectomy or Microdiscectomy - is used to treat the herniated disc in the vertebrae by removing all or part of the disc. A disc separates two vertebrae and if it herniated inwards it put pressure on the spinal nerves causing pain. Surgeon may have to make a large incision in the back to perform the surgery. Microdiscectomy is a minimally invasive spine surgery procedure.
• Laminectomy - this type of surgery is considered for the spinal conditions caused by spondylolistheis and stenosis. In this procedure, surgeon will remove parts of the bone, bone spurs or ligaments in the back to relive pressure on the spinal nerves and can ease pain or weakness. In some cases, it can make the spine less stable and required to perform in combination with spine fusion surgery.
• Laminotomy - in this procedure, a portion of the vertebral arch (lamina) that covers the spinal cord is removed. Laminotomy removes less bone than in a laminectomy. Both these procedures are decompression procedures in which a tissue compressing a spinal nerve is removed.
• Foraminotomy - this surgical procedure involves removing the tissues that compress the nerves in the back. During this, surgeon removes parts of the bone that constricts the nerves in the spine. Like a laminectomy, this procedure can make the spine less stable. Surgeon may require performing a spinal fusion surgery at the same time.
• Disc replacement - it is an alternative method to fusion and is not very common. In this, surgeon removes the injured or damaged disc and replaces it with an artificial disc between the vertebrae. This surgery let the patient continue to move his/her spine. Recovery time is also shorter but there is the slight risk of the new slip disc.
• Spinal fusion - a surgical technique that involves joining of the vertebrae that can result in restricted movements and limits stretching of nerves. Spinal fusion may include the use of bone graft (autograft or allograft) with or without instrumentation like rods, screws etc.
• Interlaminar implant - the surgeon implants a U-shaped device between two vertebrae in the lumbar spine (lower back) that helps in keeping the space open between the vertebrae and releases the pressure on the spinal nerves. This can be done along with a laminectomy. This procedure also provides stability in the spine and let the patient move their back more easily but may not be able to bend backward with much ease.
There are some risk and complications involved with the spine surgery:
• Reaction to anesthesia or any other drugs
• Unexpected bleeding
• Infection at surgery site
• Thrombophlebitis (Blood clots)
• Heart attack
• Stroke
• Herniated disc
• Damage to nerves that can cause weakness, paralysis, pain or loss of bowel or bladder control
• Lung problems
• Persistent pain
• Sexual dysfunction

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