Spine Surgery

Spine

Our spine provides both structural and nervous system support for the entire body. The spinal column holds the body upright, bears the weight of our body, allows a lot of movements while we work or even rest, with ease, and provides a conduit for major nerves running from the brain to the tips of the toes—and everywhere in between.

The spinal column is divided into four areas, any of which can be affected by spinal cord disorders. These areas include:

• Cervical (neck)

• Lumbar (upper back region)

• Thoracic (lower back region)                                                                      

• Sacral (pelvis)

 

Spinal disorders or diseases

A lot of problems or disorders can arise in the spine in one’s life. Spinal cord disorders can originate from either outside or inside the spinal cord.

Damage from the outside of the cord is caused by compression of the spinal cord or injury.

Common causes of outside compression of cord or nerves are :

• Traumatic fracture

• Osteoporotic fracture

• Degenerative spine disorders

• Hematoma,

• Tumor

• Disc herniation.

• Congenital anomalies

Causes of disorders arising within the cord are:

• Spinal cord tumors

• Tuberculosis or other infections

• Congenital disorders

 

What are the common problems in spine disorders?

• Pain (most commonly back and neck pain)

• Pain radiating to legs or arms

• Weakness or paralysis of limbs

• Loss of sensation

• Changes in reflexes

• Loss of urinary or bowel control

• Uncontrolled muscle spasms

 

Diagnosis of Spinal Cord Disorder

The first and foremost need is a careful clinical exam by a spine specialist or neurosurgeon.

The  doctor may then recommend tests including:

• X-rays to check for fractures or tumors

• Spine MRI or Spine CT scan to show areas of pressure on the spinal canal and look for fractures, tumors, or other disorders.

• Myelography to determine the location and presence of abnormalities of the spinal cord.

• Electromyogram to determine the exact nerve root that is involved.

 

How Is It Treated?

The goal is to ease pain and stop more damage. Your doctor will suggest the best plan for you, based on your symptoms and how serious your condition is. Treatment may include:

Medical management: Milder symptoms can be managed with medications. They also constitute an important part of treatment in the postoperative period as supportive therapy. They can ease your pain and decrease inflammation.

Physical therapy: Specific movements make the muscles in your neck and back stronger and more flexible. This supports the spine.

In most cases, physical therapy and pain medication are enough for long-term relief.

Pain management with nerve blocks: Therapeutic nerve blocks are used to treat painful conditions. Such nerve blocks contain local anesthetic and steroids that can be used to control acute pain. Nerve blocks can also be used to manage chronic, or long-term, pain or pain after surgery. Sometimes, They can also offer longer-term relief, because some injections reduce irritation to the nerves and let them heal.

 

How do you know when you need spine surgery?

1. Many patients with spine problems can be treated non-surgically. Physical therapy, home exercises, medication, and spinal injections or nerve blocks are recommended before considering surgery. If the problem still isn’t resolved, then surgery becomes a good option.
2. For those with focal deficits like weakness in any limb, and bladder and bowel incontinence, surgery becomes a necessity.
3. Patients having spinal tumors, and fractures causing cord compression do need surgery.

 

Some of the common spine surgical treatments are :

Minimally invasive spinal surgery: A variety of spinal disorders like spinal canal stenosis, spondylolisthesis, and some spinal tumors can be operated on with a small incision only providing a quicker recovery than traditional open surgical techniques. The surgeries which can be done with this approach are MIS-TLIF, Microdiscectomy, pedicle screw, and rod fixation under O-arm navigation guidance for fracture stabilization.

Discectomy/microdiscectomy: Surgical removal or partial removal of a vertebral disc to relieve pressure from the nerves under microscopic guidance with a small incision.

Disc replacement: Surgical replacement of a diseased or herniated disc with an artificial disc.

Laminectomy: Surgical removal of part of the lamina to relieve pressure on the spinal cord and nerve roots.

Vertebroplasty: Some acute fractures due to injury or osteoporotic fractures can be managed by injecting bone cement into the vertebrae to stabilize fractures and relieve pain. It helps in early mobilization of the patient and needs a very small cut over the skin.

Tumor Surgery:  A variety of tumors can occur in the spine and need surgery ranging from intradural extramedullary, intramedullary, extradural, or even bony tumors. Depending upon the disease severity, either an open or minimally invasive approach can be offered. Sometimes, the spine needs stabilization with implants like pedicle screws, rods, cages, etc.

Spine Injuries: A lot of patients sustain injury to the spine while at work, in a road traffic accident, or even at home due to a fall. Such patients need surgery for relieving spinal cord compression and stabilization of spine fractures.

Category:Spine Surgery