Sugical Treatments for Back Pain
Sugical Treatments for Back Pain
By Brennan Howe
The good news about surgical treatments for is twofold: 1)
Less than 1 percent of those who suffer from ever need it.
2) Medical advances have made back surgery easier to tolerate and
recover from, with more optimistic prospects for recovery than ever
before. At present, many experts agree that more back surgery
than was medically necessary was performed in the past, with too
many of the recipients not benefiting from it. Some even
became worse as a result. Today the standard for back surgery
is that an individual has a clearly defined medical condition with a
specific solution that will provide clear benefits.
Below we will look at the three most common types of back surgery:
disc surgery, spine stabilization and creating additional space in
There are general standards that must be met before one can be a
candidate for disc surgery, a procedure that is usually done when a
disc is herniated (protrudes from its normal spot) and causing
An MIR or CT scan reveals that a disc is pressing against the root
of a nerve.
Persistent pain is experienced despite the use of more conservative
measures, such as weight loss, exercise, and ergonomic measures.
Severe pain is radiating down the leg or into the buttock, despite
conservative interventions of physical therapy or medications.
Neurological warning signs are observed, such as the loss of
reflexes or bodily control. These may be indicators of a surgical
Once the need for disc surgery has been established there are a
number of approaches available:
Discectomy: This is the most frequently performed back operation. In
general, an incision is made over the disc and a part, or all of it,
is removed in order to relieve pressure on the nerve.
Microdiscectomy: The procedure is much the same as for a discectomy.
The difference is that a smaller incision is made because
magnification is used to enlarge the view of the target space.
Laser Decompression: A needle is inserted into the disc and a
portion of it is destroyed with a laser. This relieves pressure on
the nerve. The advantage of the procedure is that it is less
invasive than traditional surgeries and can be performed on an
Percutaneous Removal: A small tube called an endoscope is inserted
into the back and used to remove portions of the disc. This allows
the surgeon to pinpoint the problem and leave the surrounding area
intact. This, too, can be performed on an outpatient
Chemonucleolysis: This is an alternative to taking out part or all
of a disc. A preparation from papaya plants, called chymopapain, is
injected and has the effect of decreasing the size of a disc, with
the intention of relieving nerve pressure.
In this form of back surgery two vertebrae are joined together in a
process called spinal fusion. It is accomplished by putting
bone grafts either between or alongside the vertebrae. Hollow
metal cages filled with bone graft can also be inserted between the
vertebrae. The bones may be attached to the vertebrae with
metal plates or screws that serve as a brace.
Once the grafts are in place the bones begin growing together, which
serves to fuse the vertebrae. This serves to bring normal
stability and strength to structures that have been fractured or
damaged by disease.
Creating Additional Space
The purpose of this form of surgery is quite simple: by opening up
more room for the vertebrae pressure is taken off the affected
nerve(s). Most often this is done for patients with spinal
stenosis. In this condition the spinal canal has become too
narrow, with the result being a lack of suitable space for the
spinal cord and nerves that causes pain in the back and weakness of
In order to provide more space a laminectomy is performed. This
involves removing portions of the laminae, the bones on the back of
An Improved Process
With greater specialization in back surgery and the ongoing
development of techniques, success rates have improved and there has
been a reduction in post-surgery difficulties. Recovery times,
especially given the growth in outpatient procedures and
rehabilitation strategies, have been significantly reduced.
Surgeries that once were regarded as things we needed months to
fully recover from are now seen more as temporary interruptions,
with some only requiring a few hours.
An important point to remember when considering back surgery is that
it is only helpful when a specific change in the anatomy of an
individual’s back is called for to correct a condition that has been
clearly identified. It is not done on an exploratory basis or
because no cause has yet been found. In addition, even when
the problem has been identified, surgery is generally regarded as a
last resort and recommended only after more conservative approaches,
such as medication and physical therapy, have been attempted and
judged not to be sufficient.
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