Chronic Back Pain and Spine Surgery – What are the Options?
It is rare that spine surgery is ever the initial course of treatment recommended for a patient suffering from chronic back pain. In most cases doctors will try a fairly lengthy course of conservative treatment first, which typically involves physical therapy, the use of narcotic pain medication, steroid shots and even sometimes acupuncture.
However if a patients back pain is not improved, or indeed worsens, over the course of a three to six month period of conservative treatment then most medical professionals consider it reasonable to consider spine surgery to alleviate the patients distress.
There is no such thing as a ‘one size fits all” back surgery, just as there is no single cause of chronic back pain.
The most common cause of back pain though is a herniated disc. For these patients a discectomy, or these days the less invasive microdiscectomy, is the usual surgical treatment. During the procedure the herniated disc itself is removed in an attempt to relieve pressure on the nerves that are being affected by it. This form of spine surgery is actually more effective for reliving the leg pain that is associated with a herniated disc rather than the lower back pain itself.
Foramenotomy is another form of spine surgery that is used to relieve pressure on the nerves, but for patients who have nerve impingement that is caused by more than just a herniated disc. Often during a foramenotomy procedure bone fragments and other debris that may be compressing the nerves are surgically removed.
For those who suffer from conditions such as spinal stenosis and spondylolisthesis (an unstable spine) a laminectomy is the most commonly performed spine surgery. This procedure is designed to relive pressure on the spine itself. As the procedure often involves the removal of a considerable amount of bone spinal fusion is often performed at the same time to prevent future spine instability.
A spinal fusion procedure is far more involved than other types of spine surgery. A spine fusion links together vertebrae, most often using metal, and limits motion to encourage new bone growth. There are a number of risks associated with the procedure, depending on how many “levels “are fused. Patients may become limited in their natural movement and in some cases the previously healthy segments next to the fused portions of the spine degenerate, as a result of the additional pressure they are under. To combat that spinal disc replacement surgery is being developed.
That relatively new spine surgery technique is still in it’s infancy, having only fairly recently been approved by the FDA. Although there are many difficulties left for spinal surgeons to overcome, such as what material works best to fashion the replacement disc from, and how to stop it from wearing out, it is hoped that in the future this type of spine surgery can be used to treat a number of chronic back conditions.
October 5th, 2009 at 3:24 pm
I recently had laser spine surgery at a new clinic in Florida, I had multitudes of things wrong with my lower back and they fixed every single one of them! Pro’s……. it really worked and it has changed my life. Con’s…… they don’t except insurance so it had to be CASH before they do anything. I had a one inch incision and 3 stitches to close it. They don’t knock you out so you don’t have to worry about anethesia they put you in a twilight something like your dentist would do, I went in for surgery at 8:30 AM and was back in my hotel room just a little after noon. Do your research before you go for any of the traditional surgery that takes months to recover from. If anyone is wondering, no I don’t work for them and they didn’t pay me to write this.