Spinal Surgeries for Degenerative Dieases of the Spine

18 de abril de 2020

4 min de lectura

Spinal surgeries are generally the last resort if more conservative treatments fail. This is especially true of degenerative spinal diseases, usually brought on by wear-and-tear or conditions such as arthritis. Besides pain, symptoms of the degenerative spinal disease may include:

Weakness or numbness
Loss of sexual function
Bowel or bladder incontinence.

The good news is that some of these surgeries are minimally invasive. There is less risk of infection or blood loss, along with minimal scarring. However, the surgeon may find during the procedure that the patient’s condition is not suited for a minimally invasive operation, and traditional surgery is performed instead.

Spinal Fusion Surgery

Spinal fusion surgery can allow patients to again live without pain. Movement between the affected vertebrae can cause severe back pain. In spinal fusion surgery, two or more vertebrae are fused together. In time, they will form one vertebra.

Conditions treated with spinal fusion surgery include:

Degenerative disc disease
Spinal instability
Spinal stenosis – spinal canal narrowing
Spondylolisthesis – a vertebra slips forward onto the one below it
Tumors
Vertebral fractures

This surgery stops the vertebrae from moving as did before. Because of the fusion, the patient is no longer able to stretch the ligaments, muscles, and nerves causing the pain.

There are two ways of performing spinal fusion surgery. In posterior fusion, the surgery is done through the back. In anterior lumbar interbody fusion, it is performed via the abdomen. In both situations, the surgeon inserts either a bone graft taken from the patient or material resembling bone into the space between the spinal vertebrae. Metal plates, rods, and screws and placed for vertebrae stabilization, with the goal of them healing into one piece.

Patients with affected discs may have them removed during the spinal fusion, a procedure known as a discectomy.

Spinal Fusion Surgery Recovery

Recovery after spinal fusion surgery can take some time. Complete recovery, including returning to work full-time, may take up to six months.

Patients usually stay in the hospital for several days post-surgery. Once home, the patient requires pain medication and is generally on bed rest for at least two weeks. Home preparation beforehand is vital. That means installing a raised toilet seat, shower chair, and other items to assist the patient.

Physical therapy must usually wait until six weeks after surgery. The patient is often advised to wear a brace to keep the spine in proper alignment.

Spinal Fusion Complications

While spinal fusion is usually safe, there are risks in any surgical procedure. For spinal fusion, possible complications may include:

Bleeding
Blood vessel injury
Infection
Nerve damage

There is another potential complication for the patient. Spinal fusion changes spinal movement in the individual. It could increase wear-and-tear in the vertebral joint near the site of the fusion, requiring more surgery in the future.

Spinal Fractures

Spinal fractures most often occur in older individuals with osteoporosis. This condition results in weakening of the bones, causing brittleness. Spinal fractures, also known as compression fractures, are most common in older women, although anyone may experience a spinal fracture. The most vulnerable are petite white and Asian women.

Of course, trauma may cause a spinal fracture. Motor vehicle accidents may result in “chance” fractures, due to seat belts. The vertebral fracture occurs during impact when the upper body is thrown forward as the seat belt prevents the lower body from moving.

Spinal Fracture Symptoms

Pain is the most frequent symptom in a spinal fracture, but some people are asymptomatic. Pain may occur in the back, arms or legs. Spinal compression symptoms might include weakness or tingling in the extremities. When these symptoms occur, they are an indication of the fracture pressing on the spinal cord.

Some symptoms require emergency treatment. That is the case if experiencing:

Bladder incontinence
Bowel incontinence
Difficulty urinating

Cancer patients should seek prompt treatment if presenting with spinal fracture symptoms, as tumors may cause a spinal fracture.

Spinal Fracture Stabilization

Minor fractures may stabilize after several weeks of bracing, with or without traction. However, spinal instability usually necessitates surgery. Vertebroplasty and kyphoplasty are the most common types of surgery for spinal compression fractures.

In vertebroplasty, the surgeon places a catheter into the compressed vertebrae. The area is then injected with bone cement. After it hardens, stabilization of the vertebral column occurs.

Kyphoplasty involves the insertion of a tube into the vertebral column with the guidance of an X-ray. Via a small incision, a bone tamp is inserted. After the inflation of this tamp, the vertebral column is brought back to normal height. The surgeon then fills the opening created by the procedure with bone cement, which ensures it will not collapse.

Some patients may benefit from spinal fusion surgery for spine stabilization.

Spinal Fracture Surgery Recovery

With both vertebroplasty and kyphoplasty, patients can return to normal activities more quickly than with spinal fusion. However, they should still expect to wear braces for six to 12 weeks post-surgery and spend several weeks in physical therapy.

Sources

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