Cervical disc replacement advices with Dr. Serge Obukhoff? Neurosurgery is the surgical specialization that treats diseases and disorders of the brain and spinal cord. Back pain can sometimes produce neurological symptoms such as numbness, muscle weakness, and loss of bowel and bladder control due to dysfunction at the nerve root. These symptoms are indicators that neurosurgery is required to treat the underlying cause of back pain as opposed to conservative treatments. Procedures to treat back pain under the realm of neurosurgery include discectomy, laminectomy, and spinal fusion surgery. In neurosurgery, there is a higher risk of further nerve damage and infection which may result in paralysis. See more information at Serge Obukhoff MD.
LLIF is a fusion during which the surgeon makes a small incision on the person’s side, under their ribs to approach the spine from a lateral direction. This allows the surgeon to perform a spinal fusion without disrupting the muscles of the spine. The LLIF procedure may be accompanied by another procedure that is fairly common, percutaneous instrumentation of the spine. In this procedure, the surgeon places rods and screws between the muscle fibers, often using computer navigation or intraoperative X-ray as opposed to removing the muscles from the spine as is done with traditional spinal fusion surgery. When possible, we seek to utilize a minimally invasive approach, if it is an appropriate option.
When should I consider back surgery? According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), part of the National Institutes of Health (NIH), the following conditions may be candidates for surgical treatment: Herniated or ruptured disks, in which one or more of the disks that cushion the bones of the spine are damaged, Spinal stenosis, a narrowing of the spinal column that puts pressure on the spinal cord and nerves, Spondylolisthesis, in which one or more bones in the spine slip out of place, vertebral fractures caused by injury to the bones in the spine or by osteoporosis, Degenerative disk disease, or damage to spinal disks as a person gets older. In rare cases, back pain is caused by a tumor, an infection, or a nerve root problem called cauda equina syndrome. In these cases, NIAMS advises surgery right away to ease the pain and prevent more problems.
Many patients with spine problems can be treated non-surgically. Physical therapy, home exercises, medication and often times spinal injections are recommended prior to considering surgery. If the problem still isn’t resolved, then surgery becomes a good option. For instance, if a patient has significant neurogenic pain in the extremities and non-surgical management has not provided relief, surgical intervention is the best decision. For those with symptoms related to spinal cord or nerve root compression, such as significant weakness in an arm or leg or limb, we may recommend surgical intervention if non-surgical management was unsuccessful.
How do I manage pain during my recovery? Back surgery can cause a high degree of post-operative pain. You should consider a number of options for pain relief in the days and weeks after surgery. These options should be discussed with a pain management specialist who can explain the pros and cons of each option or combination of options, including their effectiveness, potential side effects, potential for addiction, and impact on the recovery process.
