March 13, 2024

Understanding Surgical Options For Severe Back Pain

Back pain plagues millions of people across the globe. If you're one of them, you know the utter frustration of sharp aches preventing you from simple daily motions like getting out of bed.

Severe, chronic back pain robs you of doing all the activities you love and may even leave you unable to work. When every non-surgical solution provides little relief, know surgery may still help you reclaim your active lifestyle.

Today's innovative, minimally invasive spine procedures can effectively eliminate pain's grip. But before that, self-education is a must. Educate yourself on the different surgical options, what's involved with each procedure, expected outcomes, etc.

Consulting specialists at Summit Orthopaedics or other reputable spine centers can also help guide you.

What Causes Severe Back Pain Necessitating Surgery?

You may become a candidate for back surgery if you suffer from severe, chronic pain caused by any of the following common conditions:

  • Herniated Discs

The soft, gel-like centers of the discs between your vertebrae can begin to push out through tears in the outer layers. This presses on nearby nerve roots and causes intense pain, numbness, or weakness that fails to improve with conservative treatment.

  • Spinal Stenosis

If bony overgrowths or swelling narrows the canal encasing your spinal cord and nerves, it can pinch these delicate structures. This typically induces pronounced pain in the back, along with numbness, tingling, and cramping in the legs, which severely limits movement.

  • Degenerative Disc Disease

Over years of use, the discs lose hydration and height, which allows vertebrae to rub together. The bones and nerves exiting the spine become inflamed, causing localized back pain, possibly with pain radiating down the legs. Severe cases lead to difficulty walking or standing.

  • Scoliosis

An abnormal sideways spinal curve strains the vertebrae, muscles, nerves, and discs. Advanced scoliosis causes rib cage deformation along with unrelenting pain, making your torso feel rigid.

Common Surgical Options

Depending on what specifically is causing your back pain, the spine surgeon may recommend one of these common procedures:

  • Laminectomy

This surgery removes bone and ligaments rubbing on spinal nerves. The doctor creates space by taking out the lamina bone that forms the roof over the spinal canal. This procedure effectively relieves pinching and inflammation of the spinal nerves.

  • Spinal Fusion

If slipping vertebrae or abnormal curvature are causing chronic pain, spinal fusion can realign your spine and prevent further slipping. The surgeon grafts bone between the problem vertebrae to fuse them together into one solid section.

  • Artificial Disc Replacement

If degenerative disc disease is behind your unrelenting pain, the damaged, arthritic disc can be replaced with an artificial one made of metal or plastic. This eliminates the source of inflammation while still permitting flexibility and motion in that area of the spine.

  • Discectomy

A minimally invasive endoscopic procedure to remove damaged disc material pressing on a nerve. This relieves pain and numbness caused by herniations without a large incision.

Let your surgeon know all your symptoms so they can determine the optimal procedure to address the specific problem within your spine that requires surgical intervention.

When Is Surgery Necessary?

Spine surgeons typically recommend surgery when:

  • Conservative Treatment Fails

Conservative treatments include medications, physical therapy, steroid injections, and chiropractic care. If chronic pain fails to improve after trying these options for a reasonable length of time, surgery may provide definitive relief.

  • Neurological Defects Occur

Numbness, tingling, radiating pain, weakness, or impaired bowel/bladder control indicate nerve compression. This requires surgical decompression via a laminectomy or discectomy before permanent damage sets in.

  • Daily Functioning Becomes Impaired

Simple activities like walking the dog, performing job duties, or completing household chores become difficult to impossible, affecting quality of life. Surgery aims to restore the ability to function.

  • Spine Anatomy And Stability Worsen

Progressively worsening scoliosis, slippage between vertebrae, or abnormal spine curvature could lead to disc herniations and nerve issues over time. Fusion procedures aim to realign and stabilize the spine.

What To Expect With Surgery?

If your specialist recommends surgery, you'll typically:

  • Undergo imaging tests if not already done to pinpoint problems
  • Have a pre-surgical exam to ensure you're healthy enough for surgery
  • Take certain medications or dietary precautions before surgery
  • Check-in to the hospital on the morning of surgery

The procedures are done under general anesthesia, last 2-4 hours, and involve a hospital stay ranging from a few days up to a week to monitor for complications. Full recovery takes 8-12 weeks.

You'll start physical therapy while hospitalized and then continue once discharged. Activity is restricted initially—about six weeks for less strenuous procedures like a laminectomy and up to 3-4 months for spinal fusion.

Risks To Consider

Despite advancements making spine surgery safer, these invasive procedures still pose select risks, including:

  • Infection: Germs could enter the surgical site, leading to painful inflammation requiring antibiotic treatment or additional procedures to clean out the infected tissue.
  • Blood Clots: Clots can form in the legs after surgery, then break off and travel to the lungs, causing breathing issues. Blood thinners aim to prevent this.
  • Nerve Injury: Though rare, spinal nerves could become stretched or damaged during surgical manipulation. This could cause pain, numbness, or weakness.
  • Spinal Fluid Leakage: The protective dural sac around the nerve tissue could get punctured, allowing spinal fluid to leak out. Surgery would be needed to patch this hole.

Minimizing risks is a surgical team's top priority for all patients. However, carefully considering if projected benefits outweigh these potential complications is imperative before signing up for an elective operation.

Questions To Ask Your Doctor

Thoroughly discuss surgery options with your doctor to determine if it's right for you. Important questions include:

  • What exact problem does my imaging show that's likely causing symptoms?
  • What surgical approach do you recommend and why?
  • How often do you perform this surgery, and what results do patients typically achieve?
  • What types of relief can I expect in terms of pain reduction and improved function?
  • How long is the recovery process, and what restrictions will I have post-surgery?
  • What risks or complications could I face with this procedure? How will you minimize these?

Ask all other questions that arise, no matter how small. A complete understanding of spine surgery's specifics helps determine if cutting-edge procedures can truly improve your situation rather than provide temporary, partial relief.

Get Informed, Then Decide

You may face a difficult decision if surgery is presented as an option for severe, unrelenting back pain. While often extremely beneficial for many patients when conservative treatment fails, these invasive procedures still carry risks.

Carefully weigh the pros and cons with your doctors while also educating yourself on surgical specifics using reliable sources. An informed decision puts you in the best position for the greatest chance of safe, optimal surgical success.

Final Thoughts

Severe back pain can significantly interfere with normal functioning and quality of life. If non-surgical options haven't provided sufficient relief, talk to qualified spine professionals about potential surgical solutions like laminectomies, spinal fusions, or artificial disc replacement.

Learning about the procedures, projected outcomes, recovery processes, and risks helps you make a well-informed decision if surgery is the best route to resolve your back problems.


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