Back and Spine Treatments
What are back and spine treatments?
Back and spine treatments are surgeries to treat a variety of conditions affecting the back and spine. Your spine runs from your skull to your tailbone. Treating back or spine problems can include back surgery, neck surgery to treat cervical spine issues, and lumbar surgery to treat lower back problems.
Common types of back and spine treatments include:
Disc replacement and discectomy for damaged or diseased spinal discs
Why are surgical back and spine treatments performed?
Doctors may recommend surgery as a back pain treatment or to correct physical problems with the spinal canal, discs between vertebrae, or the vertebrae themselves. The goals are to improve movement, spine stability, and quality of life. Common back and spine conditions that may require surgery include:
Back and neck pain that persists despite trying more conservative treatments, such as medications and physical therapy
Degenerated, herniated, prolapsed, bulging, slipped or ruptured spinal discs
Scoliosis or kyphosis, which are abnormal curvatures of the spine
Trauma or injuries of the vertebrae including spinal fractures and dislocations
Tumors in the back or spine
Who performs back and spine surgery?
There are several types of doctors who can perform back and spine treatments including:
Interventional radiologists diagnose and treat diseases using imaging technologies.
Neuroradiologists diagnose and treat diseases and conditions of the brain, spine, head, neck and nerves using imaging technologies.
Neurosurgeons use surgery to treat diseases and conditions of the nervous system including the nerves of the spine.
Orthopedic surgeons specialize in treating diseases and conditions of the muscles and bones including the spine.
Your primary care doctor will refer you to the specialist who is most likely to be able to help. Look for a surgeon who has plenty of experience treating your specific condition and who regularly performs the back procedure you need. A high degree of surgical expertise helps reduce the chance of complications.
How are surgical back and spine treatments performed?
Back and spine surgeries take place in a hospital or surgical center. The specifics of the procedure will vary depending on which one you need. Most back and spine procedures are major surgeries. However, doctors can complete some spine treatments using minimally invasive techniques. In general, minimally invasive surgery (MIS) results in less pain and shorter recovery times than traditional open surgeries.
Laser spine surgery is a form of minimally invasive spine surgery. Laser technology shows some promise as a treatment for herniated discs and tumors causing spinal nerve or spinal cord compression. Using X-ray guidance, the surgeon inserts a needle through the skin and into the treatment area. Heat generated from the laser dissolves the unwanted material.
The type of anesthesia you receive will also depend on the specific procedure. Many require general anesthesia so you sleep through the surgery. Some outpatient procedures may use regional anesthesia with sedation to help you relax. Your surgeon will provide all the necessary details for the procedure you are having, but don’t hesitate to ask questions if you need clarification.
What to expect the day of your surgical procedure
In general, this is what happens the day of your surgery:
You will change into a hospital gown and a preoperative nurse may perform a brief exam.
You will get a sedative to help you relax before the team takes you to the operating room (OR).
Your team will start anesthesia in the OR. With general anesthesia, you won’t remember anything else until you wake up in the recovery room.
It’s common to stay in the hospital after back or spine surgery. However, some back or spine surgeries are outpatient procedures and you will go home the same day. In either case, your team will give you detailed instructions about activity level, medications, and follow-up appointments before you leave.
What are the risks and potential complications of back and spine surgery?
Any surgery involves risks and possible complications. Some of these can be serious and may develop during surgery or recovery.
General risks of surgery
The general risks of surgery include:
Anesthesia reaction, such as an allergic reaction and problems with breathing
Excessive bleeding, which can lead to shock in case of heavy bleeding (hemorrhage)
Infection and complications of infection such as sepsis
Potential complications of surgical back and spine treatment
Most back and spine treatments are successful, but potential complications include:
Nerve, muscle, or blood vessel damage
Ongoing pain or disability
Problems healing, although this is more of a problem in people who smoke
Spinal headache, which is due to leaking cerebrospinal fluid
Worsening back or neck symptoms
Reducing your risk of complications
You can reduce your risk of certain complications by:
Following your surgeon’s directions for activities and diet before your surgery and during recovery
Notifying your doctor immediately of any concerns while you are recovering, such as bleeding, fever, or increase in pain
Taking your medications exactly as your doctor prescribes
Telling all members of your care team if you have allergies
How do I prepare for spine surgery?
The right preparation can make the day of surgery go smoothly and improve your comfort in the days, weeks and months following surgery. It can also improve your chances of successful treatment without complications. You can prepare by:
Arranging a ride home. You will also need someone to stay with you the first 24 hours.
Getting preoperative testing if your doctor orders it. This will vary depending on the procedure and your medical history.
Losing excess weight before surgery
Making sure all your healthcare providers have your complete medical history. This includes chronic conditions, allergies, and medications you take, even if you take them occasionally. When listing medications, include prescriptions, over-the-counter drugs, herbal treatments, and vitamin supplements.
Not eating or drinking before surgery as directed
Stopping smoking as soon as possible to help the healing process
Taking or stopping medications as directed (both before surgery and afterwards)
Questions to ask your doctor
Writing down a list of questions can help you remember them when you see the doctor. Questions you may want to ask include:
Why do I need the spine treatment you are recommending? Are there any other options we can try first?
How long with the surgery take? When can I go home?
What restrictions will I have after surgery? What kind of assistance will I need at home?
When can I return to work and other activities?
When will I start physical therapy? How many treatments are typically necessary for recovery?
How will you manage my pain?
What changes, if any, to my medication plan do I need to make?
When should I follow up with you?
How should I contact you after hours if I have a problem?
What can I expect after back and spine surgery?
It’s easier to plan and prepare for a successful recovery after spine surgery when you know what to expect.
How long will it take to recover?
You may need to wear a back brace or cast to stabilize your back or spine while it heals. This will restrict your activity level. However, your doctor will likely encourage you to walk frequently. You will also begin physical therapy to help you recover. Your therapist will teach you how to move properly, reposition yourself, turn over in bed, and walk in ways that protect and support your back and spine. You will also learn about activities to avoid, such as twisting your spine or hyperextending it while it heals. Full recovery can take several months.
Will I feel pain?
You will likely have some pain and discomfort after spine surgery. Controlling the pain is important for healing and a smooth recovery. It lets you walk and complete rehabilitation activities that are necessary for your recovery. Tell your doctor if your pain worsens or changes in any way. This could be a sign of a complication.
When should I call my doctor?
Contact your doctor if you have questions between follow-up appointments. Also, call your doctor right away or seek immediate medical care if you have:
Breathing problems or shortness of breath
Confusion or changes in level of alertness
Chest pain, pressure or tightness
Drainage of pus, redness or swelling around your incision
Inability to urinate (urinary incontinence) or move your bowels (bowel incontinence)
Unexpected or heavy bleeding
How might back and spine surgery affect my everyday life?
It’s important to have realistic expectations about back or spine surgery. Some procedures can improve symptoms, but may not completely eliminate the problem. Some level of pain and disability can remain. However, many people experience symptom relief soon after surgery. Staying physically active and maintaining a healthy weight can help you recover and avoid chronic pain and other symptoms.