Spine surgery/treatment

SPINE SURGERY/TREATMENT

Introduction

Fracture surgery is a complex procedure recommended to people suffering from numbness in hands or legs, weakness in hand or legs, or severe pain in lower back or neck. Spinal fracture surgery is advised in cases when these weaknesses or pain are very severe, and are not responding to preliminary treatments. At first, pain reliever medicine may be prescribed. If medication doesn’t yield the desired fracture care, physical therapies or steroid injections may be the next alternate. When all these methods fail to relieve pain, a bone fracture surgery may be recommended. 

Cause of pain in spine

The spine is made up of a series of bones, called vertebrae, which are stacked upon each other like blocks with a cushion called disc in between the blocks. The discs are flat round cushioning pads made up of very strong tissues, with a soft gel like center and a tough outer layer. The disc acts as a shock absorbent for the spine.
The spine can experience a severe pain due to the following reasons:
  • Damaged disc: with growing age the discs between the vertebras tend to dry out. This may lead to cracking of the tough outer layer. If this happens, the soft inner gel escapes and press on the spinal cord and nerve which cause pain in the spine.
  • Damaged bone: bone overgrowth due to Paget’s disease, or wear and tear of bone due to osteoarthritis are other major reasons for pain in the spine.
  • Ligament thickening: the tough cords that help hold the spine together can become stiff and thickened over time. This thickening causes a pain in the spine.
  • Tumors: tumors of the spine are less common and can be identified spine imaging with an MRI or CT scan.
  • Injuries of the spine: accidents may cause a dislocation or fracture of one or more vertebrae. Swelling of nearby tissues after back surgery can also put pressure on the spinal cord or nerves, and may cause pain.

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Types of spine surgery

There are different types of spinal fracture surgery depending upon the cause and nature of pain in the spine. Every method had its own pros and cons associated with it. 

  • Spine fusion: For patients suffering from chronic nonspecific back pain, this is the most common surgery. In this surgery the painful vertebrae are fused together to form one single block. This type of fusion limits the motion between the vertebrae thus giving pain relief. This technique limits the stretching of the nerve but, doesn’t limit activity. A rare risk in this technique is that sometimes the bones sometimes don’t fuse completely. If such a thing happens, the patient may be required to go through another operation.
  • Laminectomy: This surgery is carried on for the patients suffering with lumbar stenosis. Stenosis is disease in which the spaces within the spine narrow down thus exerting pressure on the nerve that travel through the spine. When stenosis occurs in the part of the spine in lower back, it is called lumbar stenosis. In this procedure, surgeon removes the back part, i.e. the lamina, of the affected vertebrae. This procedure is also known as decompression surgery as it releases the pressure on the nerves by creating more space around them. This procedure is very common but can make spine less stable. If this happens, the surgeon may also carry a spine fusion surgery. In many cases, both the procedures are done together.
  • Laminotomy: This surgery is almost same as the Laminectomy, but in this procedure only a portion of lamina is removed. A hole just big enough to relieve pressure on the nerve is made to give relief from pain.
  • Laminoplasty: This technique, also known as cervical spine surgery, is used for the vertebrae of the neck. This technique opens up the space within the spinal canal through a hinge made on the lamina. The spine is provided stability by use of a metal implant, which is fixed in the opened section.
  • Foraminotomy: This type of surgery is used relieve pain in case of compressed nerves in the spine. The bones at the sides of vertebrae are removed in order to widen the space from where the nerves exit the spine. The removal of bone releases the pressure on the compressed nerve thus reducing the pain. As in laminectomy, this procedure may also be done along with spine fusion to provide higher stability.
  • Discectomy: In many cases, the disk, that separates the vertebrae, slips out of place and presses the spinal nerve. In this kind of surgery, all or part of disc is removed to relieve the pain.
  • Disk replacement: In this surgery, the damaged disc is replaced by an artificial one. The potential risk is that the artificial implant may fall out of place and need repair.
  • Minimally invasive spine surgery: In this technique the affected bone or lamina is removed in such a way that it causes minimum damage to the adjoining healthy tissues. This method reduces the risks as well as the recovery time.

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