Spine Surgery

In the event that you have had a backache for a while, you may be wondering whether spine surgery will be the only treatment option. Sometimes surgery is the only treatment. The vast majority of back problems can be solved by non-surgical treatments, often referred to as non-surgical or conservative treatments.

Injury to the spine can occur as a result of aging, poor body mechanics, trauma and structural abnormalities which can lead to back pain and other symptoms such as leg pain and/or numbness or even leg weakness. Chronic back pain is a condition that usually requires a team of health professionals for diagnosis and treatment. Before submitting yourself to a surgical procedure, seek advice from a few experts who specializes in spine surgery. This time investment and data collection will help you make an informed decision on treatment that will best support your lifestyle and your desired level of physical activities. Spine Surgery clinics are recommended even though this medical category is sometimes linked with orthopedics department of large hospital and is also part of some stem cells therapies.

1. Artificial Disc Replacement

Artificial disc replacement surgery is the replacement of a painful disc with an artificial disc. Artificial disc surgery can be carried out on the lower back (lumbar spine) or on the neck (cervical spine). Artificial discs are designed with the aim and objective of reproducing the shape and function of the spine’s natural disc.

The artificial disk approved by the US Food and Drug Administration (FDA) for use in the lumbar spine is PRODISC-L and activL. In the cervical spine, there are many artificial discs which have been approved, including Mobi-C (the only product approved for one and two levels), the PRESTIGE, the ProDisc-C, the BRYAN, the SECURE-C, and the PCM.

The aim of replacing the artificial disk is to reduce pain and enhance mobility in patients that have chronic low-back (lumbar) pain. This is a new procedure which is considered to be an alternative to spinal fusion surgery. The risk associated with spinal fusion is accelerated degeneration of the discs at adjacent levels of the spine.

The spinal discs are situated between the bones or vertebrae of the spine and serves as a lubricant or shock absorber for the vertebrae. The discs also play an important role in the flexibility and the movement of the spinal column.

As an individual age, the discs become weakened and develop tears or cracks in the outer portion, leading to degenerative disc disease. In addition, the inner portion may swell and press against the outer portion which leads to pain.

Replacement of worn out disc is the purpose of artificial disc replacement and also preserving the movement of the spine. The outcome is decreased in back pain and there is no increased risk of developing problems near the spine.

2. Bone Marrow Transplant

This is a medical procedure that is done for the replacement of bone marrow that is damaged or destroyed as a result of disease, infection or chemotherapy (oncology procedures). Bone marrow transplant involves the transplantation of blood stem cells that go into the bone marrow where they produce new blood cells and support the growth of new bone marrow.

The spongy, fatty tissue found inside the bone is known as the bone marrow.  The bone marrow is responsible for the formation of the following parts of the blood:

  • The red blood cells that carry oxygen and nutrients to all parts of the body
  • The white blood cells that help to fight infection
  • The platelets (Thrombocytes), responsible for the formation of clots

Bone marrow also contains immature blood-forming stem cells called hematopoietic stem cells or HSCs. Most cells are already differentiated and can only reproduce some copies of themselves. However, these stem cells are not specialized, this means that they have the potential to multiply through cell division and either remain stem cells or differentiate and grow into many different kinds of blood cells. The HSC found in the bone marrow will create new blood cells throughout the lifespan of an individual.

Bone marrow transplant replaces the damaged stem cells with healthy cells. This helps the body produce enough white blood cells, platelets or red blood cells to prevent infections, bleeding disorders or anemia.

Healthy stem cells can come from a donor or your own body. In such cases, stem cells may be collected or cultured prior to chemotherapy or radiation therapy. Those healthy cells are then stored and used in transplantation.

The three types of bone marrow transplants are:

 

  • Autologous bone marrow transplantation
  • Allograft bone marrow transplant
  • Umbilical cord blood transplant

The success of bone marrow transplantation depends primarily on the genetic proximity of the donor to the recipient. Sometimes getting a good match among unrelated donors can be very difficult.

The state of your transplantation will be monitored on a regular basis. After the first transplant, it is usually completed between 10 and 28 days. The first sign of transplantation is the increase in the number of white blood cells. This shows that transplantation begins to produce new blood cells.

3. Foraminotomy

Foraminotomy is a surgical procedure that is done to extend the area around one of the bones in the spinal column. The operation reduces the pressure on the compressed nerves.

The spinal column consists of a chain of bones called vertebrae. The intervertebral discs are located above and below the flat portion of each vertebra to provide support.

The spinal column houses the spinal cord and helps to guide it against injury. The spinal cord sends sensory data from the body to the brain. The spinal cord also sends orders from the brain to the body. The nerves spread out from the spinal cord, sending and receiving this information. They leave the spinal column through a small hole (intervertebral foramen) located between the vertebrae.

During foraminotomy, an incision will be made on the back or neck by the doctor exposing the affected vertebra. Then the doctor can surgically expand the intervertebral foramen, removing any blockages.

4. Hiatal Hernia Surgery

The occurrence of a hiatal hernia is due to the ascension of the stomach into the chest. In the event that a hernia results in severe symptoms or is likely to cause complications, then the hiatal hernia surgery may be necessary.

It is not everyone with a hiatal hernia needs surgery. A lot of people will be able to treat the condition with the use of medication or making changes to their lifestyle. However, for those whose condition requires surgery, there are a number of interventions, most common is Nissen fundoplication.

When is Operation Necessary?

Most hiatal hernias do not lead to symptoms, so treatment is usually not necessary. Those with mild symptoms such as heartburn, acid reflux or gastroesophageal reflux disorder (GERB) may be able to treat their condition with drugs or lifestyle changes.

The three types of operations for hiatal hernia are Nissen fundoplication (keyhole surgery), open repairs and endoluminal fundoplication. All three procedures require general anesthesia.

5. Vertebroplasty

Vertebroplasty is an outpatient procedure that is carried out for stabilizing the spine compression fracture. Bone cement is injected into back bones (vertebrae) that have cracked or broken, often due to osteoporosis. The cement hardens, stabilizing the fracture and supports the spine.

For individuals with serious, disabling pain which occur as a result of a compression fracture, vertebroplasty can relieve pain, increase mobility, and reduce the use of pain medication.

Another procedure similar to vertebroplasty is Kyphoplasty. But unlike vertebroplasty, Kyphoplasty make use of special balloons to create spaces within the vertebra that are then filled with bone cement. Kyphoplasty can correct the spinal deformity and restore the lost height.

 

How does vertebroplasty work?

Before the procedure:

Your doctor will probably order an x-ray, establish a complete medical history, and perform a physical examination to determine the location and the specific nature of the vertebra-related pain. The doctor can also make use of magnetic resonance imaging (MRI) or computed tomography scan (CT or CAT scan).

Inform your doctor about all prescription drugs as well as any herbal supplements you are taking.

Let your doctor know in the event that you have a history of bleeding disorders or if you are taking anticoagulants drugs such as aspirin or other medicines that affect blood clotting.

During the procedure your doctor:

Give you sedation medication that will help you relax and stay calm during the procedure or general anesthetic for intense pain

Use a continuous X-ray to direct the needle through the broken vertebra, guarding your body against radiation.

He slowly injected the cement into the vertebra. Depending on how cement enters the vertebrae, your doctor may apply another injection to fill it completely.

After the procedure:

You will probably lie on your back for 1 hour while the cement hardens.

You will probably stay in the observation room for 1 to 2 hours.

You may feel pain immediately after the procedure, but it may take up to 72 hours. Your doctor can provide over-the-counter pain relievers for the temporary discomfort.

Your doctor will evaluate your pain and look for any complications.

You may have to continue to put on back brace but this is usually unnecessary.

After several weeks, you can check back for follow up an appointment

If you have back injury, spine surgery can be the best option for you. The vast majority of back problems can be solved by non-surgical treatments, often referred to as non-surgical or conservative treatments.