Back surgery: Do you need it?

BENGALURU: Trauma, aging, improper body mechanics, and normal wear and tear can injure your spine. Damage to any part of your back or pressure on the nerves in your spine can cause back pain. If you have ongoing back pain, maybe you’ve wondered - could back surgery help? In fact, back surgery is needed in only a small percentage of cases. Most back problems can be taken care of with non surgical treatments, such as anti-inflammatory medication, ice, heat, gentle massage and physical therapy. When conservative treatments don’t help, back surgery may offer relief. But it doesn’t help every type of back pain.

BACK SURGERY MIGHT BE NEEDED

• If you have a condition that compresses your spinal nerves, causing debilitating back pain or numbness along the back of your leg.
• When you have bulging or ruptured (herniated) disks - the rubbery cushions separating the bones in your spine. However, many people with bulging disks have no pain.
• If you have broken bones or other damage to your spinal column from an injury that leaves your spine unstable.
• If you have vertebral fractures and an unstable spine related to osteoporosis.
• If you’ve first tried conservative measures and they fail to relieve your back pain or other symptoms.

The following conditions may require surgery if they’re progressive, painful or causing nerve compression:

• Scoliosis, a curvature of the spine
• Kyphosis, a humpback deformity
• Spondylolisthesis, the forward slippage of a segment of the spine 
• Spinal stenosis, narrowing of the spinal canal typically from arthritis
• Radiculopathy, the irritation and inflammation of a nerve caused by a herniated disk
• Degenerative disk disease, the development of pain in a disc due to wear and tear                      The author is HOD and consultant, spine surgery, Spine Care, Manipal Hospitals Old Airport Road

TYPES OF BACK SURGERY

Discectomy: Removal of the herniated portion of a disk to relieve irritation and inflammation of a nerve. It’s done as an open surgery and involves full or partial removal of the back portion of a vertebra to access the ruptured disk

Laminectomy: It involves the removal of the bone overlying the spinal canal. It enlarges the spinal canal and is performed to relieve nerve pressure caused by spinal stenosis

Fusion: Spinal fusion permanently connects two or more bones in your spine. It can relieve pain by adding stability to a spinal fracture. It is occasionally used to eliminate painful motion between vertebrae that can result from a degenerated or injured disk.

Vertebroplasty: Here, your surgeon injects bone cement into compressed vertebrae. For fractured and compressed vertebrae, this procedure can help stabilise fractures and relieve pain. With a similar but more expensive procedure - called kyphoplasty - a balloon-like device is inserted to attempt to expand compressed vertebrae before bone cement is injected.

Artificial discs: Implanted artificial discs are a treatment alternative to spinal fusion for painful movement between two vertebrae due to a degenerated or injured disk. These relatively-new devices are still being studied, so it’s not yet clear what role they might play as an option.

Keep in mind: Before you agree to back surgery, consider a second opinion from a spine specialist. Spine surgeons hold differing opinions about when to operate, what type of surgery to perform, etc.