Having spine surgery is a big decision you should only take when non-surgical options have not had the desired effect. That said, about half a million Americans undergo surgery on their lower back alone every year. At a total annual cost of around $11 billion, this makes spine surgery a high-cost procedure.
Despite the complicated nature of many spinal injuries with the attendant risks of putting yourself under the surgeon’s knife, successful surgery is possible. For one, the mortality rate for all surgeries of the lumbar spine, at 0.13%, is low, according to the International Journal of Spine Surgery. That figure comes from a sample of 803,949 lumbar spine surgery patients operated on between 2003 and 2012.
This article will talk about important things to know about spine surgery and things you can do to ensure the success of your procedure.
1. Be Aware of the Risks
Every surgical procedure carries risk, and this is true for spinal surgery too. The back is an intricate system of the spine (and other bones), ligaments, joints, and muscles. The spinal column protects the spinal cord, which, together with the brain, forms the Central Nervous System (CNS).
It is the CNS that transmits the signals that you experience as pain. Pain stemming from your spine needs to be pinpointed so that treatment gets you back on the path of living a normal — and pain-free — life. Your physician will be aware that you might feel ambivalent about surgery, or even downright terrified.
Some people see back surgery as the ideal solution, but others weigh surgery against the worst-case scenario of spinal infection or paralysis if mistakes are made during surgery.
Your physician can explain in detail what the procedure in your case hopes to achieve. He or she will also be able to outline the benefits of the surgery, and also potential downsides.
As the patient, you have the right to know and understand all these things before you make any decision. It’s called informed consent. You need to be confident before the operation that everything will be okay; your positive attitude will contribute in a small way to the success of the surgery.
A good back and spine specialist will be able to provide you with all the advice, explanations, and expertise you need — before, during, and after surgery.
2. Some Back Surgeries Fail
Between 20% and 40% of back surgeries fail. This is according to the American Society of Anesthesiologists. There is a higher rate of failure for patients who have repeated back surgeries.
A pain management specialist might be able to suggest a path of treatment that brings you pain relief. This could be a good alternative to surgery. Combined with physiotherapy and a supervised program of exercise, it is possible that your back pain could go away without surgery.
Back surgery is meant to reduce pain. If it does not after surgery, then you might be classified as having a condition known as failed back surgery syndrome (FBSS).
3. Failed Back Surgery Is Rarely the Surgeon’s Fault
Failed back surgery, although quite common, is rarely because the surgeon made an error while performing the procedure. One of the main reasons for failed back surgery is that it is difficult to identify the source of the patient’s pain. This can result in a surgery being selected which does not adequately address the underlying problem.
This is also why you will so often hear the advice that you should consider non-surgical interventions and think of surgery as the last in a long line of options.
Failed surgeries are those where complications set in after surgery. Complications after back surgery do not occur that often, but you should be aware of the most common ones.
4. Possible Complications After Successful Surgery
Deep venous thrombosis is a possibility after surgery to the lumbar spine or near the pelvis.
One painful potential complication is dural tear, caused by disruption of the covering around the spinal cord during surgery. Surgeons do repair dural tears during surgery, if detected, and most dural tears heal on their own. If healing does not happen, then the resultant leaking spinal fluid could cause your headaches.
If the procedure is performed under general anesthesia, your lungs might not function as well as they normally do. Your surgeon will advise you before surgery if this is a risk for you.
Spinal surgeries generally have a low infection rate. If the site of any incisions made during surgery becomes infected, that infection could spread to the spinal cord and vertebrae. If bone grafts or metal implants are involved in your surgery, then the risk of infection is greater.
Your surgeon will prescribe antibiotics before surgery if warranted.
Metal hardware such as rods, plates, and screws could become displaced before the surrounding bones have healed. A second, corrective surgery might be needed.
If surgery damages nerves near your pelvic area, you might experience sexual dysfunction.
Spinal fusion operations (where two vertebrae are fused together) tend to cause “transitional syndrome”. This is where the healthy vertebrae adjacent to the problematic ones take on a greater part of the load during the post-surgery healing process. This can cause pain, but is usually temporary.
Spinal fusion also carries the risk of pseudoarthrosis, where the vertebrae do not fuse successfully and you experience continued pain. Additional surgery is required to fix this condition if healing does not take place or your pain worsens with time.
Remember that each surgery is unique. Talk to your surgeon about possible complications in your case.
5. When Should I Have Back Surgery?
Every single individual is different, so there is no easy answer. What we can tell you is that your physician will not recommend back surgery if it is not necessary. In some cases, as with any medical condition, spine surgery is urgent.
In other cases, surgery is possible and even desirable, and when exactly you schedule your surgery is entirely up to you.
6. Post-Operative Rehabilitation
Rehab after your operation is something you should definitely be clear about before giving consent to the operation in the first place. Aside from post-surgery check-ups with your specialist, you will probably be encouraged to follow a program of massage, physiotherapy, and exercise until you have fully recovered.
Recovery periods will vary depending on the type of surgery you have had. What is important is for you to prioritize your recovery. Follow the advice of your physician!
7. Other Chronic Conditions and Back Surgery
Heart and lung disease, diabetes, and obesity are among the chronic conditions which make back surgery riskier. If your heart and/or lungs are likely to be severely compromised, then you might not be able to have back surgery.
Another factor that brings high risk with it has to do with the number of previous back surgeries you have had. Put simply, there are only so many screws that a spine can take. Hopefully, you do not fall into this category.
There are some spine conditions that previously did not have a surgical remedy. If you have one of those conditions, keep checking from time to time to see whether new technologies have now made operating on your spine possible. You might be surprised, and it is worth checking on things that could alleviate your pain.
Be Sensible
If you have the start of back pains and problems, get them attended to right away. This applies to a sports injury or a minor injury from a vehicle accident or fall. The chances of successful surgery are much greater when a problem is dealt with early on.
Do yourself a favor and deal with the problem long before deterioration sets in and surgery becomes the only option. If you really do need to undergo a procedure, find a back or spine specialist that you can trust.
One last word: if you are healthy and have no back problems at all, keep it that way by observing good posture and following a program of regular exercise. Also, be sure to check out the rest of our blog for more helpful articles!
