Spinal surgery, also known as lumbar surgery, concerns any kind of surgery conducted on the lower back. There are two types of lumbar surgery: lumbar fusion and lumbar decompression.
The main objective of a lumbar decompression surgery is to ease the pain caused due to neural impingement (pinched nerve). This pain is referred to as sciatica or radiculopathy. This involves removing a tiny part of the bone above the root of the nerve to address the pinching of the nerves. The commonest types of a lumbar decompression surgery include discectomy and microdiscectomy.
Lumbar fusion concerns itself with easing the pain at a particular portion in the individual’s lower back. Mostly, this type of a surgery is carried out in the case of any disability or pain from spondylolisthesis or a lumbar degenerative disc condition. This technique uses a bone graft to thwart any type of movement in the painful part of the vertebra that in turn takes care of the pain that was caused due to the movement. Bone stimulators, bone grafts, and other medical devices are used in this surgery.
A Lumbar Microdiscectomy is one of the most important minimally invasive surgical procedures carried out to ease pain from pinched nerves. Firstly, a minor incision is made in the patient’s lower back and the affected part (that is in contact with the pinched nerve root) is removed. It has a pretty high success rate (of about 90-95%) in alleviating pain. Often times, the patient experiences instant relief from pain. However, for some, the symptoms might not resolve completely.
A Lumbar laminectomy, on the other hand, is performed to address lower back stenosis symptoms. In this technique, the lamina (the bone that is present at the back of one’s vertebra) at one or multiple segments is taken out that in turn prevents any further pressure to be put on the nerves in the spine.
Spinal surgery is carried out because:
There is no non-eligibility criterion as such. If the patient experiences pain from a pinched nerve or spinal instability, he/she should consult a spine surgeon and consider the decision of a spinal surgery. However, if any evidence of an anatomic cause isn’t detected through a CT scan or an MRI scan, then spinal surgery should be avoided. In a nutshell, there must be some anatomical lesion that can be considered to be the reason behind such a pain. At the end of the day, however, it is completely the patient’s discretion whether or not to go for spinal surgery.
The possible side effects and complications depend on the patient’s age, the overall state of health, the type of procedure opted for and the problem that is being treated. Some of the possible side effects are:
After the spinal surgery, the patient will be kept under supervision for a few days. If the patient is recuperating at home, bed rest would not be required. A back brace might be prescribed by the doctor for you so as to speed up the recovery process. Rehabilitation post-surgery can take its own time. Usually walking, swimming and riding a static cycle are some of the activities that constitute the rehabilitation program.
Post spinal surgery, recovery can take about 4 months’ time. This is because the bones take the time to heal completely and the healing process may continue over a period of one year. In the case of a spinal fusion, the doctor will recommend one to be off work and other activities for about a month or even more (approximately 4-5 weeks); especially if the patient is young and is in otherwise good physical shape.
The cost of spinal surgery in India lies in the range of approximately Rs.4, 22,500- Rs.6, 17,500.
Spinal surgery is important to render stability to the spine after any trauma, accident or injury. However, there isn’t sufficient research about whether it works as effectively for other problems of the spine as well. Studies have failed to come up with stark differences in the way this surgery and intense rehabilitation would work for chronic problems. Though it does provide relief from quite a few problems with the back, it will always be wise to consult with the doctor regarding the risks and benefits, given that it is a costly surgery and entails its fair share of side effects.
The possible alternatives include: