Back surgery - an overview

Your spine runs down the length of your back from just underneath your skull down to your coccyx. There are twenty-four small bone blocks called vertebrae each with a spongy, tough cartilage in between them called discs.

These discs ensure the bones move smoothly over one another and provide important shock absorbing qualities during physical movement. Muscles, ligaments and tendons hold them all in place ensuring the spine provides a continuous, protective surrounding for the spinal cord – the main communication cable between your body and brain.

This article on back surgery (spinal surgery) is written by Jackie Griffiths, a freelance journalist who writes health, medical, biological, and pharmaceutical articles for national and international journals, newsletters and web sites.

Back pain

Back pain often just disappears by itself over time, even if it’s been extremely painful for a while. It can sometimes take weeks or even months for the pain to go away completely, but if it does not get better and you develop chronic back pain you may be a candidate for back surgery.

Back pain is caused by damage to the nerves in the spine, which in turn is caused by any number of back-related problems, the most common of which include: a herniated or prolapsed disc (commonly referred to as a ‘slipped disc’), osteoporosis, osteoarthritis, spinal stenosis, or a bulging disc.

Back surgery

Spinal surgery is rare as most problems are resolved without such drastic measures, however in emergencies, such as sudden onset incontinence, or for people with progressive neurological function loss, back surgery can help. There are three ways that having an operation can help in treating chronic back pain conditions – by decompressing a nerve root or the spinal cord, by fusing a segment of the spine, or by helping to reduce the appearance of deformity, such as scoliosis surgery in the mid-spine area.

If you’re one of the few people who need back surgery to solve the chronic pain in your back then you’re likely to undergo one of the following procedures:

Discectomy – this kind of back surgery is undergone by people who’ve experienced a prolapsed disc. Although in 90% of cases the problem will heal by itself, there is a minority of people who need surgery. Each disc that sits in between your vertebrae consists of a jelly-like substance contained within a tough outer shell. If this shell becomes damaged the jelly-like substance can spill out. This is called a prolapse, and can press on the surrounding nerves causing pain known as ‘siatica'. During a discectomy operation, all the remaining jelly-like substance is cleared away, leaving scar tissue to fill the space.

Lumbar laminectomy – for people who have stenosis, this operation can help relieve the pain they feel every day. It involves cutting away some of the bone that’s causing the pressure on the nerves, giving the nerves more room and minimising everyday pain. Although the nerves may not completely recover from being previously squashed, in 70%-80% of patients there is significant pain relief.

Spinal fusion – if you’re experiencing chronic back pain due to the movement of worn out or damaged discs, spinal surgery can be performed to fuse two or more vertebrae together, which will stop them moving and prevent the pain. The operation involves removing the damaged disc completely and linking the two vertebrae together in one of three ways: by plates and pins, inserting a cage into the space where the disc used to be, or by using bone grafts.

Disc replacement – this is an alternative operation to the spinal fusion back surgery. After the removal of the damaged disc, a disc implant made of metal or metal and plastic, is put in its place, minimising stress to neighbouring vertebrae. However, this is a new procedure and there are some problems with breaking or infected implants.

Vertebroplasty – carried out under local anaesthetic, this procedure helps people who’ve had a spinal fracture caused by severe osteoporosis. You can usually go home the same day. During the operation, the surgeon injects liquid cement or glue into the collapsed vertebrae, in order to make it solid and strong and relieve the pain.

As with all surgery, there are inherent risks when undergoing back surgery, however most people with back pain will never need an operation as pain can be managed with medication, exercise and physiotherapy. Many people also find that the pain clears up by itself. But in the small minority of people who need more robust medical intervention, back surgery can offer a way back to a more mobile and pain-free life.

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Back surgery - an overview
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