Spine or Back Pain
Get an Consultation
Orthopedic Center of Excellence
Spine or Back Pain
Back pain includes lower back pain, middle back pain, upper back pain or low back pain with sciatica. Nerve and muscular problems, degenerative disc disease, and arthritis can result in back pain. Back pain symptoms may be relived with pain medication or pain killers.
Aging, improper body mechanics, trauma and structural abnormalities can injure your spine, leading to back pain and other symptoms such as leg pain and/or numbness or even leg weakness. Chronic back pain is a condition that generally requires a team of health professionals to diagnose and treat.
Open surgery vs. minimally invasive surgery
Traditionally, spine surgery is usually performed as open surgery. This entails opening the operative site with a long incision so the surgeon can view and access the spinal anatomy. However, technology has advanced to the point where more spine conditions can be treated with minimally invasive techniques.
Because minimally invasive spine surgery (MISS), does not involve long incisions, open manipulation of the muscles and tissue surrounding the spine is avoided, therefore, leading to shorter operative time. In general, reducing intraoperative (during surgery) manipulation of soft tissues results in less postoperative pain and a faster recovery.
The advantage over traditional open surgery is that the joint does not have to be opened up fully. For knee arthroscopy only two small incisions are made, one for the arthroscope and one for the surgical instruments to be used in the knee cavity. This reduces recovery time and may increase the rate of success due to less trauma to the connective tissue. It is especially useful for professional athletes, who frequently injure knee joints and require fast healing time. There is also less scarring, because of the smaller incisions. Irrigation fluid is used to distend the joint and make a surgical space. Sometimes this fluid leaks (extravasates) into the surrounding soft tissue, causing edema.
The surgical instruments are smaller than traditional instruments. Surgeons view the joint area on a video monitor, and can diagnose and repair torn joint tissue, such as ligaments. It is technically possible to do an arthroscopic examination of almost every joint, but is most commonly used for the knee, shoulder, elbow, wrist, ankle, foot, and hip.
When surgery may help
Most back surgeries are done to treat nerve pain from herniated discs. Surgery might be an option when a disc problem causes pain in your leg that prevents you from doing everyday tasks. You may have pain, numbness, or tingling through your buttock and down the back of your leg or in the front of your thigh.
Other problems that may require surgery include:
- A spinal fracture caused by an injury.
- An infection in your spine.
- A problem that causes your spine to be unstable.
- A tumor in your spine.
- Spinal stenosis.
- Loss of feeling or weakness in your back or legs that gets worse over time.
- Loss of control of your bowel or bladder.
Having surgery for a herniated disc or another back problem is a big decision. Talk to your doctor about it.
There are several types of back surgery. Some, like a discectomy, can help people who have severe symptoms. Others have not been proved to work.
If you do need surgery, you and your doctor will decide which type is best for you. Types of surgeries include:
- Percutaneous discectomy.
- Laminectomy for spinal stenosis.
- Kyphoplasty and vertebroplasty.
- Surgeries for tumors and infection.
- Spinal fusion.
Rehabilitation after surgery
A comprehensive rehabilitation program is very important after most back surgery. As you regain flexibility, recondition your back and stomach muscles, and increase your endurance for activity, you increase your chances of treatment success.
If you are unable or unwilling to commit to physical therapy after surgery, you may not be a good candidate for surgery.
Deciding whether to have surgery
Before resigning yourself to surgery, consider getting opinions from Dr T Sringari, MCH, MS, Ortho. The consultation with him is an investment of time and information-gathering that will help you make an informed treatment decision that will best support your lifestyle and desired level of physical activity