Surgery and Risks
Deciding to proceed with spine surgery can be challenging. Surgery for back or spinal conditions is usually considered only after non-surgical treatments have failed to provide sufficient relief. Even then, surgery does not guarantee improvement for every patient.
Understanding the potential benefits and risks of spine surgery is an important part of the decision-making process. Having clear information in advance can help patients make informed choices about their care.
Benefits of Spine Surgery
The primary aim of most spine surgery is to relieve pain caused by structural problems in the spine. For many patients, successful surgery results in a significant reduction in pain.
Reduced pain may lead to several additional benefits, including:
- Improved ability to remain active
- Better overall physical fitness
- Improved mood and quality of life
- Reduced reliance on pain medication and fewer medication-related side effects
- Ability to return to work
- Improved productivity at work
It is important to note that not all patients experience a reduction in pain following surgery. Predicting who will benefit most can be difficult. As many spinal conditions improve over time, non-surgical treatments such as physiotherapy are usually recommended before considering surgery.
Risks of Spine Surgery
The majority of patients undergoing spine surgery do not experience complications during or after their procedure. However, as with all surgical procedures, spine surgery carries some degree of risk.
General risks associated with spine surgery may include:
- Reaction to anaesthesia or other medications
- Bleeding
- Infection
- Blood clots, including clots in the legs or lungs
- Heart attack or stroke
- Recurrent disc herniation
- Nerve injury, which may result in weakness, pain, paralysis, sexual dysfunction or loss of bowel or bladder control
The level of risk varies depending on the individual, the underlying condition and the type of surgery performed. Discussing personal risk factors with a spine surgeon is an essential part of surgical planning.
Types of Spine Surgery: Risks and Benefits
Spinal Fusion
Spinal fusion is one of the most commonly performed procedures for spinal conditions. It involves joining two or more vertebrae together to reduce movement and stabilise the spine. Limiting motion between vertebrae can help relieve pain and reduce nerve irritation.
For most patients, reduced spinal movement does not significantly limit everyday activity. A specific risk associated with spinal fusion is incomplete fusion of the vertebrae, which may require further surgery. Smoking increases the risk of incomplete fusion and post-operative infection.
Laminectomy
A laminectomy involves removing part of the vertebral bone, bone spurs or ligaments to relieve pressure on the spinal nerves. While this procedure can be effective in reducing pain and weakness, it may reduce spinal stability.
If instability develops, a spinal fusion may be required either at the same time as the laminectomy or as a later procedure.
Foraminotomy
During a foraminotomy, bone is removed from the sides of the vertebrae to widen the space where nerve roots exit the spine. This can reduce pressure on the nerves and improve symptoms.
As with laminectomy, foraminotomy may lead to reduced spinal stability in some cases. A spinal fusion may be performed at the same time or later if instability occurs.
Discectomy
A discectomy involves removing part or all of a damaged intervertebral disc that is pressing on a nerve. The procedure may be performed through a traditional incision or using minimally invasive techniques.
Discectomy is often combined with other procedures such as laminectomy, foraminotomy or spinal fusion, depending on the underlying condition.
Disc Replacement
Artificial disc replacement involves removing a damaged disc and replacing it with an artificial implant. This procedure aims to preserve motion in the spine and is an alternative to spinal fusion in selected patients.
Recovery time may be shorter than with spi