What are the Different Types of Spinal Surgery

There are a variety of different procedures available to patients undergoing spine surgery, depending on what condition is being treated and which surgical techniques are utilized. Knowing your options can help you make a more informed decision about which type of surgery is best for your lifestyle.

While it is highly effective, spine surgery is not for everyone; in most cases, conservative treatments will be attempted before surgery is even considered as an option. These include physical therapy, lifestyle changes, rest, and medication. Many patients respond well to conservative treatments and never need surgery at all. However, some patients need surgical treatment. For patients who need it, spine surgery can be life-changing.

Conditions

Spine surgery is used to treat a variety of common conditions, including:

• Herniated discs
• Bulging discs
• Stenosis
• Arthritis
• Bone spurs

While these conditions can occur in any part of the spine, they are most common in the lower back (lumbar spine), followed by the neck (cervical spine) and upper back (thoracic spine). The lumbar spine bears the most weight and also has a large range of motion, making it most prone to injuries; the thoracic spine has a relatively small range of motion while also carrying the least amount of weight, making it most prone to injury. Because the spinal cord ends early in the lumbar spine, becoming the cauda equina ("horse tail"), surgery on that area is usually a less delicate procedure than surgery on the cervical or thoracic spine.

Spine surgery may be needed to treat more rare conditions, such as spinal cord tumors. While most surgeries are performed by orthopedic surgeons, treatment for tumors and other serious conditions is performed by specialists.

The symptoms of many of these conditions mirror each other - since they generally cause pain by pressing against the nerves, there is often no way to differentiate the conditions without further diagnostic testing, such as MRI.

Most of the routine spine conditions listed above cause symptoms because excess or misplaced tissue presses against the spinal cord or nerve roots. During surgery, this tissue is removed, alleviating symptoms. In addition, it may sometimes be necessary to perform procedures which strengthen the spine, such as vertebral fusion or the addition of hardware.

Procedures

Two main procedures are available for the treatment of routine spine conditions: open back surgery, and laser spine surgery.

During open back surgery, surgeons use scalpels to create a wound several inches long. Then, muscle and connective tissue is pulled back to access the vertebrae. To access the affected area, it may be necessary to remove a small part of vertebral bone, which is replaced after the procedure. Once the area is accessed, the surgeon uses special tools to manually remove tissue. Open back surgery is a major procedure, requiring a stay at the hospital, general anesthesia, and significant downtime. In contrast, minimally invasive spine surgery:

• Requires an incision about the size of a needle
• Uses endoscopic cameras to allow the surgeon to see the area
• Uses laser technology to dissolve excess tissue
  
• Uses small, specialized tools to treat issues like bone spurs
• Can be performed in an outpatient setting
• Allows patients to return to work in as little as a week

Laser surgery is an especially strong option for people with lifestyles that do not allow them to miss work for large amounts of time. It may also be considered by people with past health issues that make traditional surgery risky, such as a compromised immune system. People who respond negatively to general anesthesia or prescription painkillers may also be particularly strong candidates.

Only a doctor can tell you whether you are a good candidate for spine surgery. To schedule your consultation today, please call the Datta Endoscopic Back Surgery and Pain Center at 212-420-0312.