Spinal disc surgery usually becomes an option only after conservative treatment for back pain fails to relieve symptoms. Because back pain is often slow to resolve, most doctors recommend treating back pain symptoms for a minimum of three to six months before considering surgery.
Two of the most common causes of back pain are a herniated disc and spinal stenosis.A ruptured, or herniated, disc happens when there is a tear of the outer lining of the disc and a fragment of the disc material protrudes and pinches the surrounding nerves. When the nerve is pinched, or compressed, it can lead to symptoms such as pain, numbness, weakness or bowel and bladder incontinence. If these symptoms are not relieved with conservative treatment, surgery may be able to remove the part of the disc that is protruding.
Spinal stenosis is a narrowing of an area of the spine, usually in the neck or lower back areas. This narrowing puts pressure on the spinal cord or nerves and the nerve roots can become swollen and irritated from being compressed. Depending on where the narrowing occurs, pain can arise in the legs, back, neck, shoulder or extremities. Spinal stenosis is most often a result of age-related degeneration of the spine although there are several genetic disorders that can cause this condition. It can also occur because of a spinal tumor or traumatic injury.
There are several different types of spinal surgery that can be performed, depending upon the type and severity of the condition being treated. A microendoscopic discectomy is a minimally invasive procedure used to remove parts of a bulging disc. A microendoscopic discectomy is performed by making a small incision in the back. A small probe and camera are inserted into the back and the surgeon uses the camera to locate the problem area. Using small tools inserted into the back through the probe the surgeon removes the herniated fragments. This procedure usually takes about an hour and the patient is often able to return home on the same day as surgery.
A laminectomy is also performed to relieve symptoms from a herniated disc as well as spinal stenosis. A laminectomy is preformed to remove the lamina, which is the bony roof of the spinal canal. Removing the lamina increases the room available for the spinal cord and nerve roots and reduces the pressure on the nerves that is causing symptoms.
A laminaplasty is similar to a laminectomy. Instead of removing the lamina, however, it is hinged on one side and rolled away from the spinal cord. This procedure allows greater expansion of the spinal canal and relieves compression of the nerve roots. This procedure is usually performed in cases of severe spinal compression at multiple levels because not removing the lamina provides greater stability.
Spinal disc surgery is not an automatic cure for back pain and should only be undertaken when conservative treatments have failed to relieve symptoms. Working with your physician to understand the available treatment options will allow you to choose the best course of treatment and receive optimum results.
