When should I consider Back Surgery?
Back problems have become an important cause of pain, suffering and disability in the United States over the past several years. Most people are initially treated with conservative treatments. These may include weight loss, chiropractic manipulation, physical therapy, massage, acupuncture and epidural steroid injections. The results vary from good to bad. Some people initially have good relief but the treatment looses effectiveness over time.
Today people are turning to back surgery more then every to relieve pain, suffering and improve quality of life, but back surgery is not all it is cut up to be. There is a wide spectrum of results of back surgery from poor to excellent. Some people are actually worse after surgery even when there are no complications. The results of back surgery may depend on duration of the problem (is this pain or injury new or old?), pathology (what is actually wrong with the back?), your other medical conditions (poor medical health may increase the risk of surgical complications or hamper neurological recovery), type of surgery performed, but not limited to these factors.
What are the Factors to Consider?
Traditional open spine surgery involves a large skin incision, significant muscle retraction and bone removal to reach the problem. Muscle retraction may lead to muscle damage and atrophy making the back weak leading to difficulty maintaining natural curvatures and pain. Bone removal may impair facet joints ability to hold the spine together producing spinal instability, pain and slippage (called spondylolithesis). Patients are concerned about tissue damage, safety, long hospital stays, postoperative pain and recovery, return to work and long-term results. People are looking for different surgical options than traditional open back surgery.
This has led to development of new percutaneous spinal technology. Endoscopic spine surgery is the most exciting development. This is sometimes referred to as laser spine surgery. Endoscopic spine surgery is an extremely minimally invasive spine surgical option. The pencil-sized endoscope is inserted into the spine to find and fix pathology under direct visualization. The surgical site is visualized through the endoscope instead of microscope or naked eye; decreasing the skin incision size from inches to the size of a fingernail. Due to the very small surgery there is less skin, soft tissue, muscle and bone damage decreasing pain, hospital stay (most often done out patient) and recovery. This may also decrease the risk of development of future related spinal problems.