Spinal Surgery: Purpose, Procedure, Benefits and Side Effects

Long-term back pain that has not responded to medication or physical therapy requires surgical intervention. Spine surgery is only advised when the precise reason and location of the pain have been identified in situations with severe back pain. Spinal surgery can be done either by 'open surgery' or 'minimally invasive' techniques.

Open Surgery
The most common spinal technique involves making a lengthy incision at the surgical site to expose the patient, giving the surgeon the best possible view of the spine.

Compared to minimally invasive procedures, this method necessitates a lengthier surgery and recovery period.

Minimally invasive
The newest and least invasive method of doing spinal surgery includes making a tiny incision through which the surgeon views the patient's spine using an endoscope, a lit microscopic camera. The operation is subsequently finished by surgeons using specialist equipment.

Through a tiny hole in the body, the muscle and tissue are moved during this operation to avoid making big incisions. Patients get a quicker healing period and a smaller incision site as a consequence.

Open surgery and minimally invasive techniques are both intended to relieve the patient's persistent back pain.

When considering the surgical technique, physicians take three surgical methods into account. The first is known as the anterior approach, and it involves making an incision through your belly to access the spine. The second method involves making an incision on your back and is known as the posterior approach. The third method is called a lateral approach, and it involves reaching the spine from the sides.

Any sort of spine surgery ultimately aims to relieve the patient's back or neck discomfort so they get to live an improved quality of life and may take back control of their lives. Therefore, one of the primary advantages of spine surgery is that the patient will be more mobile. Additionally, patients will notice a lack of or a reduction in the need for medication and other non-surgical therapies.

Here are some of the several benefits from spinal surgery;

• Increased mobility enables pain-free participation in all of your favorite activities.
• Reduced numbness/pain.
• Little or non-existent dependence on painkillers.
• Decreased likelihood of further operations.
• A rise in both physical and mental wellbeing leads to an improvement in productivity in daily living.

Spinal surgery is performed as:

• It is a treatment option for issues including fractures.
• To treat tissues and bones that may be obstructing the spine canal and placing pressure on the spinal cord or the nerves that run along it, through spinal fusion which can be performed on its own or in combination with other treatments.
• It can also be carried out as part of a post-surgery checkup to treat issues such as herniated discs, spinal stenosis, infections, tumors, and traumas.

Any patient undergoing surgery should be aware of the risks and potential consequences. Risks involved with spinal surgery are;

• Bleeding or infection at the location of the cut
• Response to anesthetic or another drug
• Stroke or heart attack
• Harm to nerves or their roots
• Herniated disc(s)
• Chances of cerebrospinal fluid spill that happens when the dura mater, the outermost layer of connective tissue around the spine, tears.

The night before your operation, it's crucial that you don't eat or drink anything after midnight. You must refrain from eating solid meals after 9 p.m. and drinking any liquids, even water, after 12 a.m.

The night before surgery, your doctor could suggest that you have a fleets enema.

Before your hospitalization, take off any jewelry, including wedding bands, to avoid swelling in the morning.

You should bring your own toiletries with you to the hospital for comfort. Include undergarments and loose, comfy pajamas or nightgowns on your packing list. A robe (not floor length) and slippers—or soft, low-heeled shoes with closed backs like sneakers, walking shoes, or loafers—are additional necessities. Please bring cotton t-shirts to put underneath your brace if you will be wearing one following surgery.

The nurse will ask you to take off all of your clothes, including your underwear and socks, and put on a hospital gown in order to be ready for surgery. You should also take off any contact lenses, dentures, wigs, hairpins, jewelry, and prosthetic limbs. Give your guests permission to keep these and other personal items for you while you are having surgery and until you are in your designated room. Before leaving your room, you will be requested to use the restroom to empty your bladder.About an hour before your operation, an escort will carry you on a stretcher to the operating room.

The nurse will then guide any guests to the surgical family waiting area so they may stay there while you have surgery. Your surgeon will call your guests there after the procedure is complete.You will be interviewed by an anesthesiologist before going into the operating room, and they will start an intravenous line in your arm. To assist reduce the chance of infection, intravenous antibiotics will be begun and continued following the procedure.

The anesthetic that you and the anesthesiologist have discussed will be administered to you once you are in the operating room. Several hours will pass throughout the procedure. The time for skin preparation, positioning, and anesthetic is included in this estimate. To assist safeguard their spinal cord and nerves throughout the surgery, some patients require spinal monitoring known as Somatosensory Evoked Potentials (SSEP) during the process. A technician will apply sticky electrodes to your body if you are having SSEP.

Lumbar microdiscectomy
One of the most significant minimally invasive surgical techniques used to relieve pain from pinched nerves is a lumbar microdiscectomy. The afflicted area (which is in contact with the pinched nerve root) is first removed by a small incision in the patient's lower back. It effectively reduces pain with a success rate of between 90 and 95 percent. The patient frequently feels an immediate reduction in discomfort. For other people, the symptoms might not go away entirely.

Lumbar laminectomy
Symptoms of lower back stenosis are treated by a lumbar laminectomy. In this treatment, the lamina- the bone that is found at the back of one's vertebra, is removed from one or more segments, which protects the nerves in the spine from coming under any more strain.

You will awaken following surgery in the recovery room or Post-Anesthesia Care Unit (PACU) to recover from anesthesia. Usually, this takes between one and two hours. There, a nurse will routinely keep an eye on your vital signs (heart rate, blood pressure, temperature and respiratory rate). The nurse will also examine your clothing, your legs and toes for movement, as well as your circulation. A member of the surgical team will let your family know when the procedure is over.

In India, spinal surgery typically costs between 1,40,000- 3,70,000. It is crucial to think about the expense of recovery and account for any required physical therapy, back braces, medicines, etc.

The price of spinal surgery varies from hospital to hospital or from treating doctor to doctor. However, depending on the complication and infrastructure, the typical cost of spinal surgery in India starts from Rs.1,40,000 and Rs.3,70,000. The average cost of spinal surgery in India is Rs. 2,50,000.

The patient will be kept under observation for a few days following the spinal surgery. The patient wouldn't need to stay in bed if they were recovering at home. Your doctor may advise a back brace for you in order to hasten your rehabilitation. Following surgery, recovery might take time. The rehabilitation regimen often consists of exercises including walking, swimming, and stationary cycling.

After release, you ought to be capable of;

• Get out of bed on your own.
• With or without a walker, move down the hallway.
• If necessary, ascend stairs at home.
• Take a shower and take care of your personal hygiene.
• Recognize any guidance for your rehabilitation.

You may increase your chances of a positive outcome by eating-

• Fresh fruits
• Vegetables
• Lean Meat
• Berries
• Beans
• Banana

Many vitamins and micronutrients assist in the healing process following a procedure like spinal fusion surgery.

Since prescription painkillers frequently slow the intestines, stay away from fatty, processed meals that might result in constipation.

To keep your intestines regular following surgery, talk to your doctor about taking a fiber supplement or stool softener.

Spinal surgery is one of the complicated procedures that has to deal with a lot of nerves connected to your spinal cord. Like any other major surgical treatment, spinal surgery also has its fair share of side effects. However, to restore stability to the spine following any trauma, accident, or injury, spinal surgery is crucial.

Even though it does offer relief from a number of back ailments, it is always advisable to speak with the doctor about the risks and advantages before undergoing this expensive and complicated surgical procedure.

Your postoperative pain and healing are influenced by a variety of factors. The type of spinal surgery you've had, the severity of your condition, illness, or bone degeneration, your age, your degree of fitness and mobility before surgery, your mental state, if you have chronic pain, etc.

All have an impact on how painful your recovery will be. For instance, in a younger, fitter patient, pain following multiple vertebral spinal fusion surgery can be greater than pain following a less invasive laminectomy.

In general, postoperative discomfort following spinal surgeries can be severe in some cases, especially in the first few days.

Recovery after spinal surgery might take up to 4 months. This is due to the fact that it takes the bones some time to fully recover, and the recovery process might last up to a year. Especially if the patient is young and in generally good physical condition, the doctor will advise that one stay off work and other activities for around a month or even longer (about 4-5 weeks) following a spinal fusion.

Patients might choose to go home right away after surgery or anticipate staying in the hospital for one to two days to be monitored. Patients who have minimally invasive spine surgery may usually anticipate a recovery period of 4 to 6 weeks, whereas those who have open surgery can anticipate a recovery period of 2 to 4 months. These usual recuperation periods will vary based on the surgery carried out.

The patient's age, general health, the operation type chosen, and the issue being treated all affect the potential side effects and problems. The following are a few potential adverse effects:

• Having discomfort at the bone transplant location
• Failure of the metal implants and/or fusion, or both
• Possibly fatal blood clots that cause pulmonary embolism
• damaging the nerves
• Infection
• Body's rejection of the bone transplantation

Back Care
As often as you can, go for short strolls and gradually increase your distance. Exercise should be done every day to maintain muscle tone, increase strength, and aid in recovery.

Avoid bending, twisting, lifting objects that weigh more than 5 pounds (1 gallon of milk), pushing, or pulling. Avoid staying up or sitting for too long. Avoid lifting anything over your head if you've undergone a spinal fusion until it's totally healed. Your surgeon will update you on the progress of your fusion's healing.

Pain Management
To prevent gaps in your pain management, take your prescribed pain medications as prescribed and be sure to call for refills on time. If the prescription medicine is not adequately controlling your pain, don't take more than suggested, and call your surgeon.

Other non-drug pain management techniques include moist heat (not directly on a wound that hasn't healed), light exercise, massage, brief rest intervals, and frequent positioning.

Healthy diet
Establish a healthy, low-fat diet that is high in fresh fruit and vegetables. Avoid hefty, high-calorie, or fatty items while you're recovering because your activity level will be lower. Eating correctly is crucial for a speedy recovery and will also help you maintain a healthy weight once your recovery is complete.

Bathing and Incision Care
In accordance with your surgeon's recommendations, bathe just as directed. For at least 4 days following surgery, doctors normally advise keeping the skin surrounding your incision clean and dry. Till the wound has healed and your surgeon has given the all-clear, refrain from taking a tub bath.

Following surgery, there may likely be some pain near the incision, but this should lessen as the wound heals. To find out when to get sutures or staples removed, listen to your surgeon's instructions. Dissolving stitches or self-removing strips are used to seal certain incisions.

How to sit
Your back is most stressed while you are sitting. How long you should sit after surgery before getting up to move about may be suggested by your surgeon. For instance, you could be required to stand or move about for 10 minutes every half-hour.

If you can, stay away from long automobile trips while you're recovering.

Never sit with your knees higher than your hips, is the basic guideline. Your favorite chair, sofa, and car seat should all have a wedge or hard cushion on them. Get an elevated toilet seat, ideally with arms, to help you sit and stand up off the toilet. It fits on top of your present toilet seat.

When rising from a seat, slowly raise your hips to the edge of the seat and push up with your arms while simultaneously pushing down with your knees.

How to lay down in bed
Sleeping well speeds up your recovery. Find out from your surgeon how to get into and out of bed as well as the ideal sleeping posture for you. The following actions might relieve pressure on the spine and back, but see your physician first. Using an adjustable bed, a wedge, or supporting pillows, sleep on your back with your upper back, shoulders, and head lifted slightly.

Put a cushion or rolled-up blanket beneath the back of your knees to slightly flex your hips and knees.

Use the 'log roll method' to get out of bed. Bend your knees while lying on your back, keeping them close together. In order to prevent your spine from twisting, roll onto your side while maintaining your hips and shoulders aligned. With the help of your arms—start with the upper arm—push yourself up, then let your legs sag over the edge of the bed to sit up straight.

Bracing post-operatively
Wear the back brace as directed if your surgeon recommends one for your recuperation. The brace's purpose is to stabilize and support your neck or back while preventing movement of the levels of your spine that were fused during surgery. While some back braces are straightforward supports that resemble corsets, others are more stiff and custom-fitted to your body.

Spinal surgery can often be a very challenging and complex procedure due to the presence of the wide network of veins, arteries, and spinal nerves. It is often done as the last resort when almost all the medication and therapies fail to treat the chronic back pain, fractures, or as a part of a post-surgery checkup to treat issues such as herniated discs, spinal stenosis, infections, tumors, and traumas.