Orthopaedic Conditions That Require Spine Surgery

Spine surgery is a major surgery that is often the last option for most surgeons due to the complexity and risks involved. Any slight mistakes or accidents can cause permanent paralysis of the body depending on the affected nerves in the spine. Surgeons will often recommend alternative treatments such as medication and physical therapy and when left with no other choices will they opt for spine surgery. With such high risks involved, what are some orthopaedic conditions that require spinal surgery to be carried out?

Herniated disc

A herniated disc occurs when one of the spinal disc in the vertebrae slips or ruptures, causing the soft disc materials to flow out of the disc. When the disc flows out, the movement and material can pinch on the surrounding nerves, causing pain and numbness. A discectomy will need to be carried out to remove this herniated disc that is pinching onto the nerve. A modern evolution is the microdiscectomy which uses high definition microscope to see better and is minimally invasive, reducing the risk.

Foraminotomy

Foraminotomy is performed to relieve pressure from an affected nerve in the spine. This pressure is caused either by bone fragments, scar tissues or excess ligament development in the spinal area, causing it to press against the spine and causing pain and numbness. Foraminotomy will open up the back where the nerve roots leave the spinal canal, reducing the chances of pinching.

Spinal fusion

As the name suggests, spinal fusion aims to join 2 or more vertebrae together to prevent excessive movement which may pinch onto the nerves. Loose vertebrae can press against the nerves during movement, causing pain and numbness. It will also prevent the surrounding soft tissues from stretching. Spinal fusion is based on the simple logic of “if it doesn’t move, it doesn’t hurt”. Similarly to welding in metals, spinal fusion will fuse the vertebrae together. This process however will reduce some flexibility in the spine but this is very minimal.

Artificial lumbar disc replacement

Artificial disc replacement is a new surgical process that uses man-made biomaterials to replace the affected intervertebral disc. The purpose of the spinal disc is to cushion the shock and distribute it evenly. Since the spinal discs do not regenerate as easily as our skin, biomaterials will need to be used to restore flexibility and motion.

Above are 4 orthopaedic conditions that warrant the usage of spinal surgery. Although the risks are there, medical advances have significantly reduced the risks and recovery time. Nonetheless, the risks are still present and serious considerations must be made before deciding on such major surgery as this.

Spine Surgery: Orthopaedic Surgeon or Neurosurgeon?

In the event that you require spinal surgery to cure your injured back, the first and most important decision you have to make is to choose between an orthopaedic surgeon or a neurosurgeon. The choice of the right surgeon is extremely important and you have to consider factors such as the experience and success rate of the surgeon. So how different are these 2 doctors?

You will first need to understand that both are able to carry out spine surgery. In the past, neurosurgeons were the only ones that could qualify to perform spine surgery. With the evolution in medical techniques, orthopaedic surgeons are well equipped with the knowledge and skills to carry out spine surgeries for patients as well.

Neurosurgeons are medically trained doctors who have completed at least a 4 to 7 years worth of gruelling neurosurgery residency. Neurosurgeons specialise in disorders affecting the nervous system including the brain, spinal cord and nerves. There is however one distinct part that sets them apart from orthopaedic surgeons. Neurosurgeons are the only people who are able to perform surgery that is inside the dura mater of the spine. If the patient has a tumour in the spinal cord, cysts or spinal cord malfunction, only a neurosurgeon is able to perform the surgery for him.

Orthopaedic surgeons on the other hand are medically trained doctors who have completed a 5 years surgical residency focusing on musculoskeletal disorders such as the bones and joints. Most orthopaedic doctors focus on sports injuries and bone disorders. Some orthopaedic surgeons will choose to focus on spinal injuries and they will have to spend additional few years of their time to complete fellowship training on the spine. Other than the few specialised surgeries that only a neurosurgeon can carry out, orthopaedic doctors are able to carry out other spinal surgeries.

When choosing a surgeon to perform spinal surgery for you, the main question is not to decide on whether an orthopaedic surgeon or a neurosurgeon since both are equally adept to perform the surgery. Instead, you should be asking what is his specialisation. Some are specialised in cervical spine surgeries while some are inclined to lumbar disorders. The important questions you would want to ask is how many similar surgeries have they performed to date and what are the success rates. Spinal surgery being a major surgery, you would want a very experienced surgeon to perform it on you.