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YOU are here : Home > Spinecare Topics > Options for Spine Treatments > Back Surgery: When is it Appropriate?
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Options for Spine Treatments
Back Surgery: When is it Appropriate?
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Back Surgery: When is it Appropriate?
Instability: A region of the spine can be rendered unstable due to a loss of structural integrity. Excessive movement of a vertebra can lead to spinal cord or nerve injury. Excessive vertebral movement is referred to as instability. It may occur as the result of a destructive disease process, dislocation, ligamentous injury and/or fracture. Certain types of fractures may be associated with spinal cord injury or nerve root compression. Surgery may be required to decompress nerve structures and to provide stability to a region of the spine so that further neurological compromise does not occur. Surgery and fusion may be performed to reduce the risk for additional neurological injury.
Progressive Neurological Deficit (Muscle Weakness): Spine surgery is often indicated if there is a progressive loss of spinal neurological function unresponsive to conservative care. This includes progressive muscle weakness secondary to spinal nerve root compression. Muscle weakness will often be associated with pain and paresthesia. Nerve damage can lead to a loss of nerve connection (innervation) to muscle. This results in degeneration or atrophy of muscle fibers producing loss of muscle volume and muscle strength. If muscle strength does not recover with conservative treatment, surgery is the only option to prevent the likelihood of permanent muscle impairment.
Significant Spinal Trauma: Spinal cord injury is an obvious surgical emergency. However, a traumatic incident without spinal cord injury may ultimately lead to a surgical intervention. Severe disc injury and spinal ligament injury can lead to vertebral instability. Incapacitating back pain after trauma should be thoroughly investigated by a spine specialist. It is appropriate to have an MRI as well as x-rays or CT scan of the spine after significant trauma.
When Should Back Surgery Be Considered? (Elective Surgery)
In most situations, you will be given the option to accept or not accept back surgery. The surgeon will discuss your options based on three general categories: 1) you are not a surgical candidate; 2) you will need surgery in the future or; 3) surgery is necessary as soon as possible. It is important that you understand what information will be helpful in making such an important decision. Your attending surgeon may simply state that you are a good surgical candidate and may not provide you with sufficient information for you to understand whether surgery absolutely needs to be performed or should it wait. Be careful not to respond too quickly if neurological deterioration is not present. Wait until you review the facts and available options. Surgery does not always guarantee a favorable outcome. Most spine surgeries are elective, meaning there is time for the patient to do their homework and make an informed decision. The following considerations should be discussed before proceeding with back surgery.
Extremity Pain Greater Than Back Pain: Nerve root compression in the spine is often associated with radiating pain into the corresponding extremity. The pain perceived in the extremity is often greater in intensity than the associated neck or back pain. Disorders of the back, which do not result in damage to spinal nerves, are typically characterized by greater back pain and occasional referred pain into the extremities. There is generally great success relieving limb pain with back surgery than alleviating back pain.
Progressive Neurological Deficit (Muscle Weakness): Spine surgery is often indicated if there is a progressive loss of spinal neurological function unresponsive to conservative care. This includes progressive muscle weakness secondary to spinal nerve root compression. Muscle weakness will often be associated with pain and paresthesia. Nerve damage can lead to a loss of nerve connection (innervation) to muscle. This results in degeneration or atrophy of muscle fibers producing loss of muscle volume and muscle strength. If muscle strength does not recover with conservative treatment, surgery is the only option to prevent the likelihood of permanent muscle impairment.
Significant Spinal Trauma: Spinal cord injury is an obvious surgical emergency. However, a traumatic incident without spinal cord injury may ultimately lead to a surgical intervention. Severe disc injury and spinal ligament injury can lead to vertebral instability. Incapacitating back pain after trauma should be thoroughly investigated by a spine specialist. It is appropriate to have an MRI as well as x-rays or CT scan of the spine after significant trauma.
When Should Back Surgery Be Considered? (Elective Surgery)
In most situations, you will be given the option to accept or not accept back surgery. The surgeon will discuss your options based on three general categories: 1) you are not a surgical candidate; 2) you will need surgery in the future or; 3) surgery is necessary as soon as possible. It is important that you understand what information will be helpful in making such an important decision. Your attending surgeon may simply state that you are a good surgical candidate and may not provide you with sufficient information for you to understand whether surgery absolutely needs to be performed or should it wait. Be careful not to respond too quickly if neurological deterioration is not present. Wait until you review the facts and available options. Surgery does not always guarantee a favorable outcome. Most spine surgeries are elective, meaning there is time for the patient to do their homework and make an informed decision. The following considerations should be discussed before proceeding with back surgery.
Extremity Pain Greater Than Back Pain: Nerve root compression in the spine is often associated with radiating pain into the corresponding extremity. The pain perceived in the extremity is often greater in intensity than the associated neck or back pain. Disorders of the back, which do not result in damage to spinal nerves, are typically characterized by greater back pain and occasional referred pain into the extremities. There is generally great success relieving limb pain with back surgery than alleviating back pain.
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