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YOU are here : Home > Spinecare Topics > Options for Spine Treatments > Back Surgery: When is it Appropriate?
Spinecare Topics
Options for Spine Treatments
Back Surgery: When is it Appropriate?
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Back Surgery: When is it Appropriate?
Poor or No Response to Conservative Care: Surgery may be indicated in some cases where conservative care has been partially successful. Conservative treatment is the treatment of choice for most back conditions. If a course of conservative treatment does not provide significant improvement back surgery may be an option. It is important that all reasonable efforts be made to treat the back using a variety of conservative approaches. A combined or integrated approach may work when an isolated approach fails. A multidisciplinary treatment approach may offer many benefits for improvement.
When Symptoms Match Test Findings: There is a greater likelihood of having a favorable outcome after spine surgery if your signs and symptoms correlate well with a structural lesion. For example, nerve and muscle (electrodiagnostic) studies can be extremely helpful in determining the significance of nerve damage as it relates to a structural spine lesion revealed on advanced imaging such as a CT scan or MRI.
Refusal to Accept Symptoms: If symptoms are severe or progressive despite a protracted course of conservative care consider exploring your surgical options. Be cautious not to make a quick decision unless there is a surgically correctable structural lesion in the spine that correlates with the symptoms. Intractable spine pain often leads an individual to the surgeon’s office to seek out a surgical option. Do not let a surgeon determine what level of pain you can tolerate. This must be your decision.
Surgical Correction of Spinal Instability
When spinal instability has progressed to the point of severe pain and other neurological symptoms, surgical intervention may be the only choice. During surgery, vertebral dis-relationship may have to be corrected by realigning the vertebrae back into normal position and fixing or fusing it into place. The necessary modification of vertebral relationships can be performed with external traction devices as well as with manual methods. Special devices have been developed to help the spine surgeon pull a vertebra back into alignment while preserving the opening and contents of the central canal and lateral canal. Some surgical approaches require decompression of one or more nerve roots as well as fusion to stabilize a spinal region. If a vertebrae is fused in an abnormal position this may contribute to persistent pain as well as neurological signs and symptoms
When Symptoms Match Test Findings: There is a greater likelihood of having a favorable outcome after spine surgery if your signs and symptoms correlate well with a structural lesion. For example, nerve and muscle (electrodiagnostic) studies can be extremely helpful in determining the significance of nerve damage as it relates to a structural spine lesion revealed on advanced imaging such as a CT scan or MRI.
Refusal to Accept Symptoms: If symptoms are severe or progressive despite a protracted course of conservative care consider exploring your surgical options. Be cautious not to make a quick decision unless there is a surgically correctable structural lesion in the spine that correlates with the symptoms. Intractable spine pain often leads an individual to the surgeon’s office to seek out a surgical option. Do not let a surgeon determine what level of pain you can tolerate. This must be your decision.
Surgical Correction of Spinal Instability
When spinal instability has progressed to the point of severe pain and other neurological symptoms, surgical intervention may be the only choice. During surgery, vertebral dis-relationship may have to be corrected by realigning the vertebrae back into normal position and fixing or fusing it into place. The necessary modification of vertebral relationships can be performed with external traction devices as well as with manual methods. Special devices have been developed to help the spine surgeon pull a vertebra back into alignment while preserving the opening and contents of the central canal and lateral canal. Some surgical approaches require decompression of one or more nerve roots as well as fusion to stabilize a spinal region. If a vertebrae is fused in an abnormal position this may contribute to persistent pain as well as neurological signs and symptoms
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