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Benefits and Risks of Back Surgery
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Benefits and Risks of Back Surgery
An embolism can also travel from the right side of the heart to the left side of the heart if the patient has a patent foramen ovale (PFO). A PFO refers a to small developmental hole between the right and left upper chambers of the heart (atria). As many as one out of every five individuals (20%) has such as defect. This is best detected with high-resolution ultrasound imagery (trans-esophageal echocardiogram) and Doppler studies. If an embolism travels to the left side of the heart and into general circulation, it can travel to the brain and cause a blockage of a blood vessel within the brain resulting in a stroke. It is critical that all necessary steps be taken to reduce the risk for DVT.
There are two primary methods used to reduce the risk for thrombophlebitis. They are the medical and mechanical approaches. These two approaches are often used simultaneously. The medical approach requires the use of drugs to reduce hypercoagulation states and blood clotting tendencies. Pharmaceutical anti-clotting agents may be administered by mouth, via injection or through an intravenous line (IV). A mechanical approach can also be used to improve blood flow. The mechanical approach may involve the application of support stockings, compression boots (pulsatile stockings), early lower extremity movement/exercise and elevated positioning of the legs. In some cases, surgery may be required to place a filter into the vena cava, a large vein that carries blood to the heart. The filter is used to catch emboli before it reaches the heart, lungs and brain.
Transitional Syndrome
The spinal column is a stack of repeating segments referred to as spinal motion segments. When each segment of the spine is working like it should, the entire spine is capable of supporting loads, bending and protecting its neural (spinal cord and nerves) elements. Each spinal motion segment works in conjunction with neighboring (adjacent) segments to provide regional spine movement and to disperse the stresses (loads) placed upon them.
If one or more levels of the spine are fused together, the spinal segments around the fused segments are placed under additional mechanical loads/stress. The spinal segment closest to the abnormal segment accepts most of the additional stress/strain. This can lead to additional wear and tear and subsequently compromise of the supportive tissues including ligaments, tendons and the intervertebral disc. This chain of events results in inflammation and can result in intermittent or persistent pain. The intervertebral disc is exposed to greater stress and may undergo accelerated degenerative changes with eventual herniation. The constellation of signs and symptoms associated with a spinal fusion is called a transitional syndrome because it occurs where there is a transition from a normal area of the spine to an abnormal area that has been surgically fused.
Failed Back Syndrome (FBS): (also under failed back syndrome)
Failed back surgery syndrome (FBSS) is more commonly referred to as failed back syndrome (FBS). It is defined as the persistence of or new onset of back and/or related extremity complaints after spinal surgery. Failed back syndrome (FBS) is not really a syndrome but a term which is used to describe the condition of a patient who has not had a successful outcome with spine surgery. FBS occurs more frequently when the wrong patient is selected for spine surgery or complicating factors are not recognized prior to spine surgery. It has been estimated that over 60% of individuals in pain clinics suffer from failed back syndrome. Some studies have revealed that the prevalence of FBS may be as high as 25-50% depending upon what criteria is used to make the diagnosis.
There are two primary methods used to reduce the risk for thrombophlebitis. They are the medical and mechanical approaches. These two approaches are often used simultaneously. The medical approach requires the use of drugs to reduce hypercoagulation states and blood clotting tendencies. Pharmaceutical anti-clotting agents may be administered by mouth, via injection or through an intravenous line (IV). A mechanical approach can also be used to improve blood flow. The mechanical approach may involve the application of support stockings, compression boots (pulsatile stockings), early lower extremity movement/exercise and elevated positioning of the legs. In some cases, surgery may be required to place a filter into the vena cava, a large vein that carries blood to the heart. The filter is used to catch emboli before it reaches the heart, lungs and brain.
Transitional Syndrome
The spinal column is a stack of repeating segments referred to as spinal motion segments. When each segment of the spine is working like it should, the entire spine is capable of supporting loads, bending and protecting its neural (spinal cord and nerves) elements. Each spinal motion segment works in conjunction with neighboring (adjacent) segments to provide regional spine movement and to disperse the stresses (loads) placed upon them.
If one or more levels of the spine are fused together, the spinal segments around the fused segments are placed under additional mechanical loads/stress. The spinal segment closest to the abnormal segment accepts most of the additional stress/strain. This can lead to additional wear and tear and subsequently compromise of the supportive tissues including ligaments, tendons and the intervertebral disc. This chain of events results in inflammation and can result in intermittent or persistent pain. The intervertebral disc is exposed to greater stress and may undergo accelerated degenerative changes with eventual herniation. The constellation of signs and symptoms associated with a spinal fusion is called a transitional syndrome because it occurs where there is a transition from a normal area of the spine to an abnormal area that has been surgically fused.
Failed Back Syndrome (FBS): (also under failed back syndrome)
Failed back surgery syndrome (FBSS) is more commonly referred to as failed back syndrome (FBS). It is defined as the persistence of or new onset of back and/or related extremity complaints after spinal surgery. Failed back syndrome (FBS) is not really a syndrome but a term which is used to describe the condition of a patient who has not had a successful outcome with spine surgery. FBS occurs more frequently when the wrong patient is selected for spine surgery or complicating factors are not recognized prior to spine surgery. It has been estimated that over 60% of individuals in pain clinics suffer from failed back syndrome. Some studies have revealed that the prevalence of FBS may be as high as 25-50% depending upon what criteria is used to make the diagnosis.
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