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YOU are here : Home > Spinecare Topics > Options for Spine Treatments > Benefits and Risks of Back Surgery
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Options for Spine Treatments
Benefits and Risks of Back Surgery
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Benefits and Risks of Back Surgery
Spinal Cord Injury
Surgical operations performed on the neck (cervical region), mid-back (thoracic region) or upper portion of the low back (lumbar region) can potentially lead to spinal cord compromise. Spinal cord complications can occur secondary to physical compromise of the blood flow, injury to the lining around the cord (dura) or as the result of direct physical injury of the spinal cord. In rare cases, a blood clot (embolism) may travel into the spinal cord. Damage to the spinal cord can cause paralysis of specific regions with sparring of others depending on which spinal nerves are affected. Spinal cord injury typically results in disturbances of bowel and/or bladder function.
Delayed Fusion Union or Nonunion
Some spinal fusions do not heal as planned. When this occurs it is referred to as a non-union. A non-union may require another surgical procedure in order to facilitate proper bone healing and union. Some fusions take longer than expected to heal for a variety of reasons. When this occurs it is referred to as a delayed union. Non-union is often treated with a pulsed electromagnetic therapy (PEMF) device. PEMF stimulation devices promote bony growth and fusion. These therapy devices are worn daily for at least three months or longer. Regular interval X-rays are performed to assess bony union.
Hardware Fracture/Failure
Spinal fusion sometimes requires the use of instrumentation such as metal screws, rods, and plates. Instrumentation may be used in addition to a bone autograft or allograft in order to provide a solid connection between vertebrae. The hardware is positioned to provide additional stabilization and to facilitate adequate bone healing. The vertebrae and adjoining tissue are held into place during the healing process. The use of metal devices or instruments is generally referred to as surgical hardware. Once the bone heals, the hardware is not usually required to provide stabilization although it is often left in place unless it is felt to be contributing to symptoms. Sometimes the surgical hardware will fail by breaking or moving from its intended position. If the hardware breaks or slips to a vulnerable location a re-operation may have to be performed in order to remove or reposition the hardware.
Implant Migration
Some spine operations require the placement of an implant device such as a fixation device (cage) or an artificial disc. Any implanted device can potentially move out of place anytime after surgical closure. When this happens, it usually occurs relatively soon after surgery. It usually occurs during the healing process before there is firm stabilization secondary to bone growth and/or scar tissue attachment. If the implant migrates away from its intended location it may not provide adequate stabilization of adjacent vertebrae. In rare cases, an implanted device may move towards a large blood vessel near the spine. This constitutes a potential emergency. Any problem with an implanted device may require surgical intervention in order to correct the problem. If the attending spine surgeon suspects a problem he or she will probably order an X-ray study with positional views such as flexion or extension. The positional views provide an indication of instrument and spinal segment stability. Further assessment may require thin slice computerized tomography (CT) for localization.
Pseudarthrosis
The term pseudarthrosis means “false joint�. This term is used to describe either a fractured bone that has not healed or an unsuccessful fusion (failed union). A pseudarthrosis is characterized by motion between two adjacent bones that should be either healed together or fused together. Pseudarthrosis is often associated with pain that is intensifies over time. The presence of spinal motion places unnecessary stress/strain on implanted devices, fixation instrumentation and bone grafts. The presence of motion can lead to further failure of the stabilization mechanisms resulting in increased symptoms. Spinal segment motion can stress the hardware leading to breakage of implanted instrumentation. Correction or treatment of a pseudarthrosis may require a re-operation. The spinal surgeon may want to add an additional bone graft or additional instrumentation or replace existing hardware. In some cases the surgeon may need to prescribe a PEMF bone stimulator to facilitate bone growth.
Surgical operations performed on the neck (cervical region), mid-back (thoracic region) or upper portion of the low back (lumbar region) can potentially lead to spinal cord compromise. Spinal cord complications can occur secondary to physical compromise of the blood flow, injury to the lining around the cord (dura) or as the result of direct physical injury of the spinal cord. In rare cases, a blood clot (embolism) may travel into the spinal cord. Damage to the spinal cord can cause paralysis of specific regions with sparring of others depending on which spinal nerves are affected. Spinal cord injury typically results in disturbances of bowel and/or bladder function.
Delayed Fusion Union or Nonunion
Some spinal fusions do not heal as planned. When this occurs it is referred to as a non-union. A non-union may require another surgical procedure in order to facilitate proper bone healing and union. Some fusions take longer than expected to heal for a variety of reasons. When this occurs it is referred to as a delayed union. Non-union is often treated with a pulsed electromagnetic therapy (PEMF) device. PEMF stimulation devices promote bony growth and fusion. These therapy devices are worn daily for at least three months or longer. Regular interval X-rays are performed to assess bony union.
Hardware Fracture/Failure
Spinal fusion sometimes requires the use of instrumentation such as metal screws, rods, and plates. Instrumentation may be used in addition to a bone autograft or allograft in order to provide a solid connection between vertebrae. The hardware is positioned to provide additional stabilization and to facilitate adequate bone healing. The vertebrae and adjoining tissue are held into place during the healing process. The use of metal devices or instruments is generally referred to as surgical hardware. Once the bone heals, the hardware is not usually required to provide stabilization although it is often left in place unless it is felt to be contributing to symptoms. Sometimes the surgical hardware will fail by breaking or moving from its intended position. If the hardware breaks or slips to a vulnerable location a re-operation may have to be performed in order to remove or reposition the hardware.
Implant Migration
Some spine operations require the placement of an implant device such as a fixation device (cage) or an artificial disc. Any implanted device can potentially move out of place anytime after surgical closure. When this happens, it usually occurs relatively soon after surgery. It usually occurs during the healing process before there is firm stabilization secondary to bone growth and/or scar tissue attachment. If the implant migrates away from its intended location it may not provide adequate stabilization of adjacent vertebrae. In rare cases, an implanted device may move towards a large blood vessel near the spine. This constitutes a potential emergency. Any problem with an implanted device may require surgical intervention in order to correct the problem. If the attending spine surgeon suspects a problem he or she will probably order an X-ray study with positional views such as flexion or extension. The positional views provide an indication of instrument and spinal segment stability. Further assessment may require thin slice computerized tomography (CT) for localization.
Pseudarthrosis
The term pseudarthrosis means “false joint�. This term is used to describe either a fractured bone that has not healed or an unsuccessful fusion (failed union). A pseudarthrosis is characterized by motion between two adjacent bones that should be either healed together or fused together. Pseudarthrosis is often associated with pain that is intensifies over time. The presence of spinal motion places unnecessary stress/strain on implanted devices, fixation instrumentation and bone grafts. The presence of motion can lead to further failure of the stabilization mechanisms resulting in increased symptoms. Spinal segment motion can stress the hardware leading to breakage of implanted instrumentation. Correction or treatment of a pseudarthrosis may require a re-operation. The spinal surgeon may want to add an additional bone graft or additional instrumentation or replace existing hardware. In some cases the surgeon may need to prescribe a PEMF bone stimulator to facilitate bone growth.
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