There are a large number of different spine operations. It is important to have full assessment and careful discussion to ensure you have the correct procedure and that you understand what you will be undergoing. Here are some of the potential procedures:
Injections can be an excellent treatment option for certain spinal conditions. They aim to place local anaesthetic and steroid around the area causing the pain to reduce inflammation in that area. The effect of the steroid may well wear off over time but, if used for conditions such as slipped discs, the underlying condition may have resolved spontaneously by the time the steroid wears off. It is a daycase procedure and is often done under local anaesthetic.
This is a microsurgical procedure to remove a slipped disc from pressing on a nerve, to help reduce sciatic pain. It can be performed as a daycase procedure or with an overnight stay in hospital. There is a small scar over the lower back. It generally has excellent outcomes with the majority of patients feeling significantly better very soon after surgery. It is advisable to avoid heavy lifting, deep bending, and awkward twisting for a period of time after surgery in order to reduce the chance of further slipped disc whilst it is healing.
This is a microsurgical procedure to relieve the pressure on nerves caused by enlargement of facet joint and ligament in the lumbar spine. If it is a single level of the spine, it is performed through a small incision over the lower back and can be done as a daycase procedure or overnight stay. If more than one level of the spine is operated on, the scar may be slightly larger, and a one or two night stay may be required. Patients can often return to normal activities soon after the operation.
This is generally performed in combination with decompression of the nerves to help improve leg pain or sciatica. It is required to provide stability if the spinal segment moves when you stand up, or if decompressing the nerves would necessitate removal of too much bone and the spine would be destabilised.
It can be achieved using rods and screws through an incision over the lower back. Some people are suitable for minimally invasive procedures which aim to reduce the trauma of the more invasive operations. It may also require a cage to be inserted into the disc space. Fusion via an anterior approach (scar over the lower abdomen) or via a lateral or oblique approach (scar over the side of the abdomen) may also be appropriate in some people. The type of fusion performed can be discussed in the clinic to work out what will aid your recovery the best.
Anterior cervical decompression and fusion
This procedure aims to remove the pressure on the nerve in the neck, to help reduce neuropathic arm pain. This is performed via a horizontal scar on the front /side of the neck. The disc is removed, pressure taken off the nerve, and an artificial cage is inserted to fill the disc space with bone graft. Most people will be able to go home after an overnight stay.
Posterior cervical decompression +/- fusion
This microsurgical procedure removes the pressure on nerves from age-related changes in the cervical spine. This may include micro-foraminotomy. Fusion may also be required if the nerve decompression necessitates too much bone removal that could destabilise the spine. If decompression alone is performed, most people will be able to mobilise very quickly after surgery.
Scoliosis or kyphosis correction
This aims to prevent further curve progression and achieve partial curve correction. It is often performed via a scar down the back but may be done via a scar on the side of the trunk. It requires screw and rod insertion to correct the alignment. In degenerative scoliosis, segments of bone may need to be removed (osteotomies) or nerves may require decompression to help reduce pre-operative leg pain. Most people require at least a few days in hospital and the back can be sore for a number of weeks afterwards. Activities may need to be limited for a period of time, as discussed with you prior to surgery in the clinic.
Kyphoplasty / Vertebroplasty
This is a percutaneous (very small scar) procedure which aims to treat a vertebra fracture that has not healed by itself. The procedure involves inserting cement into the fractured (broken) vertebral body to stop it moving which often results in reduction in pain from that vertebra. It is often performed as a daycase procedure.
Risks of Spinal Surgery
Whilst the majority of people have no problems around the time of their operation, there are a large number of potential risks and complications associated with spinal surgery. Most of them are uncommon or rare but it is sensible to be aware of them prior to deciding to proceed with an operation. The ones listed below are some of the more common risks associated with spinal procedures. However, this list may not be exhaustive and Mr Morris will discuss specific risks regarding your procedure in clinic prior to the operation.