Spine surgery

Spine Surgery: When It Is Necessary and Why

Spine Surgery: When It Is Necessary and Why

Here’s a fact that may surprise you: Only about 10 to 15% of patients suffering from back or neck pain require surgery.

And yet, many patients arrive at their doctor’s office resigned to the idea that they need spine surgery—some terribly anxious at the prospect. If a previous regimen of pills or shots has failed to eliminate pain, surgery is commonly viewed as the next step. Less reputable healthcare practitioners reinforce this idea with patients.

However, surgery is neither an inevitable cure-all nor is it a last resort if all else fails. Surgery is a well-thought-out treatment plan that targets a specific diagnosis and intends to permanently resolve the underlying cause of pain. The decision to proceed with surgery is made only after your spine specialist has diagnosed you with one of the few conditions requiring surgical intervention. Remember: The decision is more important than the incision. Your spine specialist must find the cause of your pain and match the treatment to the cause.

The decision to undergo spine surgery isn’t to be taken lightly. Surgery is irreversible, causes varying degrees of collateral damage to surrounding healthy tissues, and requires a period of recovery time that disrupts your ability to work and perform daily activities. When discussing surgery with you, your spine specialist or surgeon should explain what the chosen procedure will entail and how it will address your specific problem.

What Surgery Can Fix

Spine surgery is only used to treat a precise mechanical problem with the spine, usually covering an area smaller than your fingernail. Three common mechanical spine problems afflict patients:

  1. Nerve compression (otherwise known as a pinched nerve, this condition is caused by a ruptured, herniated, or bulging disc pressing against nerves in the spinal canal, or by stenosis, which is the narrowing of a bony area in the spine containing nerves)
  2. Abnormal motion in a spine segment (associated with cracks, loose ligaments, or worn-down joints)
  3. Fractured spine segments

In treating these conditions, a surgical procedure will focus on one of two goals:

  1. Decompression: Relieving pressure on a nerve.
  2. Fusion: Stabilizing a segment of the spine that is moving excessively.

To accomplish the stated goal, your surgeon will select the least invasive method possible to treat your condition, mitigate tissue impact, reduce pain and blood loss, and minimize recovery time.

What Spine Surgery Cannot Fix

If the cause of your back or neck pain is not mechanical, spine surgery is unnecessary because it won’t fix your problem. If you’re like the vast majority of patients suffering from back or neck pain, your diagnosis will fall into this category.

These are some of the most common non-mechanical causes of back and neck pain:

  • Arthritis (joint damage or inflammation)
  • Neuropathic pain (nerve pain common in patients with diabetes)
  • Being overweight or obese (associated with physical inactivity, which weakens muscles, and extra body weight exerting an abnormal load on the spine)
  • Overworked muscles associated with manual activities and repetitive movements
  • Sprained or pulled muscles

These types of problems can be addressed effectively using non-surgical means. In a recent blog post, we explored how you can relieve back and neck pain—such as home remedies, biologic or tissue-regeneration procedures, and various forms of therapy.

Pain is merely a symptom. There are myriad reasons for why you could be hurting. It’s time to end the mystery surrounding your back or neck pain—is it the result of a mechanical problem that requires surgery or not? Once you know, you can take the most appropriate, efficient step to eliminate pain permanently.

At Advanced Spine Institute, we’re dedicated to providing the highest quality of care in helping you get relief now. For an initial free case review, please schedule an appointment.

How You Can Relieve Back and Neck Pain for Good

Many people looking for back and neck pain relief think that a lifetime of shots and pills or a complicated surgical procedures are their only treatment options. But this is absolutely not the case.

A good treatment plan isn’t about a quick fix. No reputable spine specialist will offer pain blocks—an injection of an anesthetic into an affected area—as a cure for back and neck pain. Unfortunately, many patients have been misled into believing that a pain block is a cure, only to be disappointed when the pain returns after the effects of the anesthetic have worn off. Additionally, many patients fall into the vicious cycle of numbing their pain with prescription medications. As patients consume more medication, they become more inactive and disabled, their muscles weaken, and the pain continues to mount—fueling the constant dependency on medicine. Shots and pills only address the pain symptom temporarily—they don’t resolve the underlying cause of pain and are not intended for long-term use.

A good treatment plan isn’t a one-size-fits-all solution either. Surgery, while understandably anxiety inducing, shouldn’t be viewed as an inevitable, “if all else fails” option. The reality is that 85% of patients suffering from back and neck pain do not need surgery to overcome their problem. For the minority of cases in which surgery is recommended, surgical techniques have advanced significantly to minimize patient discomfort.

Keep in mind that the ideal treatment plan targets a specific diagnosis, addresses the underlying cause, relieves pain for the long term, and restores your body to its normal function. Let’s explore the broad treatment options available to you.

Non-Surgical Treatment

Home Remedies
If your pain is mild to moderate, and it’s your only symptom, then it’s fine to try to resolve it independently. There are many steps you can take at home to help dissipate the pain:

  • If needed, rest in bed for 1 to 2 days maximum.
  • Walk slowly around your home or in a pool.
  • Perform simple exercises, such as lying facedown with your arms beside your body. After spending a few minutes in this position, roll over onto your back and insert a rolled towel under your lower back to keep it in the correct position while you rest. Avoid rounding your lower spine.
  • Start an exercise program that combines general aerobic, stretching, and strengthening activities to improve your mobility and core stability. Stronger muscles help to ward off pain.
  • Apply heat or cold packs to the area with pain.

If your back and neck pain persists, worsens, or recurs on and off, then you should see your primary care physician (PCP) or a trusted spine specialist to understand what is causing the pain and how it can be fixed.

Biologic or Tissue-Regeneration Procedures
Advanced new treatments harness your body’s natural healing capabilities to slow down aging-related changes in tissue and even facilitate tissue regeneration. Our cells produce substances that help to repair tissues. A biological treatment involves collecting these cells and applying them to affected areas.

Other Non-Surgical Solutions

  • Aquatic therapy is a great way of relieving pain through gentle movement while minimizing pressure on the spine.
  • Therapeutic ultrasound involves the application of a hand-held wand to the area with pain to enable sound waves to pass through the skin into the affected tissue. Vibrations from the sound waves generate heat in the body, which reduces pain and inflammation.
  • Laser photobiomodulation techniques involves targeting laser beams to the affected area to repair tissue and reduce pain and inflammation.
  • Trigger-point injections, acupuncture, or targeted pain blocks can be helpful if pain becomes debilitating. The injection of medication decreases swelling and inflammation of affected tissues and nerves, and relieves pain temporarily while the source of the pain is identified. By enabling physicians to understand where pain treatment is most effective, these techniques are valuable diagnostic tools.

Surgical Treatment

If the culprit for your back and neck pain is mechanical—such as a pinched nerve or herniated disc—then restorative spine surgery may be the best treatment option for you. Restorative spine surgery is the least invasive procedure necessary to solve your problem, minimizes impact on surrounding healthy tissue, reduces pain and blood loss, and speeds up recovery time.

Your spine surgeon has many options available for how to carry out a procedure, ranging from using microscopes and endoscopes to using lasers, robots, and stereotactic navigation. The approach that your surgeon ultimately takes depends upon your diagnosis, in addition to what you and your surgeon agree is best for achieving your desired outcome. As the patient, you should have an active part of the decision-making process. Regardless of the technique your surgeon uses, the ultimate goal of any surgical procedure is to either relieve pressure on a nerve (decompression) or stabilize a segment of the spine that is moving excessively (fusion).

Do you suffer from chronic or bothersome back and neck pain? Are you interested in learning more about how you can eliminate pain and improve your quality of life?

At Advanced Spine Institute, we are happy to conduct an initial review of your case for free. Simply click here and we’ll schedule your consultation as soon as possible.

Q&A: Dr. Robert Talac comments on the future of spine surgery

Robert Talac comments on the future of spine surgery
Robert Talac, MD, PhD, an orthopedic spine surgeon at the Richmond, Texas-based Center for Advanced Surgical Treatment, discusses the future of spinal care.
Question: What led to your interest in nonsurgical techniques?

Dr. Robert Talac: Surgery is necessary in about 10 to 15 percent of patients with neck or low back pain due degenerative changes in their spine. Ever evolving minimally invasive techniques require better and more precise identification of the source of the pain, including those who does not need surgery — this is where nonsurgical techniques come in. I believe spine care is evolving in the following direction as we observed in oncology; we now have surgical oncologists, who are oncologists that use surgery as one of their tools. The era of a general surgeon who just happens to cut out tumors is pretty much over. In spine care, we will soon see spine specialists who will be able to diagnose an entire spectrum of problems and use different tools to treat them, including surgical techniques.

Q: How has spinal care evolved since you graduated from medical school?

RT: Spine care is rapidly evolving. In fact, most of the techniques that I use these days did not exist when I graduated. I believe the biggest breakthrough was understanding that the source of pain can be found, and should be a primary focus of our care.

Q: What do you see as the biggest area for growth in orthopedics today?

RT: The biggest area of growth in orthopedics is in biologics. We are beginning to understand how to manipulate the local tissue environment to promote the healing of injuries. We are slowly, but steadily, moving from a replacement philosophy to restoration, using a combination of new reconstructive techniques that minimize collateral trauma of treatment and utilize more biologics to manipulate the local tissue environment to promote healing and improve function.

Learn more from Dr. Talac at the 15th Annual Spine, Orthopedic & Pain Management-Driven ASC Conference + The Future of Spine in June 2017! Click here for more information.