Spinal Surgery, This Is What You Need to Know

 

Spinal surgery is a surgical procedure on the spine that usually aims to treat pain bone back or back . The type of spinal surgery performed depends on the type of disease suffered by the patient.

Spinal Surgery, This Is What You Need to Know

The spine consists of 33 bone segments, with 24 of the top bone segments separated one by one, which comprise a series of vertebrae from top to bottom. Between each vertebrae, there is a bearing of cartilage called a spinal disc. In the center of each vertebrae have a hole, so that between one hole to another form a channel filled with spinal nerves along the spine.

Spinal surgery is a medical procedure that is usually performed after treatment others failed to relieve spinal pain. In addition to relieving pain, spinal surgery can also deal with complaints that occur in one or both arms or legs, caused by spinal cord disorders. Treatment methods that can be recommended for patients with spinal disease before surgery include:

  • Rest
  • Giving medicine
  • Physiotherapy
  • Use of brace or support

If the treatment method is not effective in relieving spinal pain, then new patients are advised to undergo spinal surgery. The type of spinal surgery performed will depend on the type of disease suffered by the patient.

Types of Spinal Surgery

Based on the technique, there are many types of operations spine. However, in general spine surgery can be divided into 2 types, namely decompression operations and stabilization operations. Both decompression surgery and stabilization surgery aim to relieve pain and paralysis due to disorders of the spinal cord.

Decompression surgery aims to relieve pain due to spinal cord disorders by removing parts of the spine that compress the spinal cord. While stabilization surgery aims to relieve pain by stabilizing the position of the spine to prevent re-emergence of pressure on the spinal cord. If needed, decompression and stabilization operations can be performed simultaneously in one surgical procedure.

Spinal surgery using decompression techniques, including:

  • Laminotomy. This procedure aims to reduce the pressure on the spinal cord by cutting a portion of the lamina, the back of the vertebrae, so that the emphasis on the spinal cord can subside.
  • Laminectomy. It's almost the same as a laminotomy, but in laminectomy the entire lamina of the spine will be removed. Laminectomy can help reduce inflammation due to pressure on the spinal cord, although it is not immediately felt after this procedure.
  • Discectomy. This procedure aims to relieve pressure on the spinal cord due to the abnormal shape of the spinal disc and experience herniation or protrusion (hernia nucleus pulposus). Disectomy is done by cutting the spinal disc, so that there is more space for the spinal cord and the pressure on the nerves will decrease by itself. Disectomy can be combined with laminectomy for maximum results.

Spinal surgery that uses stabilization techniques, among others:

  • Spinal fusion. This procedure is done by regulating the arrangement of the spine, then uniting the actual vertebrae separate, to prevent movements that can cause emphasis on the spinal cord. Spinal fusion can also be performed after decompression surgery to prevent re-emphasis on the spinal cord.
  • Vertebroplasty. This procedure is done by injecting a substance such as cement into the part that has a vertebral fracture. This injection of a cement-like substance is to make the spine more stable and restore the shape of the spine as before.
  • Cifoplasty. Just like vertebroplasty, kypoplasty is also done by injecting cement into the part that has a vertebral fracture. However, before the semen is injected, the part that has a vertebral fracture will be widened with a special balloon.

Indications of Spinal Surgery

Most spinal surgeries not an emergency medical procedure. However, you should immediately consult with an orthopedic doctor or neurosurgeon to plan whether to require surgery, if the following occur:

  • Pain that does not subside or worsens after two weeks.
  • Stiffness or tingling in the arms or legs.
  • There are weaknesses and loss of movement of the arms or legs.
  • Fever.

These symptoms can be a sign of a disease that requires spinal surgery, such as:

  • Spinal stenosis.
  • Myelopathy or spinal cord abnormalities.
  • Spinal damage or shift.
  • Tumor in the bone or spinal cord.
  • Infection of the spine or spinal cord.
  • Shift or thin the bone bearing back.

Spinal Surgery Warning

Not all people with spinal disease can undergo surgery back lang. In addition, each spinal surgery technique has different requirements.

In general, there are no absolute conditions that cause a person to be unable to undergo decompression surgery. However, spinal decompression surgery should be avoided if the patient:

  • Have kyphosis.
  • Still a child.
  • Have not undergone non-surgical therapy with maximum.

As for spinal stabilization surgery, it should be done with extreme caution if there is:

  • Osteoporosis.
  • Injury severe in the epidural layer.
  • Malignant tumors, especially in the spine.
  • Spinal fractures.
  • Infection.

Preparation of Spinal Surgery

Before spinal surgery, the patient will undergo a general health check to ensure that his condition is ready for surgery. The patient must notify the relevant doctor:

  • Medications that are being consumed, including vitamins, supplements, and drugs that can be purchased freely.
  • Drug allergies, especially allergies to anesthesia.
  • Pregnant or planning to get pregnant.

A few days before surgery, patients will be asked to stop smoking and stop taking blood-thinning drugs. Patients also need to fast for several hours before the operation begins. If the patient has thick hair around the operating area, it will be shaved first. Patients will also undergo additional tests before undergoing surgery, such as blood tests, X-rays, or MRI to provide additional information regarding the condition of the spine that will undergo surgery.

Spinal Surgery Procedures

The patient will be asked to change clothes with special surgical clothes and remove the jewelry worn, then be taken to the operating room. After that, the patient is given general anesthesia so that he or she will not be aware during spinal surgery, and is positioned according to the type of surgery, usually face down.

When the patient is unconscious, the doctor will start making incisions or skin slices in the area of ​​the spine to be operated on. Incisions can be made in the neck, upper back, lower back, or abdominal area so that the spine can be operated from the front. The size of the incision made can vary according to need.

After the incision is complete, the doctor will then perform decompression or stabilization of the spine. In decompression surgery, the doctor removes the part of the spine causing pressure on the spinal cord. The doctor can remove the spinal segment (vertebra) or the spinal segment bearing which causes an emphasis on the nerve. During decompression surgery, the doctor can also correct the position of depressed spinal nerves by regulating nerve fibers to return to the spinal cord space. The spine and spinal pads that are targeted for decompression surgery are often not completely discharged, but are only removed in the part that causes nerve suppression.

Whereas in the stabilization operation, after an incision is made, the doctor will install a spinal counterweight in every spinal segment that undergoes a shift. This tool is usually made of special metal mounted using a direct bolt on the spine.

After that, the doctor can add a bone graft to the spine to accelerate fusion or unification between the vertebral segments undergoing stabilization. This bone graft can be taken from the patient's own body or from a donor. But in patients undergoing decompression and stabilization surgery simultaneously, the bone removed in the decompression procedure can be used as a graft during the stabilization process. In some cases, bone grafts can be replaced with synthetic materials so that the integration of the spine can run faster.

After all the surgical procedures are complete, the doctor will then close the operating area using a sewing thread. The operating area will also be covered with sterile bandages to prevent infection. The patient will then be taken to the treatment room for hospitalization and postoperative recovery.

After Spinal Surgery

Patients will generally be hospitalized for 2-3 days. During the treatment and recovery period, the patient can feel pain and discomfort in the operating area. Doctors can provide pain relievers for consumption during hospitalization and outpatient care. During recovery, both in the hospital and at home, patients are encouraged to exercise mobility or movement by walking.

Generally the total recovery period of patients undergoing spinal surgery is around 6 weeks. However, the recovery period depends on how severe the pain is and the complexity of the spinal surgery. In addition to feeling pain, patients can also feel pain and stiffness in the back part of the surgery. To train the body to do physical activity again after the recovery period, patients will be assisted with physiotherapy.

Stitches made during surgery, can use sewing threads that can be fused or that cannot blend with body tissues. When using a sewing thread that is not integrated with the body, the doctor will remove the sewing thread after the surgery wound closes. The doctor will also schedule the patient's regular control time to monitor the recovery process during outpatient care.

Patients should immediately contact a doctor if they experience symptoms of infection, such as:

  • Discharge from surgery wound.
  • Fever.
  • Shivering.
  • Redness, swelling, or hardening of the tissue in the operating area.

Risk of Complications of Spinal Surgery

Complications that can occur after spinal surgery include:

  • Infection.
  • Bleeding.
  • Blood clots.
  • Pain in the area of ​​bone taken for bone graft.
  • Damage to blood vessels or nerves near the location of the operation.
  • Surgical wounds that are difficult to heal.
  • Reappearance of pain in the spine after surgery.
  • The occurrence of a spinal cord membrane tear causing leakage of brain and spinal cord fluid.
  • The face feels stiff and visually impaired.
  • Paralysis.

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