Your spine gives your body stability and strength whenever you move around, while spinal bones (vertebrae) protect your spinal cord. Therefore, a skilled orthopedic surgeon should address any issues with your spine. Your surgeon will first use conservative methods to treat your pain and debilitating problems. If they fail, the doctor will resort to advanced spine surgery using cutting-edge technologies and techniques.
LAMIS is the home of an experienced team of Los Angeles orthopedic specialists. We offer advanced spine surgery procedures using state-of-the-art technology in imaging, motion preservation, and disc replacement and can assist you in restoring full functionality and relieving pain. We also believe in a patient-centered process of shared and informed decision-making. We have prepared this article so you can learn about various advanced spine surgery options, know if you need surgery, and what to expect after the procedure.
Minimally Invasive Spine Surgery (MISS)
Minimally invasive spine surgery is a surgical procedure that uses tinier incisions than standard surgery, causing less harm to surrounding muscles and tissues. It can result in a faster recovery following a surgical procedure.
The standard spine surgical procedure is known as open surgery. It uses a long incision, and soft tissues and muscles around the patient’s spine are moved away.
During the MISS, your surgeon will make a tiny incision before inserting a tube-shaped tool known as a tubular retractor. The stiff tubular retractor creates a tunnel to the spine’s problematic area, gently pushing soft tissues and muscles aside. Tissues and muscles removed during the operation are also withdrawn through the tubular retractor. Next, your surgeon will put tiny tools via the tunnel to work on your spine. When the tubular retractor is removed, your muscles will return to their original position. Finally, your surgeon will close your incision with staples or suture glue and cover it with a bandage.
To determine where to make the incision, your surgeon will use an endoscope or a fluoroscope. An endoscope is a thin, telescope-like instrument attached to a small video camera that gives a view of your spine to the screens in the theater. A fluoroscope is a portable X-ray gadget that offers real-time images of your spine.
Spinal Fusion
Spinal fusion is a welding process that corrects issues with the tiny bones in your spine. It fuses at least two vertebrae, so they recover into one solid bone. The procedure restores the spine’s stability and eliminates painful motions.
The process is ideal when motion is the cause of your pain, like movement in an area of the spine that is arthritic or unstable due to aging, disease, or injury.
The procedure can be performed in either posterior fusion (from your back) or anterior lumbar interbody fusion (through the belly). Your suitable option depends on the location and nature of your disease.
Here is what to expect with spinal fusion:
Bone Grafting
Spinal fusion uses bone material known as a bone graft to promote the fusion and stimulate bone healing.
Previously, a bone graft harvested from the patient’s pelvis (autograft) was the only option for increasing the required fusion material. Autograft requires an additional incision during the procedure, which is lengthy for the surgery and its recovery duration.
An alternative to the autograft is the allograft (cadaver bone) obtained from a bone bank. The tissues are processed, and the possibility of infection is low.
Your doctor should discuss the best bone graft material for your procedure and condition.
Immobilization Phase
Next, your surgeon will hold the vertebrae together to aid the fusion's progress.
Your surgeon will hold your spine with screws, rods, and plates. The process is called internal fixation and can increase the success rate of your recovery. With improved stability from internal fixation, many people move earlier following the surgical procedure.
The doctor can recommend putting on a brace to protect your welding process.
After your spine surgery, you will remain hospitalized for days. The admission duration depends on your fitness level and whether you have other diseases. During this time, you will be connected to machines that monitor your heart and ensure you are okay.
Artificial Disk Replacement
In artificial disc replacement, damaged or worn disk material between tiny bones in your spine is removed and replaced with an artificial disk or prosthetic. This advanced spine surgery is considered when low back pain from degenerative discs fails to improve with conservative treatment.
Ideal candidates for ADR have the following characteristics:
- No previous lumbar spine surgery.
- No scoliosis (spine deformity).
- Have strong bones.
- Not obese.
Typically, the procedure takes two to three hours.
Your surgeon will approach the low back from the front via an incision in the abdomen, allowing them to move your blood vessels and organs to the side. The doctor will replace the problematic disk with an artificial disc implant during the operation.
You will remain in the healthcare facility for up to three days after the ADR. The duration of your stay depends on your return to function and how well-managed your pain is.
Your surgeon will encourage you to walk and stand immediately after the surgery. Since bone fusion is unnecessary after the operation, you can move through your midsection. Early motion in your trunk area can result in quick recovery and rehabilitation.
Disc Design
There are numerous disc designs. While each is unique, they are all designed to reproduce the function and size of your intervertebral disk.
Some remove the nucleus of the intervertebral disc but leave the annulus in place. On the other hand, others substitute the nucleus and annulus with a mechanical device that simulates spinal fusion.
Your physician should guide you on the best design for your needs and health goals.
Laminectomy Surgery for Back Pain
During the laminectomy procedure, your surgeon will remove the lamina (a tiny section of your bone) to release pressure from compressed nerves or your spinal cord. The operation can be performed on the lower spine, neck, or middle of your back.
The natural aging process of spinal bones begins at around age 30 and can result in nerve-related symptoms and pain in most people. Laminectomy is the best option when the symptoms affect your quality of life and function.
For this advanced spinal procedure, you will lie on a device that pads your body’s front with your face facing down. The surgeon will administer general anesthesia so that you will sleep during the surgery. Then the healthcare provider will:
- Make an incision in your lower back.
- Separate your spine to access your spine.
- Remove lamina to release pressure on your spinal cord or nerves.
Typically, the procedure takes approximately two hours but can be longer if many areas need to be addressed.
How to Tell If You Need Spine Surgery
While spine surgery should be the last resort, there are cases where it is essential and can improve the quality of your life. If you suffer from a chronic spinal condition or back pain that does not improve, it is customary to wonder whether you should consider surgery. Here are symptoms to look out for, particularly if they worsen.
- You experience pain radiating to the legs and arms — The spine entails vertebrae (bones) and a spinal cord running through the vertebrae’s center. Additionally, nerves travel between every vertebra and impact various body parts. If the lower back nerves become damaged or pinched, you will experience pain radiating to the legs and arms (radiculopathy). Causes of radiculopathy include bone spurs and herniated discs. A herniated disc happens when the soft inner layer pushes against the outer layer and presses on your nearby nerves. Depending on the pressed nerve, you can experience pain in your legs or arms. On the other hand, bone spurs happen due to spine osteoarthritis. Osteoarthritis wears down the cartilage between your bones, causing the bones to rub against each other and cause bone spurs.
- You experience constant pain — Typically, back pain is mild and can last a few days. On the contrary, chronic pain can last more than twelve weeks even after receiving treatment.
- You experience reduced mobility — If constant spine pain has affected your mobility, you should visit a spine center for an evaluation. Chronic spine pain can prevent you from engaging in previously enjoyable activities and doing your work.
- Weakness and numbness in the legs — Having weakness or numbness in the legs is not a symptom to ignore. Conditions like disc herniation, tumors, spine infections, and spinal stenosis cause weakness or numbness. Other signs you might develop as the disease worsens include losing sensation in the feet and burning pain running down your legs.
- A tumor on the spinal cord.
- Your bone has a dislocated or broken bone.
- Lost bowel or bladder control.
If You Need Advanced Spine Surgery, Timing Matters
Generally, spine surgery is not rushed. Your doctor will advise you to wait several weeks before the surgical procedure to give your body a chance to recover independently. Additionally, it allows your physician to see whether conservative treatments and physical therapy (PT) can assist.
However, the following are reasons why you could require the surgical procedure sooner rather than later:
- You have severe and unrelenting pain and neurological symptoms.
- You have spinal cord injuries.
Spine surgery is a joint decision between the patient and their doctor. If a physician recommends it and the patient ignores it, that could result in issues. It is particularly true if a degenerative condition has compressed the spinal cord.
Maintain a healthy lifestyle after your surgery to reduce the possibility of experiencing spine pain in the future. It includes eating healthy meals, avoiding smoking, maintaining healthy body weight, and exercising regularly.
What to Expect After Advanced Spine Surgery
While each patient recovers differently, here are some things to expect during recovery.
Pain Management
One significant benefit of advanced spine surgery is pain relief. Depending on the type of procedure, most patients report a substantial reduction in pain after the operation. While the relief is not immediate for every patient, most people start feeling better within a few days post-surgery.
Your physician should prescribe pain medication to relieve symptoms related to the surgery. If you are experiencing residual discomfort even after successful treatment, it will improve over time with rehabilitation and physical therapy.
Lying in Your Bed Following Spine Surgery
Quality sleep promotes quick recovery. The steps below can take the stress off your back and spine, but remember to check with the doctor:
- Sleep on the back with the upper back, head, and shoulders raised a bit, using an adjustable head or supportive pillows.
- Place a pillow under your knees’ back so your knees and hips are bent.
- When leaving your bed, use the “log roll method.” While lying on the back, bend the knees and ensure they are together. Roll on your side with your shoulders and hips in line to prevent your spine from twisting. Finally, push your body up with your arms and allow your legs to bend over your bed’s side so you can sit.
Wear Your Post-Operative Braces
If the surgeon prescribes a back brace for recovery, wear it as instructed. The brace is tailored to stabilize/support your back and restrict movement of the spinal levels fused during surgery.
Sitting After a Spine Surgical Procedure
Sitting puts pressure on the back. Your physician could recommend how long you should sit after your surgery. You should also avoid extended car rides.
The rule of thumb is to avoid sitting with your knees higher than your hips. Use a firm pillow or wedge on your chair, sofa, and seat.
Incision Care and Bathing
You should keep your skin around the incision site dry and clean for more than four days following surgery. Avoid tub baths until your incision has recovered and your surgeon has cleared you.
After the procedure, pain in your incision area is normal and will subside over time. Follow your doctor’s guidelines on when to have staples or sutures removed.
Find a Qualified and Certified Advanced Spine Surgeon Near Me
Pain is a symptom that you have an underlying condition. Maybe your spine's tissues and muscles are inflexible or too weak. Maybe your body mechanics have worn out, or you lifted something heavy and hurt your back. The doctors at LAMIS can develop a rehabilitation plan that meets your needs and conditions, and if your symptoms fail to respond to conservative non-surgical care, they could recommend advanced spine surgery. We offer the best, minimally invasive, and least aggressive options to relieve your pain so you can return to your everyday life safely and faster.
To schedule an appointment with one of our Los Angeles specialists, please call 310-734-6088.
