Emergency back surgery may be performed in cases of severe trauma, when bowel or bladder function is interrupted or when sudden paralysis of an extremity occurs.
When a surgical emergency is not involved, back pain surgery is reserved for those patients whose back pain is most severe and who have not responded to several months of conservative treatment. Generally, only 5 percent of patients need back pain surgery to treat their non-emergent condition.
Your physician may recommend surgery if the cause of pain is nerve root impingement, degenerative conditions like spinal stenosis with neural compression or a spinal structure deformity. After conservative therapy has failed, your physician may also consider prescribing surgery when the pain limits your ability to take care of yourself, or you cannot perform daily activities or work.
Physicians often use terms unfamiliar to people not involved in the medical profession. Patients experiencing chronic upper back pain, mid back pain or lower back pain caused by nerve impingement who are under a physician’s care are likely to have heard considerable medical terminology to describe the various treatments available. The definitions of the following terms may be helpful in the discussion of back pain surgery:
- Foramen – Means “opening.”
- Neuroforamen – “Neuro” means “nerve” and “foramen” means “opening.” Neuroforamen, therefore, is an opening through which nerves pass. The 31 pairs of spinal nerve roots that exit the spinal column do so through these openings, which are located to the left and right of each bony vertebra. Nerve space is created by the intervertebral discs found between the vertebrae, separating the vertebrae and providing just enough room for nerve roots to exit the spinal column. When talking about back pain surgery, a physician might discuss the need to remove bone tissue and enlarge one (or more) neuroforamen in order to provide more space for spinal nerve passage.
- Spinal decompression surgery General term for any number of surgeries designed to “decompress” or reduce pressure on nerves within or exiting the spinal column — the surgery is meant to reduce painful stimuli emanating from these nerves.
- -Ectomy – You may notice that many surgical terms end in “-ectomy.” A surgery that ends in “ectomy” means “removal.” If your physician, therefore, talks about a discectomy, it means the removal of an intervertebral disc. A laminectomy is the removal of a lamina, which is part of the arches of bone that protect the spinal cord. A foraminectomy is technically a misnomer. “Plasty” means “change in.” A foraminectomy is more technically a foraminoplasty. However, a foraminectomy has come to mean a surgery to expand the neuroforamen (one of the openings) in the spinal column; this is done by removing a large amount of bone.
- -Otomy – The suffix “otomy” means cutting or incision. Surgical terms ending in “-otomy” typically mean the cutting of tissue, but not necessarily a great deal of tissue removal.
If you are not responding to conservative treatments such as exercise, physical therapy, acupuncture or injections, you may need more invasive treatments like back pain surgery. Open back surgery is no longer the only surgical option available, however. Laser Spine Institute offers minimally invasive procedures in which far less tissue is damaged to gain access to the area needing surgery. Micro-instruments are used to remove the tissue impinging a nerve, thus releasing that nerve tissue from pressure and typically easing painful symptoms. For a free review of your MRI or CT scan, or to learn more about our advanced procedures, contact us today.