Spine surgery, this is what you need to know

Spinal surgery is a spinal surgery that is usually intended to treat spinal or back pain. The type of spinal surgery performed depends on the type of illness the patient is suffering from.

The vertebra column consists of 33 vertebrae, the 24 upper vertebrae separated one by one, forming a vertebral sequence from top to bottom. Between each vertebra there is a bearing of cartilage called a spinal disc. In the center of each segment of the spine has a hole, so that between each hole to form a channel filled with spinal nerves along the spine.

Spine surgery is a medical procedure that is usually done after other treatments fail to relieve pain in the spine. In addition to relieving pain, spinal surgery can also help overcome problems in the arms or legs caused by spinal cord disorders. Treatment methods that can be recommended to patients with spinal cord disease before surgery include:

  • Break
  • Give medicine
  • physiotherapy
  • Use support or support

If this treatment method is not effective in relieving pain in the spine, it is recommended that new patients undergo surgery on the spine. The type of spinal surgery depends on the type of illness the patient is suffering from.
Types of spinal surgery
Based on the technique, there are many types of spinal surgery. However, in general, spinal surgery can be divided into two types: decompression surgery and stabilization surgery. The purpose of decompression and stabilization is to relieve pain and paralysis due to spinal cord disorders.

Decompression surgery is designed to relieve pain caused by disruption of the spinal cord by removing the part of the spine that is compressing the spinal cord. While stabilization surgery aims to relieve pain by stabilizing the position of the spine to prevent the recurrence of pressure on the spinal nerves. If necessary, decompression and stabilization operations can be done in one single procedure.

Spine surgery uses decompression techniques, including:

  • Laminotomy. This procedure is intended to reduce pressure on the spinal cord by cutting off part of the blade, which is located behind the spinal cord, so that the pressure on the spinal cord can subside.
  • Laminectomy. This is almost the same as laminotomy, but in laminectomy, the entire spinal blade will be removed. Laminectomy can help reduce inflammation due to pressure on the spinal cord, although it is not felt immediately after this procedure.
  • Discectomy This procedure is intended to reduce pressure on the spinal cord because of the abnormal shape of the intervertebral discs and cause herniation or bulge (central hernia lumps). Disectomy is done by cutting the spinal discs, thus leaving more room for the spinal nerves and reducing the pressure exerted on them. Dectectomy can be associated with laminectomy for optimal results.
Spinal surgeries that use stabilization techniques include:

  • Vertebral Fusion. This procedure is done by adjusting the composition of the spine, then connecting the spine itself, to avoid movements that can cause pressure on the spinal nerves. Spinal fusion can also be done after a decompression procedure to prevent pressure on the spine.
  • Vertebroplasty. This procedure is done by injecting substances such as cement into the broken spine. Injecting substances such as cement must make the spine more stable and restore its original shape.
  • Kifoplasti. Like vertebroplasty, kifoplasti is also done by injecting sperm into the part of the spine that is broken. But before being injected with cement, the part that breaks the spine will be enlarged with a special balloon.

Indications for spinal surgery


Spinal surgery is usually not an emergency medical procedure. However, you should immediately consult an orthopedic surgeon or neurosurgeon to determine whether surgery is needed if the following conditions occur:

  • Pain that does not go away or worsens after two weeks.
  • Stiffness or tingling in the arms or legs.
  • There are weaknesses and loss of function of arm or leg movements.
fever

These symptoms may be signs of a disease that requires spinal surgery, such as:

  • Spinal stenosis.
  • Myelopathy or spinal cord abnormalities.
  • Spinal lesions or displacement.
  • Bone tumors or spinal nerves.
  • Spinal infection or spinal cord.
  • Removal or thinning of the spinal pillow. 
Spinal operational warning
Not everyone with spinal cord disease can undergo spinal surgery. In addition, each spinal surgery technique has different requirements.

In general, there are no absolute conditions that prevent someone from performing decompression operations. However, vertebral decompression surgery should be avoided if the patient:

  • Have kyphosis.
  • Another child
  • Do not undergo maximum non-surgical treatment.

In connection with spinal stabilization surgery, this must be done with extreme caution if any:

  • Osteoporosis.
  • Serious injury to the protective layer of the spinal cord (epidural).
  • Malignant tumors, especially in the spine.
  • Spinal fracture
  • Infection.

Preparation of spinal surgery

Before spinal surgery, the patient will undergo a general medical examination to ensure his condition is ready for surgery. The patient must tell the doctor about:

  • Medicines consumed, including vitamins, supplements, and medicines that can be purchased freely.
  • Drug allergies, especially drug allergies.
  • Pregnant or plan to become pregnant

A few days before surgery, patients will be asked to stop smoking and take anticoagulant drugs. The patient must also fast for several hours before the operation begins. If the patient has thick hair around the operating area, they will be shaved first. Patients will also undergo further examinations before surgery, such as blood tests, X-rays, or MRIs, to provide additional information about the condition of the spine to be operated on.

Spinal surgery procedures

Patients will be asked to change their clothes with special clothes and to remove the jewelry that is worn and then taken to the operating room. After that, the patient receives general anesthesia so as not to be alert during spinal surgery and is positioned according to the type of surgery, usually on the stomach.

When the patient is unconscious, the doctor starts making incisions or skin incisions in the spine to operate. Incisions can be made on the neck, upper back, lower back or abdomen so that the spine can be operated from the front. The size of the incision can vary as needed.

After the incision is made, the doctor will decompress or stabilize the spine. In a decompression surgery, the doctor will remove a part of the spine that puts pressure on the spinal cord. The doctor can remove the spinal segments (spine) or the spinal segment pads that put pressure on the nerves. During decompression surgery, doctors can also improve the position of the depressed spine by regulating nerve fibers so that they return to the spine. The spinal cushions and spine that are the target of decompression surgery are often not completely removed, but only in parts that cause nerve compression.

When in a stabilization operation, after the incision, the doctor will place a spinal balancer on each segment of the spine that has moved. This tool is usually made of special metal and installed with bolts directly on the back.

After that, the doctor can add a bone graft to the spinal column to speed up fusion or fusion between the stabilized spinal segments. This bone graft can be taken from the patient's body or from a donor. However, in patients undergoing decompression and stabilization surgery, bone removed during the decompression procedure can be used as a graft during the stabilization process. In some cases, bone grafts can be replaced with synthetic materials, enabling faster integration of the spine.

After all the surgical procedures are finished, the doctor will then cover the operating area with suture 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 recovery after surgery.

After spinal surgery

Patients will usually be hospitalized for 2-3 days. During the treatment and recovery period, patients may experience pain and discomfort in the operating area. Doctors can provide painkillers for consumption during treatment in hospitals and outpatients. During the recovery period, both at the hospital and at home, patients are encouraged to move or move while walking.

In general, the total recovery period for patients undergoing spinal surgery is around 6 weeks. However, the duration of this recovery depends on the severity of the pain and the complexity of the surgery on the spine. In addition to feeling pain, patients can also experience pain and stiffness in the back undergoing surgery. To train the body to resume physical activity after the recovery period, physiotherapy is offered to patients.

Stitches made during surgery can use mixed sewing threads or those that cannot be inserted into the body's tissues. When using a non-integrated sewing thread, the doctor will remove the stitches after closing the wound. The doctor will also arrange a time for the patient's routine checkups to monitor the recovery process during outpatient care.

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

  • Leucorrhoea from a surgical wound.
  • fever
  • Shivering.
  • Redness, swelling or hardening of tissue in the operating area.

Risk of complications from spinal surgery
Complications that may occur after spinal surgery include:

  • Infection.
  • Bleeding.
  • Blood clots.
  • Pain in the bone area is taken for bone graft.
  • Damage to blood vessels or nerves near the operating site.
  • Surgical wounds are difficult to cure.
  • Pain relapse in the spine after surgery.
  • The tearing of the protective membrane of the spinal cord causes leakage of cerebrospinal fluid and spinal cord.
  • Stiff face and impaired vision.
  • Paralysis.

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