Objective correct structural abnormalities of the spinal column.
The correction of the structural abnormality that causes back pain, when this is the cause. For example, when a disc herniation compresses a nerve root, and all non-surgical treatments have failed, extract the herniated disc material eliminates the compression.
Scientific evidence of its effectiveness
Some evaluation methods, scientifically optimal, may not apply to the case of surgery by its own characteristics. For example, it is not acceptable to stop operating a group of patients where surgery is necessary, according to the currently accepted criteria, to demonstrate that those who do not operate are paralyzed.
Yes, there are studies on the definition of the criteria that should suggest the desirability of operating. Some of the existing recommendations based on scientific evidence have considered these studies and the criterion of experts to establish the particulars mentioned below. Although the criteria for operating each type of structural abnormality of the spine are mentioned in the corresponding section generic criterion is to operate only when evidenced that:
There is a compression of the nerve roots or the marrow, important enough to leave sequelae in the event that it is not resolved quickly (this is the case of the intervention by "syndrome of horsetail due to herniated disc")
There is a compression of nerve roots that, although you will not necessarily leave sequelae, it causes symptoms and lasts more than 6 weeks without improving despite non-surgical treatments, and
Characteristics of clinical manifestations and the result of the physical examination show quela compression should without a doubt to the detected structural anomaly.
Surgery in patients with back pain
Perhaps you have fear of back surgery but, in fact, only 5% of people must undergo back to treat lumbar problems. Your pain may be sharp, but the majority of the strains and pressures do not need surgery.
Surgery is reserved for the most serious cases of back pain (if the spinal cord is committed, if there is deformation, structural, or in severe cases of spinal stenosis).
Surgery should be assessed only after a non-surgical treatment for several months.
Many surgical procedures can be carried out using techniques minimally invasive (i.e. with less "cuts" or income in the body). These techniques involve smaller incisions, shorter hospital international, less post surgical pain and a faster recovery.
Typical spinal surgeries include:
Previous cervical Discectomy and Fusion: A procedure whereby it reaches the cervical spine (neck) by a small incision in the front of the neck. The intervertebral disc is removed and replaced with a piece of small bone or other graft substitute and, eventually, the graft merges with vertebrae.
Cervical Corpectomía: this procedure removes a portion of the vertebra and intervertebral discs adjacent to decompress the spinal cord and spinal nerves. Grafting bone and, in some cases, a metal plate and nails is used to stabilize the spine.
Facetectomía: Is the procedure whereby a part of the facet (a bone structure of the spinal canal) is removed to make more room.
Foraminotomy: Procedure according to which the lateral is removed (the area where are the roots of the nerves of the spinal canal) in order to increase the size of the passage of the nerves. This surgery can be done alone or with a laminotomía.
Laminoplastía: According to this procedure, it reaches the cervical spine (neck) from the back of the neck, which is then reconstructed to make more space for the spinal canal.
Laminotomía: Procedure by which is only removed a small piece of blade (part of the vertebra) to relieve the pressure on the nerve roots.
Micro-discectomy: procedure that removes a drive through a small incision, using a microscope.
Spinal Laminectomy: is the procedure dealing with spinal stenosis relieving pressure on the spinal cord. A portion of the lamina (part of the vertebra) is removed or reduced in order to widen the spinal canal and make more space for the spinal nerves.
Risk and contraindications
Some of the existing recommendations based on scientific evidence establish that risk of infection or hemorrhage during a first operation of the intervertebral disc is less than 1%, although this risk increases much with older patients or when it is not the first disc operation.
The real risk is that the operation does not have satisfactory results. Some of the existing recommendations based on scientific evidence establish that, among patients with disc herniation without evident signs of compression of the nerve on physical examination or by electromyogram, less than 40% of those who operate obtain satisfactory results. Scientific studies show that the main cause of surgical failure is to operate on patients who should not be, and the more strict is the selection of patients who refers to surgery, best are the results of this.
Another risk of surgery is postoperative fibrosis. It is accepted that the less aggressive is surgery and minor bleeding during the operation, lesser is the risk of emergence.
On the other hand, the surgery requires a minimum of general health status. Some general, such as cardiac, pulmonary or metabolic diseases, can prevent it.
If you can not live with the back problem, a lot of pain and your treatment is only surgery, "MCG Back Surgery" recommend the best specialist in back surgery.