Spine Surgery

spine surgery

Pain in the lower back and neck affects most people at some time during their lives. In most cases, the symptoms quite rapidly passing – within a few days to a few weeks. A few have problems with long-term, more or less difficult and restrictive function aches. Pain in the lower back or neck is more often an expression of a serious illness.

The problems and pains in the back that leads to surgery is usually due to degenerative conditions. In Sweden, was carried out almost 16,000 surgical operations back in 2011. The most common diagnoses were stenosis (narrowing of the spinal canal) and herniated discs, which together accounted for over 70% of all diagnoses that led to surgery. The most common surgical procedures are discectomy for a herniated disc which involves surgical removal of the herniation, decompression which is a widening of the spinal canal and fusion (arthrodesis) to lock one or more vertebrae. In most cases, the operations aimed to ease the pressure, decrease the nerves and stabilize the spine.

Challenges in Spine Surgery

There are a number of underlying diseases that cause spinal surgery. This leads to a diverse population of patients with different conditions for a successful outcome of the surgical procedure. Data from the Swedish spine surgical records shows that there is a variation between health care providers with respect to patient-reported outcomes and patient composition (ie casemix). What type of patients that have the best conditions for a successful outcome of surgery is therefore important to study – both with respect to the actual health outcomes and social costs. It is also important to create conditions to be able to monitor and compare the quality of care in as fair a way as possible by taking into account differences in patient composition between different health care providers. It is also important how health outcomes reported in public comparisons to facilitate patients’ informed choice of healthcare providers. Care processes need to be defined and the importance of the postoperative outpatient rehabilitation with physiotherapy for health outcomes, needs to be monitored and evaluated.

Back Surgery for Herniated Discs

Disc herniation is a protrusion (hernia) of an intervertebral disc (disk) between the vertebrae in the spine. Such occurs in a disk that has undergone some sort of change age, so that it formed a cracking in the disk package. In this sprickdelning, portions of the platter inner penetrate and form a hernia. Sometimes this occurs as a result of lifting, back bending or twisting the back, or other accident. Most often arise, however, a herniated disc without any triggering event.

All herniated disc does not hurt. One can have a herniated disc without ever had pain in either back or leg before. Disc herniation is seen on magnetic imaging of 20-30% of back healthy individuals.

Herniated discs cause trouble if the touch nerves. Then you get sciatica, pain that radiated teaches in a leg. Moreover, one can get weakened e.g. foot and impaired Fighter.

Most herniated discs heal on their own without treatment. If the herniated disc does not heal within 3 months or if you have to have great trouble of sciatic pain can be considered

Operation. The need for surgery is determined by how much sciatic pain you have and if you eg have drop foot, that is difficult to control the foot. At the inability to urinate need emergency surgery should be considered.

What is a herniated disc surgery? Are there different surgical procedures?

The surgery is done under general anesthesia. Via a 4-6 cm skin incision and solution of muscles from the spine, you enter the spinal canal and removes the herniated disc. The operation takes 30-60 minutes.

The surgeon can use a microscope or loupe glasses to see better because the operating area is small. You can also use the so-called keyhole technique (endoscopy).

The aim, however, is the same at all the techniques, that is striving to remove the herniated disc so that the nerves are free. Keyhole surgery is still under implementation and not a general routine.

One advantage is that soft tissue damage is minimal and the skin incision 1-2 cm. The operation time is about 30 minutes. If it is difficult to access the herniated disc can happen that the operation is converted to an open surgery. If the keyhole technique to use your doctor will inform you about it.

How to prepare for the surgery?

The fitter you h ave before the surgery, the easier rehabilitation after such. Make sure to have a relative / friend available when you get home. In the beginning, you may need assistance with shopping, cooking, cleaning and caring for your health. If you eat anti-inflammatory drugs (Treo, Bamyl, Aspirin, Voltaren, diclofenac, aspirin, Brufen, Artrotec, ORUDISĀ®, Vioxx, Celebrex, etc.), you should stop taking them at least two weeks before surgery. These drugs increase the risk of haemorrhage so that blood loss during surgery becomes larger. However, you can take ordinary painkillers that Alvedon, Panadol, Tradolan, Tramadol, Dexofen, Distalgesic or Citodon. If you are eating blood-thinning medication (Coumadin), this must be uti good time and replaced by other preparations. If so, contact the operator in good time.

Smoking should preferably abstain from during the period around the operation, ie, about two weeks before surgery to two months after surgery when the healing process can be considered complete.

How good are you after surgery?

The aim of surgery is to cure your sciatica pain. The chance that you will be completely pain in the leg is about 80%. Often the pain disappears immediately.

If you have back pain before surgery, it is possible that you have left a part of this afterwards. Removal of the herniated disc will not always back pain. If you have numbness or weakness is that almost always left immediately after surgery. When the nerves gradually heal, and you exercise, this decreases gradually. However, a certain degree of numbness or weakness persist.

How long will it take before the surgery is healed?

The wound is healed after two weeks. Inside the healing takes about 6 weeks.

How long you need to be on sick leave?

It depends on how quickly the pain goes away after surgery and on the job you have. A mobile office work to ka n control yourself, you can return to after a couple of weeks. If you have a heavy work with much lift may need to be on sick leave for two months.

How long is the hospital stay?

Some patients can go home the same day they are operated. Usually going to be home the day after surgery.

How is repatriation at discharge?

It is usually good to go home in a normal car. To sit up with little reclining backrest easier. If you have very long travel time can be horizontal transportation more convenient.

What is rehabilitation after surgery?

Before the operation, you have received a brochure with information from a physiotherapist and intructions on appropriate exercises. Perform these regularly. During the hospital stay you will receive exercise instructions by the physiotherapist at the hospital but if it’s the weekend and if you go home quickly after surgery might not have time for.

You should consult a physiotherapist in primary care of continued training within a couple of weeks.

You will live as usual but be a little careful with sitting and avoid lifting.

What about the doctor’s visit after the surgery?

There is no routine visits to the doctor after the operation. Instead, you will be invited for follow-up visits to the physiotherapist at the back reception 6 weeks after surgery. Questions regarding this visit and depreciation and rebooking of time takes place on the phone 031-342 88 95 Mon-Thu 8 Fri 08 00-14.30 and 00-14.00.

If the process is complicated in any way physiotherapist opportunity to arrange a return visit to one of our doctors.

If necessary, you can also get in touch with your orthopedic surgeon via the hospital “contact 2” on telephone 031-343 31 00 weekdays between 07:30 and 17:00.

Upon discharge from the department you will receive recipes and sick of what we perceive as normal convalescence for you. If you need additional sick leave or recipes for this, you turn to your local health center.

Remember to inform the prescribing physician in the department which health center you belong to (or if you wish to go to another doctor), so that we can send copies of your medical records there.

Do you need help when you come home?

No, you do not need any special tools. The movements required for activities of daily living is a great workout.

Are there any risks with the surgery?

Yes, as in all other operations, there is a risk of complications.

Wound infection occurs in 1-2%, nerve damage with temporary or permanent muscle weakness, numbness or nerve pain occurs in 0.2%.

Infection of the disk occurs in 0.1-1%. The risk of blood clots is 0.1-1%. The risk of getting a new herniated disc requiring surgery is 5-10%.

The risk of infection is reduced by antibiotic prophylaxis. The risk of blood clots decreased with early decompression after surgery and leg and foot movement during bed rest.