We often see patients who know a friend of a friend who had spine surgery and “it did not work.” Spine surgery encompasses a very large field that includes treatments for fractures and spinal cord injuries, spinal tumors, disc herniations, scoliosis, kyphosis, cervical myelopathy, stenosis and other conditions that may cause back or neck problems. Each condition carries with it different implications in terms of the success of the surgical invention. In general, when the right patient has the correct diagnosis and has the right surgery by the right surgeon, results are favorable. However, individual conditions have variable expected outcome. It is important for the patient to be well educated about what to expect from surgery and have the appropriate goals.
Generally, most conditions affecting the spine can be treated by your primary care physician. The vast majority of patients with a degenerative condition causing back pain or neck pain will resolve their symptoms with non-operative modalities. Symptoms that do not respond to non-operative modalities such as physical therapy, exercises and anti-inflammatories should be further investigated by your primary care physician or sent for a spinal evaluation.
Minimally invasive spine surgery, or minimal access spine surgery, combines the goals of traditional open surgery with smaller incisions using different approaches and retractors. Like anything else, when applied in the correct setting, minimally invasive approaches can minimize blood loss, operating time, and post-operative pain. It is important to realize that minimally invasive may sometimes end up being minimally effective if not done correctly, or if done in the incorrect setting. We utilize minimally invasive approaches when appropriate and educate individual patients if minimally invasive surgery is applicable to their condition.
Artificial Disc Replacement is an evolving technology that has been under strict trials in the U.S.A for less than 10 years. It has been performed in Europe for about 20 years. The thought behind artificial disc replacement is to eliminate the source of the pain (the lumbar degenerative disc) without eliminating the motion, like with a fusion operation. I am very cautious about using this evolving technology. The results so far are equivalent to fusions in general. Some of the potential complications from artificial disc replacement may outweigh the potential benefits, and it is important for patients to be well educated. Motion preservation is an emerging field in spine surgery and is promising, but it is important to apply it correctly to the right patient. It is certainly not a “magical solution” for low back pain.
Depending on your condition, and what surgery you have, recovery varies widely. Patients with a disc herniation who undergo a microdiscectomy often have minimal post-operative pain, and in the vast majority of cases, go home the same day. On the other hand, patients that require a multi-level spinal reconstruction for scoliosis have a much more intensive post-operative and recuperative period. Pre-operative education and preparation are crucial to the post-operative success of the surgery. What sets our practice apart is that we are truly by our patient’s side during their road to recovery. Thru open communication and close monitoring and we are able to customize a plan which will facilitate the individual patient’s recovery.
At the Orthopaedic and Spine Center of New Jersey, we believe firmly in conservative care and exhausting all non-surgical treatment options. We are confident that our treatment plan is the correct one for your benefit, and as such, we make it a regular practice to send patients for a second opinion so that they too have full confidence that we have made the right call.