When is spinal surgery necessary?

The decision to perform spinal surgery is often made after a conservative approach has failed. This initial approach should include physiotherapy, medication, and pain management techniques. Symptoms that significantly impact daily life, both socially and professionally, leading to a reduced quality of life, also justify spinal surgery. Most spinal surgeries are not urgent. Exceptions include certain post-traumatic or oncological conditions requiring immediate surgical intervention.

What are the most common pathologies treated in spinal surgery?

Spinal conditions frequently treated surgically include:

• Spinal arthritis (joint inflammation);
• Spinal osteoarthritis (chronic degenerative joint disease);
• Herniated discs;
• Vertebral fractures;
• Spinal deformities, such as scoliosis;
• Spondylolisthesis: a condition where a vertebra slips forward progressively onto the one below;
• Cervical or lumbar stenosis: narrowing of the spinal canal, compressing the spinal cord and/or nerve roots;

What are the most commonly used procedures in spinal surgery?

Common surgical approaches for spinal pathologies include:

• Minimally invasive percutaneous surgery, primarily for herniated or protruded discs;
• Discectomy (removal of an intervertebral disc);
• Laminectomy (removal of part of the vertebral arch, often used for lumbar stenosis);
• Laminoplasty (lifting, not removing, part of the vertebral arch to widen the spinal canal, often used for cervical stenosis);
• Lumbar spine arthrodesis (fusion of vertebrae to prevent movement, often used for spondylolisthesis);

Except for minimally invasive percutaneous surgery, procedures are generally performed under general anesthesia and require about a week of hospitalization.

What are the risks of spinal surgery?

When performed correctly, spinal surgery carries negligible risks, especially compared to the benefits for appropriately indicated patients. Paralysis after spinal surgery is extremely rare. Conversely, for some spinal conditions, not having surgery can lead to severe disability and a compromised quality of life.

Surgery for a herniated disc: what is the risk of recurrence?

The risk of recurrence after herniated disc surgery is very low and insignificant compared to the benefits of properly performed minimally invasive surgery.

What does spinal surgery consist of?

Most spinal surgeries aim to decompress nervous structures (spinal cord, nerve roots). Another key objective is to prevent or treat vertebral instability through stabilization or spinal fusion (arthrodesis), often using implants or prostheses.

What is the length of stay before and after spinal surgery?

Hospital admission is usually on the day of surgery. For surgeries under general anesthesia, at least 24 hours of post-operative observation is needed. Mobilization is usually the same day or the following morning. Post-operative stay is typically 24-48 hours. For local anesthesia, mobilization is almost immediate, with potential for same-day discharge.

What kind of pain should I expect after spinal surgery?

Pain improvement depends on many factors. Significant pain reduction is often immediate. For chronic pain, improvement may be gradual. Most specialized centers have anesthesiologists and pain specialists to manage post-surgical pain.

What kind of functional limitations will I have after spinal surgery?

A normal life is usually possible during recovery. Walking is encouraged, but heavy lifting, sports, and driving are usually restricted for at least 20 days. For spinal fusion, a brace may be needed for the first month.

What can I do if the pain returns after spinal surgery?

A specialist assessment and MRI are necessary. Conservative treatment often resolves the issue. In some cases, procedures to address post-surgical scar adhesions may be needed. Re-operation is very rare.