Definition & Overview
Spinal cord surgery refers to any procedure performed either on or near the spinal cord. There are many types of surgery on the spinal cord, each one with a different intended function, but when combined, they make up more than 50% of all neurological surgeries performed. They are either decompressive or reconstructive and used to treat different disorders of the spinal cord as well as diseases involving the pelvic and thoracic region, and other spinal cord injuries.
Who should undergo and expected results
Spinal cord surgery is recommended for patients who are suffering from:
- Inborn spinal defect
- Spinal cord damage due to an accident
- Cervical herniated disk
- Lumbar disc disease
- Craniocervical junction anomalies
- Spinal fractures
- Spinal cord tumors
- Spinal cord injuries
- Spinal stenosis
How the procedure works
All the different types of spinal cord surgeries are broken down into two main categories – minimally invasive surgery and major (or more) invasive surgery.
Minimally invasive spine surgeries are microscope-assisted, allowing surgeons to perform the surgery without making a large incision. These typically use an intraoperative CT scanner navigation system. The techniques used in minimally invasive spinal cord surgery are usually used for discectomy, laminectomy, spinal instrumentation, and fusion procedures.
Major spinal cord surgeries, on the other hand, are often reserved for specific conditions, such as adult scoliosis, severe spinal deformities, and serious trauma-related injuries. This kind of surgery receives special focus from neurosurgeons because of their extensive nature. They also usually take a long time to complete because, in most cases, multiple sites on the spinal cord need to be corrected. The same techniques used in other neurosurgical and orthopaedic surgeries such as those performed for trauma and tumors are used in spinal deformities surgery.
Possible risks and complications
The following are the possible complications of a spinal cord surgery:
- Blood clot
- Lung problems – Lung and breathing problems may be caused by the anesthesia or any medications used during the procedure.
- Hardware fracture – Some problems may be caused by the metal screws, rods, and plates that are often used to keep the vertebrae in position while the surgery is being done; these problems are often due to misplacement of the hardware before the recovery period ends, and they usually require another surgery to be fixed.
- Infection – Infection is a common risk for any surgery that requires an incision.
- Spinal cord injury - The nerves of the spinal cord may suffer damage during the procedure, which can lead to paralysis.
- Implant migration - Implants used in the surgery may also move from their position before the healing process is complete.
- Pain - Unsuccessful surgeries may not completely eliminate spinal pain. Sometimes, surgery may even result in even worse pain than before the surgery has been performed.
- Sexual dysfunction - The spinal cord and the nerves associated with it are the body parts responsible for carrying nerve signals that allow the other parts of the body to work properly. Damage to the spinal cord can lead to certain dysfunctions such as sexual dysfunction, especially if the damage is near the pelvic area.
- Deep vein thrombosis – This is the occurrence of blood clots in the veins of the legs or calf; this tends to occur more when the surgery is performed near the pelvis as the body attempts to stop the bleeding during the surgery.
Pulmonary embolism - This is a serious life-threatening condition that can develop from a blood clot problem.
Chou R, Loeser JD, Owens DK, Rosenquist RW, et al; American Pain Society Low Back Pain Guideline Panel. Interventional therapies, surgery, and interdisciplinary rehabilitation for low back pain: an evidence-based clinical practice guideline from the American Pain Society. Spine. 2009;34(10):1066-77.
Chou R, Qaseem A, et al. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med. 2007;147(7):478-491.