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Overview

Spinal issues manifest in a large number of people at all phases of life. Back pain is one of the most common complaints that individuals visit a doctor for. Many orthopedic issues such as arthritis and other joint problems are manifested in the spine. Improper body mechanics, aging, trauma, and structural abnormalities can harm your spine, leading to back pain and other symptoms.

Many spinal problems occur in the lower lumbar portion of the back as this is the region which endures most of your body weight, and hence, a great amount of strain is put on this part of the spine.

Most common spine issues such as herniated discs occur due to damage of the joints and vertebrae. This is manifested gradually with age, as the joints are less lubricated and damage occurs slowly over time.

If you have been suffering from back pain for a long time, then spinal surgery may be your most effective treatment option.

Causes of Spinal Problems

Common spinal issues, such as herniated discs and stenosis, are caused either due to injury or age. However, there are several other risk factors that increase the chance of having spinal problems, and these problems are more common among:

  • Obese people
  • Pregnant women
  • Men
  • Individuals over age 40
  • Workers whose work involve heavy lifting
  • Individuals who have a family history of spine problems
  • People with history of back injuries in the past
  • People with jobs requiring long periods of sitting
  • Truck drivers
  • Smokers

Common Spinal Procedures

Some of the common spinal procedures employed as part of surgical treatment for back pain include:

  • Laminectomy: In this procedure, a thin bony plate on the back of the vertebrae known as the laminae is removed to create more space within the spinal canal and ease pressure.
  • Laminotomy: In this procedure, a part of the lamina (vertebral arch) that covers the spinal cord is removed to create more room to relieve pressure.
  • discectomy or microdiscectomy: In this procedure, herniated intervertebral discs are removed thereby removing pressure from the compressed nerve.
  • Foraminotomy: This is a procedure involving removal of tissue or bone at the passageway known as the neuroforamen, where the nerve roots branch off the spinal cord and leave the spinal column.
  • Spinal Fusion: This is a surgical technique where two vertebrae are fused together using a bone graft.
  • disc Replacement: In this procedure, the damaged disc is replaced with an artificial one as an alternative to fusion.

Am I a Candidate for Spine Surgery?

The first line of treatment for spine problems is always conservative treatment such as activity modification, pain medication, non-steroidal anti-inflammatory drugs, muscle relaxants, physical therapy, spinal injections, etc. However, if conservative treatment fails to provide satisfactory results and you continue to have chronic and persistent back pain or if you have spine conditions such as degenerative disc disease (arthritis), herniated disc, compressed spinal cord or nerve root, scoliosis, spondylolisthesis, and other common spinal conditions, you may be a candidate for spine surgery.

Whether or not you are a suitable candidate for spine surgery can be further ascertained by your answers to the spine surgery questionnaire mentioned below;

  • In general, your pain can be described as:
    • Mild but does not affect movement
    • Moderate and some difficulty with movement
    • Severe and great difficulty with movement
    • Extremely severe and certain movements are impossible
  • Does your back pain affect your sleep?
    • Never
    • Sometimes
    • Mostly
    • Every night
  • Are you able to perform your basic household functions?
    • Yes, with very little difficulty
    • I cannot perform certain tasks
    • I can only perform some tasks
    • I am mostly dependent on others
  • Do you feel your back is unstable or may give way?
    • No
    • Sometimes
    • Often
    • Always
  • While working, how long does it take before you experience severe back pain?
    • More than half an hour
    • 15-30 minutes
    • 5-15 minutes
    • Less than 5 minutes or instant pain with working
  • After sleeping for a long time, describe the pain you experience on trying to get up?
    • Mild, with little difficulty getting up
    • Moderate, with some difficulty getting up
    • Severe, with great difficulty getting up
    • Extremely severe, requiring assistance to get up
  • While driving, entering and exiting a car or using other forms of transport, your back pain can be described as:
    • Mild
    • Moderate
    • Severe
    • Extremely severe
  • How much has your back pain interfered with your work, hobbies, or recreational activities?
    • Mild
    • Moderate
    • Severe
    • Extremely severe
  • Could you do the household shopping on your own?
    • I can with no difficulty
    • I can with some difficulty
    • I can but it’s very difficult
    • Impossible
  • Have you had any trouble dressing yourself because of your back pain?
    • No
    • Sometimes
    • Often
    • Always

  • American Medical Association
  • American College of Osteopathic Surgeons
  • American Osteopathic Association
  • North American Spine