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Who Needs Spine Surgery?

Considering that it is the most common musculoskeletal cause of pain in the world, you have probably felt some back pain in your life, whether it was dull, achy, sharp, or radiating. Even if your occupation does not involve lifting or heavy physical labor in the fields of Wyoming, you are still at risk for developing back pain. You might be wondering how to manage and when surgery is necessary for the injury, so Memorial Hospital of Converse County has some explanations.

Your spine contains 33 vertebrae, which are bones that protect your spinal cord. It is divided into five regions – the cervical vertebrae, thoracic vertebrae, lumbar vertebrae, sacral vertebrae, and coccygeal vertebrae. In between each of the first 24 vertebral bones, the discs function as shock absorbers for forces transmitted through your vertebrae. The vertebrae in the sacral and coccygeal regions are fused and do not have these discs.

Common sources of back pain include traumatic injuries, such as lifting a heavy object or falling, degeneration over time, or nerve issues arising from a change in the vertebrae or spinal cord size or alignment. Below are some of the most common injuries that may necessitate surgery if conservative treatments do not work:

  • Herniated discs can arise from a forceful lift, push, or pulling motion or from prolonged sitting. The disc changes positions and can impinge on nerve roots and other tissues surrounding the spine, resulting in pain and limited function.
  • Disc degeneration and spondylosis (vertebral degeneration) are often seen in aging individuals.
  • Arthritis is an inflammatory condition in the joints between vertebral bones caused by the breakdown of cartilage, which cushions the joints. Bone spurs can form when bones that make up the joint rub against each other due to cartilage loss.
  • Sciatica or radiculopathy is when the sciatic nerve or its branches, which innervate a large portion of your buttocks and the back of your leg, is impinged. Other back injuries, such as spinal stenosis, spondylolisthesis, herniated discs, and spondylosis, can cause sciatica or radiculopathy.
  • Spinal stenosis is due to narrowing of the vertebral openings that house the spinal cord. This narrowing can compress the spinal cord and nerve branches and result in radiating pain.
  • Spondylolisthesis occurs when vertebrae shift positions, which can compress nearby nerves and result in radiculopathy.
  • Sacroiliac Joint Dysfunction or S/I Joint Dysfunction occurs when joints move improperly due to damage or injury to the joint between the pelvis and hip. Often this leads to feeling unstable or unsteady.

Many individuals have one or more of the above injuries but are asymptomatic and do not necessarily need treatment. However, suppose you are experiencing debilitating back pain. In that case, a physician will probably order imaging such as an MRI or x-ray to see the alignment and structures in your spine and to diagnose findings.

Before initiating a non-emergency surgery for back pain, conservative treatments are the first approach. This treatment plan can include rest, ice, anti-inflammatory medications, diet changes, and exercise. You may see a physical therapist to strengthen weak muscles that place extra pressure on your spine. They may also change your movement patterns to reduce pain. If physical therapy treatment does not help, a physician may try spinal injections to decrease inflammation and symptoms. If none of these conservative measures lessen the pain to a tolerable level, surgery may be necessary. The following are the basics of common back surgeries:

  • Spinal fusion: two or more vertebrae are fused to prevent movement between the two bones. This procedure can be done for severe arthritis, instability, or degenerative disc disease.
  • Spinal cord stimulator: an implant that uses electrical impulses to block or decrease pain sensations from traveling to the brain.
  • Decompression/Laminectomy: the lamina (part of the vertebral bone) is removed to increase the space where the spinal cord sits. This procedure is often performed to alleviate symptoms arising from stenosis.
  • Discectomy: part or all of a disc is removed when it is herniated and putting pressure on nerves.
  • S/I Joint Fusion: a minimally invasive procedure that uses proprietary or specialized implants or screws inserted directly into the SIJ.

If you or someone you know is experiencing debilitating back pain that is preventing you from your occupational and recreational activities, you can learn more about our medical team here. Or call our Neurosurgery and Spine team at 307-237-3077 to schedule an appointment, no referrals or imaging are needed to schedule.

We want to create the right plan for you to get you back out fishing, hunting, hiking, biking, and enjoying the things that fill your life with memories and adventures.