Most people have back pain at some time in their lives. The most common causes of back pain are muscle injury and arthritis of the spine. Muscle injury can be a result of a specific event or simply because the muscles that support the trunk have become weak. Arthritis is a result of aging, genetics or wear and tear on the joints and discs of the spine. Wear and tear alone can cause back pain and may cause leg pain if nerves are affected. Less common causes of back pain include disc herniation, certain deformities, fractures, infections, tumors and other medical problems.
Most patients will recover without surgery. Symptoms may decrease with medication, injections and physical therapy. If symptoms are not reduced with these treatments, loss of bladder/bowel control occurs, or if recovery is not good enough after two to three months of conservative treatment, then surgery may be an option.
Surgery is necessary in only a small number of patients with spinal problems. Factors that may lead to the need for surgery include:
- Response to prior treatment.
- Level of pain and loss of function.
- Degree of nerve damage or threat of future nerve damage.
- Spinal damage.
- Long-term outcome without surgery.
The patient and his or her doctor need to make a careful and thoughtful decision to proceed with surgery.
Many of the risks of spine surgery are the same as with any type of surgery. Risks include bleeding, infection, damage to nerves or vessels, scarring, pain and the risk of the anesthesia itself. However, these risks are all low and not common.
Some patients go home the same day after surgery; many go home the next day. Patients who have a spinal fusion will most likely be in the hospital two to three days.
Blood transfusions are very rare after this surgery.
Your heart will be monitored during surgery. If it is necessary, your heart will be monitored after surgery during your hospital stay.
Many surgeons advise their patients to stop smoking before surgery and to think about quitting for good. Tobacco products have an adverse effect on blood vessels, which can affect the body’s way of healing wounds and bones. The risk of infection and lung problems after surgery is also greater for patients who use tobacco. There are many sources of information offered to help people quit smoking.
You should resume low-impact activities as soon as you can. Walking is the best exercise. Try to build up the distance you walk slowly over time. Two to three weeks after surgery, you may try more vigorous activities such as an exercise bike. Talk to your surgeon before starting activities such as jogging or high-impact activities.
You should limit lifting to less than 10 pounds. Avoid too much twisting and high-impact activities. Always clear strenuous activities with your surgeon prior to doing them.
Pain medication is often needed after surgery. The strength of these medications and the length of time they are used depend on the nature of the surgery itself. Sometimes a patient needs to take narcotic pain medication for 4 to 6 weeks after spinal surgery and maybe even longer. All medications may have side effects, which should be discussed at length with the surgeon prior to their use. Keep in mind that you should not drive while taking narcotic pain medication.