Back surgery: types, complications and rehabilitation
Spinal surgery is complex and dangerous. And therefore, even surgeons will not undertake such an operation, while there is the slightest possibility to avoid it. Surgery is prescribed only in cases where a full range of conservative treatment methods have been ineffective.
Why is there a need for the operation
Today difficult to find man not that perfect, but at least with a relatively healthy spine. Increasingly, people are pestering herniated discs, and scoliosis in the thoracic or osteochondrosis of the cervical spine, we pay attention when in pain it is time to climb the wall. Well at least that in most cases, alleviate the condition, you can do special exercises physical therapy. Operations on the spine used when there is no other way.
And methods of operations have changed significantly. Another 20-30 years ago the patient was able to offer only surgical intervention, regardless of the order in which the spine – cervical, thoracic or lumbar – detected problem. Today the list of such operations has expanded considerably:
- traditional surgery;
- percutaneous discectomy (removal of an intervertebral disk or part thereof by means of a small incision);
- endoscopic surgery (performed through small pinholes, space for which is determined by the computer or the x-ray machine);
- microdiscectomy (using the tools of microsurgery removes the protruding part of the disk);
- nucleoplasty (eliminate protrusion of the intervertebral disc by means of an electrode);
- chemonucleolysis (method elimination of the hernia with the help of the introduced chymopapain).
New methods of operations, called minimally invasive, or mini-operation. Today such interventions can be performed on an outpatient basis using local anesthetics. After they human 2-3 hours is discharged from the clinic, and the ability to work fully restored in 7-10 days. Minimally invasive spinal surgery are a lot of money, but traditional open surgery in them is minimized.
In most cases, minimally invasive surgeries are limited to small punctures or incisions, so the risk they reduced complications after surgery are minimized, and postoperative rehabilitation period is shortened as much as possible.
Principal surgical interventions on the spine
Despite great progress in treatment, any operations performed on the spine, the threat of possible complications. Therefore, in case of disagreement with the opinion of the doctor, or if you doubt his skill you can feel free to request advice from another expert or issuing a direction for examination in another clinic.
Modern operations are divided into several large groups:
Discectomy (hernia at the the spinal disc) is carried out, if necessary, to remove inflammation, or reduce irritation of the nerve in cases when from-for the formed herniated spinal disk shifts and pinches a nerve. Laminectomy (removal placed over the spinal canal of bone) is performed if there is a need to minimize pressure on the nerve, and the only way to achieve this is to increase the spinal canal.
Arthrodesis is usually performed with considerable damage or wear of vertebral discs, causing the adjacent vertebrae RUB against each other, causing the person unbearable pain. In this case, is artificially merging two (and if necessary more) of the bones in the spinal column. Vertebroplasty is a modern type of operations have appeared not so long ago. It is the manipulation to strengthen damaged areas of the spine with special bone cement.
A possible solution with significant damage will be replacement of the worn intervertebral discs with artificial implant.
The implant is actually a prosthesis that is installed instead of the damaged intervertebral disc. Early implant only provides rigid fixation of the vertebrae between which it was installed. Often such substitution has led to overloading the adjacent discs and cause severe pain at the site of implantation. Modern high-quality implant takes over the main functions of the intervertebral discs, providing mobility range. To the replacement was as painless as possible, developed special exercises physical therapy.
Replacement therapy after surgery
If the operation is aimed at eliminating the causes of pain, the task of rehabilitation therapy is to help people to adapt to normal life. Rehabilitation after surgery lasts from 2 to six months. In particularly difficult cases it may continue for twice as long.
The result of any surgical intervention on the spine is a significant reduction (and even absence) of pain, which is torturing a man before. The patient appears able to move normally and cope with everyday chores. But here lies a considerable danger. Patients begin to excessively load the spine, and after a short time again suffer from pain, sometimes even stronger than before the surgery.
It is important to realize that surgery treatment ends, and that recovery from spinal surgery is an integral part of the process. And a positive end result depends on it not less than on the successful outcome of surgical intervention. The recovery period consists of 3 stages.
In the first stage, the patient is made to get rid of the pain and numbness after surgery. Ill have to get used to the «new» spine, especially if it is inserted in the implant, as initially in the postoperative period usually present a sense of skusenosti of the torso relative to the pelvis.
The second stage is for General postoperative stabilization of health and emancipation movements. In the third stage there is a kind of «running in» of the spine, especially when the replacement disk or surgically implanted. In such cases, the new and old parts of the spine necessarily need to give time to «get used» to each other.
Postoperative rehabilitation is a complex of measures, consisting of therapeutic massage, physical therapy, chiropractic and acupuncture. Its main goal is the speedy restoration of the health of the spine.
Usually 1 stage of rehabilitation the patient is in the hospital under the supervision of a physician, and 2 and 3 on an outpatient basis. At discharge, the attending physician must make the patient the program, having painted it, what kind of exercise physical therapy and in what sequence you need to perform.
Postoperative therapy at home
First of all, to reduce pain to properly apply the cold and heat. Remember that cold constricts blood vessels, heat expands them. So the first couple of days after surgery to reduce swelling and relieve inflammation at the site of the operation is better to use cold compresses. And when the inflammation will go away, to enhance the therapeutic effects of ointments and gels need a warm compress.
To avoid pain during movement, especially in the first days after surgery, you need to constantly monitor their movements. Avoid rotations and tilts of the torso, especially at a fixed position of the feet. Do the exercises to maintain proper posture. It is especially important to follow these rules, if the spinal implant is inserted, otherwise it may move.
When the complex entered the physical therapy exercises with bending, in the first weeks, follow them very carefully, trying to keep the back as straight as possible. These exercises should be done while lowering the usual-getting out of bed.
If physical therapy there are exercises to lift or carry weights (in that case, if the operation was performed on the cervical spine), then they need to carry without bending, and squatting with a straight back. Exercises for carrying cargo do, holding shipment on the sides and evenly distributed it on both hands.
In the future, you should never forget that regardless of in what Department and what surgical intervention has occurred (hernia removed or inserted implant), the integrity of the spine is still broken. And if the patient does not take care of it and will not maintain a reasonable lifestyle, the consequences can be very sad.