When is Spine Surgery Necessary?

Patients with back pain are often well acquainted with non-surgical approaches to treatment, including physiotherapy, rest, and activity modifications.

"Since most conditions of the spine are due to the progressive deterioration associated with ageing, in many circumstances surgery is not the treatment of first resort," says Dr Yue Wai Mun, orthopaedic surgeon at Gleneagles Hospital. "However, if the nerves are affected and the patient is not able to walk properly, surgery is a better option."

If you're unsure of the right treatment for your back or spine problems, consult a specialist.

Transforaminal lumbar interbody fusion: a minimally invasive approach

Minimally invasive transforaminal lumbar interbody fusion (MIS TLIF) is a surgical procedure that can treat a series of lower back conditions like recurrent disc herniation or scoliosis, but is usually carried out to ease back or leg pain due to degenerative disc disease.

Damaged discs – cartilage-made cushions that sit between the bones of the spine – can exert excessive pressure on nearby spinal nerves, thereby disrupting their proper function. MIS TLIF relieves the pressure on the nerves by replacing part of the diseased disc with an implant and fusing the bones together using screws and rods. The intervention reduces back pain and improves mobility.

MIS TLIF is a minimally invasive surgery involving multiple small incisions, instead of the traditional long incision that causes a great deal of muscle and tissue trauma. As a result, patients who undergo MIS TLIF gain more post-operative benefits.

"In the short term, patients obtain faster recovery, less pain and less blood loss," says Dr Yue. He adds that long-term outcomes for MIS TLIF are as good as those associated with open surgery – the previous standard technique.

Generally speaking, any minimally invasive spine surgery decreases the chance of getting a post-operative infection by 5 – 6 times in comparison with open surgery, according to a study conducted by Dr Yue.

Protecting the spine from injury

Common sense is key in keeping the spine in good condition, says Dr Yue. Appropriate posture is the first step to prevent damage to the spine, and involves standing up straight and avoiding slouching.

Regular exercise is also beneficial for the spine. People who work out 3 – 4 times per week have a lower chance of suffering back pain.

Smoking has also been found to be linked to the worsening of degenerative disc disease in the cervical spine.

Dr Yue adds that smoking may also affect the outcome of spine surgery because procedures performed on non-smokers achieve better results than those who smoke.

"I usually tell smokers in need of a spine surgery that it is a good time to stop smoking," says Dr Yue.

If you're worried about the condition of your back or spine, speak to a specialist.