Surgeries For Other Back Problems - When Surgery Is An Option: Back Pain

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Surgeries for other back problems

Some other types of back problems that may benefit from prompt surgery include infections, tumors, and certain kinds of fractures. In these situations timely surgery is essential. In other situations — notably when surgery is recommended to cut or destroy nerves to control pain — it's best to be skeptical, as the benefits may not materialize.

Infections

If an infection is causing your back pain and antibiotics haven't been completely effective, surgery may be necessary. In an operation usually called a debridement or decompression, the surgeon removes pus and the infected and dead parts of the bone. The surgeon then washes out the affected area with a sterile solution containing antibiotics to kill the bacteria or fungi. A bone fusion is also recommended when large portions of one or more vertebrae must be taken out to control the infection. Antibiotics will be needed for several weeks after surgery.

Tumors

For a bone tumor originating in the spine, surgery may or may not be useful, depending on such factors as whether the growth is malignant, whether it can be treated by radiation or chemotherapy, whether it's compressing the spinal canal or nerve roots, and whether it's located in a part of the spine where surgical removal is possible.

If the goal of an operation is to cure a cancer, the entire tumor must be removed, along with a portion of healthy bone. When the spine is weakened by the surgical removal of bone or by the destruction of bone by the tumor, the weakened area must be stabilized. This is usually done with metal implants, sometimes supplemented by methylmethacrylate (bone cement) or, if the prognosis for cure or control of the tumor warrants, by bone grafts.

For cancerous tumors that have metastasized to the spine from another site — such as the breast — radiation, surgery, chemotherapy, or some combination of these treatment options is used, as appropriate.

Some tumors, including lipomas, teratomas, ependymomas, and neurofibromas, arise directly from the spinal cord or the nerve roots. Although rare, such growths are often painful. Whether a surgical approach is possible depends on the type of tumor, as well as its size and location.

Dislocations and vertebral fractures

Slightly displaced spinal fractures or dislocations usually heal without causing severe pain or spinal instability. Surgery is generally reserved for serious ligament and bone damage. Your doctor will determine the extent of the damage through a physical examination and analysis of imaging studies, such as MRI scans.

During an operation, the surgeon can, if necessary, remove bone fragments from the spinal canal and can implant metal plates or rods — either temporarily or permanently — to stabilize the spine and maintain its alignment during healing. Spinal fusion (see "Spinal fusion surgery and artificial disks") is usually needed to reconstruct or substitute for damaged vertebrae or ligaments, or both.

Last updated:	January 23, 2007