Back Surgery


When you’re living with ongoing back pain, your thoughts may eventually turn to back surgery.

Back surgery is a big topic and you’re bound to have many questions about it.

Your back is a complex structure meaning your back pain could have several possible sources.

Once you have an accurate diagnosis, then it’s a case of exploring your treatment options, usually starting with conservative treatments like physiotherapy and medication and only progressing to back surgery if you really need it.

Understanding how your back works may help you understand whether back surgery would help you and, if so, which type of back surgery is most appropriate.

If you would like to arrange a consultation with our spinal surgeon Dr David Edis, please contact our clinic today.



The structure of your back

There are 4 main parts to your spine: your vertebrae, joints, nerves and discs.

Vertebrae

Your spine has 24 vertebrae plus your sacrum and coccyx at the base. That’s 26 motion segments that give your spine its flexibility.

Your vertebrae are like hollow, bony building blocks that stack on top of each other to create your spinal column. That strong, bony tunnel houses and protects your nerves and spinal cord. Various muscles, tendons and ligaments support your spine.

We divide your spine into three sections. Working from the top down, there’s your:

  1. Cervical spine: Your neck has 7 small vertebrae known as C1-C7
  2. Thoracic spine: Your chest has 12 vertebrae known as T1-T12. Your ribs attach to this part of your spine.
  3. Lumbar spine: Your lower back has 5 large vertebrae known as L1-L5 which bear the bulk of your body’s weight.

Some conditions involving your vertebrae include:

Joints

Each vertebrae has a pair of small facet joints that connect one vertebrae to another while still allowing movement, a bit like a hinge. The facet joints in your lower back are particularly vulnerable to degeneration and injury because they bear most of the stress and weight.

Some of the conditions involving your joints include:

Nerves

Your spinal cord runs through, and is protected by, your spinal column (that hollow stack of vertebrae).

Your central nervous system consists of your brain and your spinal cord, which are constantly messaging one another.

Your peripheral nervous system includes all the nerves outside your brain and spinal cord. Many of these are still in your back, taking messages from your spinal cord to the rest of your body.

Sometimes when the bony structures of your spine degenerate, one of your spinal nerves can be pinched or compressed, causing pain.

Some conditions involving your nerves include:

Discs

Sandwiched between each vertebrae is a shock-absorbing disc that prevents your bones rubbing against each other. As you get older, your discs may degenerate. The loss of that comfy cushioning affects your vertebrae, as can other conditions like arthritis.

Some conditions involving your discs include:

When is back surgery NOT required?

The good news is that back surgery is often not needed for either acute or chronic back pain.

Acute back pain can strike without warning and be intensely painful. However, it usually gets better within 3 months, either by itself or with conserative treatment rather than back surgery.

Chronic back pain is long-lasting, often present for many months or years. Sometimes, the pain persists even though the original injury has healed. In some cases, there is more than one source of pain.

These factors make chronic back pain harder to treat. But it can be done with and without back surgery. There are a range of treatment options to improve your function, desensitise your pain response and improve your quality of life.

Non-surgical treatments for back pain include:

  • Physiotherapy
    • Core-strengthening exercises
    • Postural adjustment
    • Acupuncture
    • Dry needling
  • Medications
  • Steroid injections to your nerves
  • Neurostimulation

Watch Dr. Edis explain the non-surgical options for back pain and answer the question, ‘Is the pain just in my head?’


When is back surgery required?

At the Victorian Orthopaedic Spine Service, our care pathway is designed to ensure you only progress to back surgery if you really need it.

If you clearly do need surgery, we’ll get the wheels in motion. In most cases, though, we’ll try conservative treatments first and only move to surgical options if necessary.

Many people are understandably nervous about having surgery, particularly on a complex area like the spine. Back surgery is not an instant quick fix but it can help to stabilise your spine or relieve pressure on your discs or nerves.


Types of back surgery

We perform simple and complex back surgeries to relieve your pain and improve your mobility.

We perform a wide range of spinal surgeries according to your needs. The key ones are:

These surgeries are done to relieve pressure on your nerves by widening a narrowed spinal canal or removing a portion of a herniated disc.

Spinal fusion joins together two or more of the vertebrae in your spine to help improve your spine’s stability, correct any deformity, and ease your back pain.

Robotic guidance and CT-navigation techniques make spinal surgery shorter, less invasive and more accurate.

To help stabilise your spine, reduce the impact of your injury and maximise your long term function.

Surgery enables diagnosis if tissue samples from a biopsy are inadequate. Surgery may also be required to remove the tumour and reconstruct the affected area.

Various bacterial or fungal infections can affect your spine, causing conditions like discitis, vertebral osteomyelitis and epidural abscesses. Surgery may be needed to drain an abscess putting pressure on the nerves in the canal or if the infection is compromising your spinal stability.

Your spine is supposed to curve in a certain way. Some conditions such as degenerative scoliosis and kyphosis cause your spine to twist sideways or hunch over. Back surgery for these conditions aims to restore the normal shape of your spine to improve your stability and comfort.

Your neck is a complex and delicate structure. Surgery on your cervical spine may involve widening your vertebrae, removing a herniated disc, inserting screws and rods, or fusing vertebrae.


How the Victorian Orthopaedic Spine Service can help

We don’t want you to live with ongoing back pain when there are treatment options available to help you.

Please take a look at our appointments information and FAQs.

Once your doctor writes a referral, you’re ready to make an appointment. Our spinal surgeon Dr Edis will examine you, listen as you describe your symptoms and recommend the most appropriate treatment options.


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All information is general in nature. Patients should consider their own personal circumstances and seek a second opinion. Any surgical or invasive procedure carries risks.