Frequently Asked Questions

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Question

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Are there different types of back pain?

Yes: acute and chronic

What is Degenerative Disc Disease?

One of the common causes of back pain

What treatments are available?

Non-surgical treatments and surgical treatments

What is spinal fusion surgery?

Surgery that takes pressure off of the nerves that are causing pain

Are complications possible?

Surgery always involves some risk.  Complications may include…

Other questions about surgery

 Frequently Asked Questions: Spine and spine surgery

Are there different types of back pain?

Back pain is categorised as acute or chronic. Acute pain usually lasts only six weeks. When back pain continues for more than six weeks, it is considered chronic. During this time, the individual will create new muscle patterns that compensate and circumvent the weak and painful area.

Chronic back pain is divided into two main types – mechanical or compressive pain.

Mechanical back pain results from inflammation due to an irritation or injury to the disc, the ligaments or the muscles of the back. A normal muscle strain or lower back strain may also trigger mechanical-type symptoms. Mechanical pain usually originates near the lower spine and spreads to include the buttocks and thigh areas. This type of pain usually does not extend past the knee.

Compressive pain happens when the nerve roots that leave the spine are either irritated or pinched. A herniated disc is a common cause of compressive pain. For example, the sciatic nerve controls and provides sensation to the muscles of the lower leg. When the nerve roots are irritated or pinched, the individual will feel a numbness, tingling or pain in the leg muscles, but not in the back itself.

Compressive pain may also occur in the cervical spine due to herniated discs. This is often manifested in arm pain or numbness.

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What is Degenerative Disc Disease?

There are a number of conditions that can cause pain and affect movement, including spinal stenosis, scoliosis, tumour, infections, fractures and degenerative disc disease . People with low back conditions may have symptoms such as pain or numbness that travels down one or both legs, weakness in their leg muscles, and problems or pain when they urinate. The pain often occurs when the nerves that run through the spine become pinched.

Degenerative disc disease (DDD) is one of the common causes of back pain. As people age, the discs can lose their elasticity, flexibility, and their ability to serve as shock absorbers for the spine.

DDD happens when the soft centre of the disc dries out and shrinks. This narrows the openings through which the nerves run, pinching the nerves between the vertebrae (see Illustration B). Most people have very few problems when this happens. But for others, the pressure on the nerves is very painful.

People with degenerative disc disease may have symptoms that include back pain, leg pain and weakness in their legs.

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What treatments are available?

There are many treatments for spine conditions and degenerative disc disease. You may have already tried some or all of the non-surgical treatments, and they may have helped you for a time. Non-surgical treatments include rest, ice or heat, medication, steroid injections, exercise and physical therapy.

If these non-surgical treatments do not bring relief after a period of time, you and your doctor may decide that a surgical treatment, may be right for you.

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What is spinal fusion surgery?

Spinal fusion surgery takes pressure off of the nerves that are causing pain. This is done by restoring the alignment of the spine or the space between the vertebrae, and then stabilising and fusing the spine. A spinal fusion is when bone grows between the vertebra, stopping any motion in the area, which reduces pain.

Depending on the condition of the spine, the doctor may use an anterior approach, which means the incision will be in the abdomen, or a posterior approach, which means the incision will be in the back.

Sometimes the doctor may choose to use a combination of the two. If the doctor uses a posterior approach, then a pedicle screw system is used to stabilise the spine while it fuses and heals. The pedicle screw system may be used alone or it can be combined with another stabilising device.

During surgery, the doctor may relieve the nerve compression by removing the disc (called a discectomy). The doctor may also relieve pressure on the nerve by trimming or removing the roof, or lamina, of the vertebra to create more space for the nerve (called laminectomy ). The doctor then restores the space around the nerves and prepares to stabilise the spine with the pedicle screw system. There are a number of components in a pedicle screw system, and the doctor will choose the ones that will work best for your spine.
The screws are placed through each side of the vertebrae in the part of the part of the bone called the pedicle. Rods are then attached to connect the screws and hold the spine in its restored position. The pedicle screw system is now secure. In the last step of the surgery, the doctor places bone graft ( small chips of bone) alongside of the vertebrae to be fused or puts the graft in and around a device that's placed between the vertebrae. Bone graft can come from the patient's hip bone, from a bone bank, or from a combination of both.

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Are complications possible?

Surgery always involves some risk. General surgical complications may include:

  • reactions to anesthesia
  • heart attack
  • infection
  • blood vessel damage/bleeding
  • bruise (hematoma)
  • pneumonia
  • blood clots
  • wound closure problems
  • death

Potential risks may include:

  • tear in the outer lining of the spinal cord which may result in spinal fluid leakage
  • temporary decreased or absent intestinal function
  • implant migration
  • leg pain
  • nerve complications
  • fractured sacrum

Please consult with your surgeon for a complete list of all warnings and precautions.

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How long does the surgery last?

Surgery time will vary from surgeon to surgeon and patient to patient. On average, this surgery will take an hour and a half to two hours. Note: The duration of the surgery will vary depending upon the number of levels involved and the patient’s conditions.

When can I go home from the hospital?

Usually within a few days, once you have adjusted to oral pain medications and have shown that you can get up and move around without problems.

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How do I rehabilitate after surgery?

Every surgeon follows a slightly different program depending on the patient’s physical condition. Physical therapy is often a part of recovery.

What kind of follow-up can I expect?

Follow-up varies from surgeon to surgeon. Your first follow-up visit will probably be within a few weeks of surgery, then every few months for the first year. You should be checked annually after the first year.

When can I go back to work?

Your doctor will recommend the best way to progressively continue the activities in your life based on the progress of physical therapy.  

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