Spine General (involves multiple spine areas)

I'm trying not to overly obsess about my upcoming spinal fusion surgery. But I do want to be prepared for any possibility afterwards. The surgeon's nurse gave me a list of potential problems that could develop like heart attack, blood clot, or poor wound healing. They assured me that these are uncommon and not to worry. But are there other possible (more serious) complications that I should watch for?

As with all major surgical procedures, complications can occur. The nurse has prepared you for some of the most common complications following fusion. Other less common adverse responses can include a reaction to the anesthesia or other drugs, infection (skin or deep), and nerve damage to the voice box with anterior (from the front of the spine) cervical spine fusion.

Is it true that an implant for pain control requires surgery every year to replace the battery? I don't want to get into that! Isn't it possible in today's advanced technologic world to somehow recharge the batteries and avoid unnecessary surgery?

A spinal cord stimulator, also called a dorsal column stimulator, is an implanted electronic device used to help treat chronic pain. They have been used for over 30 years. The device delivers a low level electrical current through wires. The wires are placed in the area near your spinal cord. The device is similar in size to a pacemaker.

Actual Cost of Spinal Cord Stimulation for Chronic Pain

For over 30 years now, doctors have used spinal cord stimulation (SCS), also called neurostimulation, to help relieve chronic neuropathic (nerve) pain. A stimulator is implanted into the patient's body, which then sends out impulses to interrupt the pain signals and prevent them from reaching the brain.

My surgeon tells me she is going to use a minimally invasive way to do my spinal fusion. I get the idea that I'll have a smaller incision. But if they can do these operations now with a smaller incision, why didn't they do so years ago?

Minimally invasive spine surgery means the surgeon makes a very small incision and there is as little disruption of the underlying soft tissues as possible. They can do this now because special surgical instruments have been developed just for MISS. Intraoperative microscopes, fluoroscopes (real-time X-rays), and tube-based instruments make it all possible.

When I had cancer, they talked about being cured and remission. This year, I've had a series of episodes with back pain that's not related to my past history of cancer. But I never hear the doctor say anything about remission or cure. Is there such a thing with back pain?

Back pain is much more episodic than cancer with a much higher risk of recurrence. In other words, many adults suffer from back pain many times over the course of a lifetime. With cancer, the hope is that anyone diagnosed with cancer will only have it once. Following cancer treatment, the goal is cure, meaning no return or recurrence of the disease.

I'm going to have a spinal fusion with BMP instead of using my own bone for the graft. Are there any side effects from these bone graft substitutes?

Bone morphogenetic proteins (BMPs) are a group of growth factors and proteins known for their ability to start the formation of bone and cartilage. Demineralized bone with BMPs are commonly used to augment available bone graft in spinal fusion procedures.

Surgeons can choose from several commercially available human demineralized bone matrix product formulations. But studies show there can be quite a range of variability in these commercially available bone matrices products.

Do Bone Graft Substitutes Cause an Allergic Response?

Have you ever heard of therapeutic proteins? You probably have without knowing it because insulin is a therapeutic protein. People who are missing important proteins like insulin develop problems like diabetes. They can be treated with exogenous (coming from outside the person's own body) proteins such as insulin made from animal (or human) sources.

I'm going to have a spinal fusion in the next couple of months. I'm waiting for my daughter to have her baby first and then I'll take the rest of my vacation time to have the surgery. If I'm going to ask for time off from work, should I take a few extra weeks to rest up before the operation?

All indications are that the more time people are off from work before spinal fusion, the worse their outcomes after surgery. Patients are being encouraged to remain as active as possible up to the point of surgery including staying at work.

Conservative Surgery Spares Bowel and Bladder Function

Removing giant cell tumors of the sacrum (bone at the base of the spine) can be dicey work. Taking the entire sacrum and tumor can leave the patient with unpleasant changes in bowel and bladder function due to nerve damage. But anything less can mean the tumor will come back. If the sacral nerve roots aren't removed, tiny tumor cells left behind may cause tumor recurrence.

I almost had surgery on the wrong side for a bad disc. But my surgeon took the time to review the MRIs right before the operation and saw that there was an error in the original reading. Does this happen very often?

Human error can be a factor in any medical diagnosis -- even for highly trained experts and involving something as black and white as an MRI. Studies show that there may be a two per cent error rate in MRIs of the spine. The most common mistake is to label something as being on the right side when it was on the left.

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