Expert speak: Top 7 spine surgery myths busted

If you are about to undergo a spine surgery, it is essential that you know what you are going in for. All your misconceptions about the procedure need to be cleared. Dr. Himanshu Tyagi, orthopaedic surgeon at Artemis Hospitals, Gurugram, busts the 7 most common myths related to spine surgery.

Editorial Team | Updated: October 25, 2018 2:06 pm

7 common myths of spine surgery busted © Shutterstock

“Generally, there is a lot of apprehension and fuss about spine surgery, primarily because it involves dealing with the nerves,” says Dr. Himanshu Tyagi, orthopaedic surgeon at Artemis Hospitals, Gurugram, who has specialised in spine surgery. According to him, there are many popular misconceptions and beliefs about undergoing a spine surgery which often discourage the patient. ”Don’t dismiss spine surgery just because of the rumours. Rather, have a consultation with an expert and discuss the pros vs. cons,” he said. According to him, most of these myths have no scientific basis, and with the modern world technologies the chances of complications in a spine surgery are very rare. Here, Dr. Tyagi demystifies spine surgery to help you make an informed choice.

Myth 1: Spine surgery invariably leads to paralysis

Fact: This is a very common myth about spine surgery, but of course not true. With the modern world technology (microscope and navigation assisted) the chances of paralysis are less than 1 per cent. Though some risk is still there but with each passing day spine surgeries are getting more and more safe, thanks to advancements in operating techniques. In our centre, we do almost 800 surgeries every year, but chances of paralysis post-surgery are around 0.3 per cent.

Myth 2: Spine surgery should only be done as the last option

Fact: It’s not true. Spine surgery should be done at the right time whenever indicated during the course of illness. It is indicated early on when there is a chance of paralysis in the near future, or in cases where paralysis has already started to set in. Spine surgery can be delayed in cases where a patient has only back or neck pain without any nerve compression signs. In such cases we always recommend non-surgical options first in the form of physiotherapy, exercises and medicines. Only if the patient does not improve even after two months of conservative treatment, surgery is required. Surgery is done in order to reduce the pain, restore function, and correct spinal problems. It is important for your doctor to diagnose your problems properly before surgery. The chance of success increases if the detection is accurate.

Myth 3: There is a high chance that another surgery might be required in future

Fact: It’s not true to say that one spine surgery leads to another. In over 90 per cent of cases only one properly done spine surgery at the correct time is adequate. Majority of patients don’t require a second surgery. However, it is important on the part of patient to follow certain instructions and precautions to make the surgery successful. These instructions include simple things like quitting smoking, reducing body weight and exercising regularly after the surgery. If these instructions are not followed, only then, in rare cases, a second surgery is required.

Myth 4: After spine surgery prolonged bed rest is required

Fact: Normally, in our centre we do not advise bed rest to the patient. In fact, most of our patients start walking the next day. During this period they are helped by a dedicated team of physiotherapists and pain management specialists. Moreover, with newer techniques like ‘key hole surgery’ and ‘minimally invasive techniques’ where the entire surgery is done through a small incision, the patient is even able to walk the same day (in some cases we even discharge the patient home the same day). This is possible because the incision is small, and fewer muscles are cut during the surgery. We almost never recommend bed rest to the patient. On the contrary, we prefer mobilizing our patients at the earliest.

Myth 5: It’s very painful

Fact: This myth was largely true in an era when open spinal surgeries were performed, requiring a long incision and lots of muscle cutting. However, this is not true in the present context. Spine surgeries are relatively pain free these days compared to earlier times. Thanks to technological advancements, we can now discharge the patient in less than 2 hours because the modern-day procedure requires an incision smaller than a finger nail. Gradually, we are moving towards painless surgery. In our institutes for some specific surgeries like discectomy, we don’t even give anaesthesia. The patient is awake during the procedure and even talks to us. For major surgeries like spinal fixation, that uses the minimally invasive techniques (small incision surgery), the post-surgery pain is much less, and hospitalization is required for only 2 days. Thanks to the much smaller incisions in key hole surgery, there is almost no bleeding and scarring is minimal as well. All these reduce the need for analgesics.

Myth 6: The complication rates in spine surgery are very high

Fact: It’s not true anymore. The overall complication rates in spine surgery are less than 3 per cent. In our centre, we use the state-of-the-art ‘neuro monitoring system’ which monitors each and every nerve during surgery and allows no scope for any error. Using this technique, we are almost able to avoid all complications related to nerves and give a 100 per cent success rate. With the advancements in spine surgery techniques and the available technology the complication rates have gone down drastically. We are now able to double check every step during the surgery using ‘O-arm ‘ and ‘neuro-monitoring’ to give a complication-free outcome to the patient.

Myth 7: There are lots of physical restrictions after a spine surgery

Fact: This is usually not the situation. Even after a major spine surgery, most of the patients are able to stand and walk the very next day of surgery. Lifting light weight (upto 5 kg) is allowed from 10th day and driving is allowed from the 2nd week. Sitting on the ground and sexual activity are allowed from the 3rd week and bending forward after 1 month. In cases where a surgery is done by endoscopic technique, there is no restriction of activity at all. Exceptions include cases of complex trauma to the spine with multiple fractures where period of immobilization may be prolonged. But such patients represent only a small fraction of operated cases, usually less than 5 per cent.

Published: October 24, 2018 9:24 pm | Updated:October 25, 2018 2:06 pm

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