EVERYSPINECOUNTS has been announced as 2022's World Spine Day campaign theme, emphasizing the diversity of spinal pain and disability as part of the global disease burden. An estimated 540 million people worldwide suffer from low back pain at any time. Our earth is 4.5 billion years old, and due to intense evolution, life from the ocean started migrating to land. Organisms developing the spine evolved from quadruped walking to biped walking. Human being ability to stand erect was a significant evolution in history. However, it took nearly 500-million-year-old to stand upright, and spine biomechanics is not easily understood.
Spine, aka vertebral column, backbone. It is composed of a series of small bones called vertebrae, and the total number of vertebrae is 33.
The spine has three regions, i.e., Cervical, Dorsal and Lumbar.
The spine has four curves, two primaries and two secondaries, and they have evolved and have specific functions.
Functions of curves; helps to maintain balance in the upright position, absorbs shock during walking, and helps to protect the vertebrae from fracture.
It is essential to maintain curvature to prevent further damage or injury.
LBP was pain occurring behind the region between the lower rib margin and the proximal thighs.
Low back pain affects nearly 60-80% of people throughout their lifetime. Around 23% of adults worldwide suffer from chronic low back pain. The one-year recurrence rate of 24% to 80%. 11-12% of the population is disabled by low back pain.
An Intervertebral disc is defined as a cushion between two vertebral bodies.
Disc discs bind the vertebrae and form a strong joint, permit various movements of the vertebral column, absorb vertical shocks and avoid friction during inter-vertebral joint movements.
Disc hardens and is less elastic with age. A tear into the sac will cause the disc to track into the spinal canal, leading to nerve root compression.
Today Dr S Ramesh, Senior Neuro Surgeon, Kamineni Hospitals Hyderabad, will try to answer some queries about spine treatment/spine surgery.
Every bulging disc surgery does not require surgery. Spinal conditions have been slowly progressive over time.
When should I undergo surgery for my disc prolapse? Am I going to be paralyzed unless surgery is done immediately?
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The patient will require surgery.
Clinically when you have red flag signs like excruciating pain in low back or radiculopathy, progressive weakness of lower limbs, the involuntary passage of urine and motions.
Radiologically disc extrudes into the spinal canal, significantly compressing the exiting nerve root and thecal sac.
Am I too old for surgery or young for surgery?
Age is not the deciding factor for surgery. However, when you have red flag signs and radiological significant compression patient will require surgery irrespective of age.
Is spine surgery never successful?
Neurosurgeons and patients have to spend time with one another and discuss all aspects of their recovery and risks from surgery.
More importantly, expectations from surgery are essential to discuss with the treating neurosurgeon.
If patient expectations are unrealistic or not discussed with the surgeon, they will often feel that surgery was unsuccessful.
Sometimes surgery is not successful, and complications are possible with any surgery. When it happens, people have issues with prolonged recovery.
How to choose surgery, open or microscopic or endoscopic?
The choice of surgery cannot be oversimplified. Able to do minimally invasive surgery is not an indication of it. The choice of surgery is tailored based on the patient's anatomical considerations.
Post-spine surgery will require bed rest for months
It cannot be generalised for all spine surgeries. Some spine surgeries are now done in daycare.
In minimally invasive surgery like endoscopic or microscopic
We advise early ambulation on the day of surgery or the next morning.
Based on patients, a conventional spine fixation/ laminectomy will require rest for a day or two.
It depends on factors like weight and comorbidities like diabetes mellitus and hypertension.
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