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Not all problems of the spine need surgical treatment. Spinal problems such as cervical or lumbar disc herniation and back or axial neck pain can be treated in the initial stages of the problem. However, in some cases surgery is the only method of treatment left.
How to decide who is to be operated upon?
Only twenty per cent people suffering from spinal problems eventually need surgical treatment. Therefore it is very important for a patient to contact a medical spine specialist so as to get right diagnosis and management of their condition. It is important to point out here that at the initial stage of diagnosis, it is not yet necessary to directly involve a spine surgeon.
Symptoms that Indicate Need of Spinal Surgery
There are some symptoms which can clearly indicate the need to perform spinal surgery. The most important symptom which decides the need to perform surgery is persistent extremity pain rather than pain in the back or neck. A CT scan or MRI can be used to find underlying neurological causes and corroborate the need to perform surgery.
Lumbar Disc Herniation: In this type of spinal problem, the nerves exiting from the spinal chord get compressed at the exit of the spinal canal. The reason for this compression is the herniated disc which has narrowed down the spinal canal. Excruciating pain only in the lower back is one indication of a spinal problem which needs surgical treatment.
In order to further narrow down spinal problem as the cause of pain spine specialists also keep an eye for signs such as tension while raising their legs straight up. If this is observed then the probability of performing surgery increases significantly. MRI can be eventually used to corroborate the need to perform surgery.
Spinal Stenosis: Spinal problems can also result in excruciating pain in buttocks and/or legs. It is a result of a degenerative lumbar condition which is called spinal stenosis. This type of pain is usually not there when a person is squatting, sitting or leaning but gets provoked by standing or walking. For spinal stenosis, the decision to perform surgery depends upon a combination of image data and analysis of history of neurogenic claudication. Quite unlike lumbar disc herniation, normal neurological examination would not suffice.
Image Tests- Important But When Should They Be Done?
CT scan, MRI, and Myelography are three type of imaging tests that can be recommended to corroborate the need to perform spinal surgery. However, it is not important to make a choice between them. What is more important is the timing of these tests. They are to be conducted only after the patient has not obtained any significant relief from regular methods of treatment. Further, they should be used only after other neurological symptoms have been found.
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