Spine is a very complex organ with a variety of tissue components such as bones, synovial joints, intervertebral discs, ligaments, spinal cord, nerve roots and surrounding spinal muscles. Hence, there could be many conditions affecting the above mentioned structures that could cause pain and other symptoms in the spine. Pain in the spine could be due to a simple problem such as a muscle spasm or could be due to something as sinister as a malignant tumour.
There could also be pain arising from other organs close to spine which can mimic spinal pain. So, it becomes essential that someone’s pain should be assessed by a highly competent person right at the start of the problem. It might also be necessary to do sophisticated imaging such as an MRI scan as part of the assessment. Fortunately, most of the spine problems are not complex and a vast majority are dealt with by simple measures such as rest, pain killers, physiotherapy and exercise or yoga therapy. More advanced therapies such as laser or injection therapies are required in less than 5% of patients presenting with spine pain.
Surgical treatment becomes necessary in a very small number of patients amounting to less than 1% of patients presenting with spinal pain. As with any field in medicine, the better surgeons do not consider surgery as the first choice of treatment, but as a last resort treatment where other nonsurgical treatments would not work. So, the question arises; Is it safe to undergo spine surgery? Safety in spine surgery depends on the correct indication for the specific surgery and the skill of the surgeon performing it. So, it becomes necessary to know about the training and experience of the specific surgeon who is going to perform the surgery for you. Even in the most experienced hands, there could be a small risk of complications in spine surgery. Also, in major spinal surgery such as deformity correction surgeries the risk of developing complications is understandably higher compared to minor surgeries done for disc prolapse. Fortunately, the rate of complications is very low and the rate of serious complications such as paralysis is extremely low and in the order of less than 0.1% in the hands of well trained, experienced spine surgeons. Also, the risk of complications such as complete paralysis is nonexistant in surgeries of the lower back where most spinal surgeries are done, as the spinal cord ends higher up in the top segments of lumbar spine.
So, if the spine surgeon you are consulting is well trained & experienced and suggests surgical treatment after exhausting all other nonsurgical options, it is as safe to undergo spine surgery as any other form of surgery and when it is done correctly, spine surgery can cure a lot of patients with debilitating pain.
-Dr S S Kumar
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