Que.: My doctor told me that I have arthritis of my spine and that I should learn to live with the pain. Is this true?

Ans.: Learning to live with the arthritis is certainly most commonly recommended, but that need not always mean learning to live with the pain. For example, often a consistent exercise program will significantly reduce or even eliminate the pain. If excess weight is a problem, that may contribute to the pain caused by the spinal arthritis. Sometimes, reducing excess weight will make the problem significantly more tolerable. In some instances, a medication such as an anti-inflammatory drug may provide dramatic relief. (Of course, don't take any medication without discussing with your physician). If the pain does not respond to the above measures, and is of great enough intensity, you may need to be evaluated by a specialist (if you haven't already done so).

Que.: When is surgery necessary for patients with spine problems?

Ans. :Surgery for conditions associated with disc disease is necessary when patients continue to be symptomatic despite all conservative treatments. Generally, patients try conservative treatments for between 2 and 6 months. If after this trial of conservative treatment patients continue to have severe pain, surgery is an excellent option. Surgery becomes "necessary" when patients develop signs and symptoms of progressive nerve damage ie, increasing muscle weakness or worsening nerve damage.

Que.: My spinal specialist said I need a fusion. Is that true?

Ans.: Well a lot of that depends on what the problem you are having. There are many conditions that we treat with spinal fusions, and most likely your specialist has identified that you have one of those conditions. And that if you have a spine fusion, perhaps it can relieve some of your pain or some of your symptoms.

Que.: What is Degenerative Disc Disease?

Ans.: Degenerative disc disease is not defined by any one set of generally accepted criteria. Confusion arises with the difficulty in distinguishing between age-related changes and those arising from a disease process. Degeneration is a progressive irreversible process that occurs in all connective tissue structures including the intervertebral disc. Distinguishing benign degenerative changes from disease seems to hinge on the relationship between specific structural or biochemical changes and the presence of symptoms or impaired function. Some investigators may interpret impaired functioning in performance terms, such as a restriction of normal activities, or by other researchers in structural terms, such as a loss in mechanical properties of the disc. The age related changes may be present for years and may remain asymptomatic. Other factors including the release of irritative breakdown products, extradiscal micro-trauma, abnormal micro-movements, neural tethering and displacement may provide the trigger by which the degenerate age related changes cause the onset of symptoms.

Que.: In what position will I be on the operating table?

Ans.: During surgery you will be positioned on a curved table, so that you are face downwards as if on a hump backed "bridge", in order to expose the spine as much as possible for easier access by the surgeon.

Que.:  What level of awareness will I feel?

Ans.: You will be sedated. This is not like a general anesthetic where you are totally unaware of all around you. It is similar to being in a dream-like/half aware state.

Que.:  Will I be awake during surgery and will I be able to feel pain?

Ans.: You will be aware of other people around you and of the surgeon asking you questions. This awareness is not the same as being fully awake. It is more like a dulling of the senses and being half asleep. You will not be able to feel the probe or any other instruments in your body. You will be able to answer questions put to you about where the stimulus is felt in your body. This is not a sharp pain, but an awareness of discomfort.

Que.: How long will the operation take?

Ans.: This depends very much on the type of surgery you are having and you should ask your surgeon about this. Your awareness will be of going into the operating theatre and waking up sometime later. The events whilst in the operating theatre feel like a dream. Whilst sedated you will have very little concept of time.

Que.:  Is the benefit of the surgery felt immediately? Is the pain relief total? Will there be residual pain?

Ans.: The effects of the surgery are immediately noticeable. When you wake up the sensations of pain and numbness previously felt will be noticeably different and may well have disappeared altogether.

Que.:  How active will I be after the operation? How long is the recovery period?
Ans.: You will be encouraged to walk about as soon as you wake up and to undertake a guided exercise program to improve your mobility. The length of time to full recovery will depend on you. You will be able to help yourself by taking care of your diet and building up your stamina. It is important to keep moving as much as possible. Keep things in perspective. If you have been inactive for a long period of time prior to the operation you will need to build up your program of exercise steadily so that your muscles do not fatigue.

More Medical Questions:

Que.:  Why should we use the seal on the endoscope?

Ans.: This keeps the water pressure up in the working zone and allows bleeding to be controlled, pinpointed and then sealed by radiofrequency or Laser energy

Que.: Should we always work within the sheath?

Ans.: Initially yes, but as experience is gained then once the position of the nerve has been identified and protected by the working sheath, then you can advance beyond the working sheath with endoscope. This allows you to utilize the benefits of the elliptical shape of the endoscope for entry through small foramina and in to settled discs.

Que.: What tricks do you use to control bleeding?
Ans.: Raise the water pressure in the working zone. Rotate the sheath until the shoulders press on the bleeding point and keep the pressure on this point. When bleeding has been controlled for over 30 seconds, gently rotate the tube backwards to display the vessel and then seal it formally.