Understanding Spine Surgery

with Max Lee, M.D., Neurosurgeon, Columbia St. Mary’s

Posted: May 1, 2006

Many people have back problems that can be conservatively treated and will resolve over time. Most of the Columbia St. Mary’s Spine Center patients are treated with noninvasive methods. But when surgery is necessary, the Spine Center is an excellent resource to find surgeons experienced in a wide range of spine and neck conditions.

The goal in back surgery is to alleviate a patient’s pain, enable the patient to return to daily activities and to prevent further deterioration of the spine. If it has been determined that you are a surgical candidate, you should consider seeking a second or maybe even a third opinion before you choose your surgeon. It’s important to find a surgeon who understands all of the possible treatment options and is not too quick to find a resolution in the operating room.

Minimally Invasive Surgery
Advancements in all areas of spine surgery and the resulting benefits to patients have been dramatic in the last 10 years. This is particularly true of minimally invasive spine surgery with its state-of-the-art instrumentation.

In traditional, open-spine surgery, a five- to six-inch incision may be needed in order to see the affected nerve root and the disc. In doing so, a large area of muscle also has to be cut to make an opening of three to five centimeters.

Minimally invasive spine surgery, done through an incision that measures no larger than the diameter of a penny, can achieve the same results without the muscular trauma that occurs in open-spine surgery. During minimally invasive surgery, the muscle is dilated instead of retracted. And through the tiny incision, the surgeon works through a very small channel to perform the procedure. The benefits to the patient include less post-operative pain and a quicker recovery.

Not everyone is a candidate for any type of spine surgery, and minimally invasive surgery will not take care of every spine problem, but it’s an entity of spine surgery that should be considered.

Oftentimes, good candidates for minimally invasive surgery are patients who have had previous decompression surgeries and continue to have pain or reoccurrence of pain. Pain in itself isn’t always an indicator for surgery. Other indicators may be if you are experiencing neuralgic symptoms from compression of a nerve, spine cord, or back or leg instability causing pain.

An average hospital stay for minimally invasive spine decompression in the lower back is three to five hours. Patients are very appreciative of being able to go home, sleep in their own beds and relax in the comfort of their homes. That makes a big difference in overall recovery.

Whether it is open-spine surgery or minimally invasive surgery, it’s important to remember that it’s still major surgery. Make sure you are comfortable with your decision and with your surgeon.

A spine surgeon’s reputation is important. You should consider education; what medical school did the surgeon attend? Where did the doctor go through residency? Did the doctor do a fellowship in spine surgery? Do your homework and really find out who will be entrusted with your care. A good spine surgeon will consider the whole patient and treat each patient as an individual.

Max Lee, M.D., Neurosurgeon
Columbia St. Mary’s
414-961-5005

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