What is Spine Surgery?
The spine consists of bone fragments called vertebrae located between the skull and the coccyx. Between the vertebrae, which are symmetrically arranged, there are disc and facet joints. These joints increase the strength and flexibility of the spine and give it mobility. The tissue at the front of each vertebra is called a disc and the one at the back is called a facet joint. The soft tissues between this structure, which extends from the skull to the coccyx, also surround and protect the spinal cord, an important part of the central nervous system. The spinal cord, like the brain, is surrounded by a membrane called the meninges. Between this membrane structure, which is a continuation of the meninges, and the spinal cord is the cerebrospinal fluid. The spine, which forms the basis of the human skeleton, consists of 7 cervical vertebrae, or cervical vertebrae, 12 thoracic vertebrae, or back vertebrae, 5 lumbar vertebrae, or lumbar vertebrae, and 5 sacral vertebrae, or sacral coccyx. The spine is also supported by connective and muscular tissues, known as ligaments in medicine. Thanks to this anatomical structure, the spine has a robust and movable structure. Congenital or acquired spinal disorders can greatly reduce the quality of life of the person by limiting the movements frequently performed in daily life such as standing, turning left and right, and moving. Spine surgeons treat common diseases such as herniated disc, lumbar spinal stenosis, spondylolisthesis, cervical herniated disc and disorders caused by spinal trauma.
What is Spine Surgery?
Spine surgery is the department that deals with disorders related to the spine, which consists of vertebrae and contains the spinal cord. These problems, which can be structural, functional and mechanical, can prevent a person from performing daily activities. After 6 years of medical school education, physicians who specialize in orthopedics and traumatology or neurosurgery specialize in this field by receiving additional spine surgery training. Working in a multidisciplinary manner with other disciplines such as physical therapy and rehabilitation and neurology, spinal surgeons diagnose the disease through examination and additional examinations in line with the patient’s complaints and then organize treatment specific to the disease and the individual. Spine surgery deals with conditions such as scoliosis and kyphosis in childhood; herniated discs and degenerative disorders in adults; and osteoporosis in old age. Some of the conditions followed by spine surgeons are listed below as headings:
Lumbar Hernia
Lumbar disc herniation can be defined as the protrusion or, in other words, herniation of the disc, which is located between the vertebrae and acts as a cushion, between two vertebrae. Normally, each disc consists of a solid outer layer called annulus fibrosus. In the middle part of the disc, there is a gel-like structure that gives it its cushion-like characteristic. With advancing age, the gel structure in the middle of the disc loses its properties and becomes unable to function or the outer tissue of the disc called annulus fibrosus cracks. The disc protruding outward from between the vertebrae causes back and leg pain as well as weakness in the feet and legs. Different treatment methods can be applied depending on the severity of the herniated disc. While some cases improve with medication and exercise, some cases require surgical operation to remove the pressure of the herniated disc on the nerve.
Neck Hernia
Cervical disc herniation, also called cervical disc herniation, occurs when the disc protrudes outward between the vertebrae, as in lumbar disc herniation. This condition in the neck area causes burning, pain, loss of sensation and strength in the arms. When consulting a physician with these and similar complaints, the physician takes a detailed anamnesis from the patient. The physician then evaluates the muscle strength, sensation and reflexes in the arms to get an idea about the severity and location of the cervical hernia. After additional radiologic examinations, treatment is recommended. The treatment may include exercise, physical therapy, medication, injections or surgical intervention. Cervical hernia surgeries performed by a spine surgeon provide a high rate of recovery. The patient is discharged after approximately 24 hours.
Lumbar Spinal Stenosis
Lumbar spinal stenosis, commonly known as narrow canal or lumbar canal stenosis, is one of the most common conditions encountered by spine surgeons. Lumbar spinal stenosis is mostly seen due to the decrease in the amount of fluid in the disc structures located between each vertebra due to advanced age. Due to this deformation, the discs harden and are displaced from their current position towards the spinal canal. Sometimes the facet joints between the vertebrae are also subjected to the same process, leading to narrowing of the canal structure. Due to the narrowing of the canal, the nerve root is compressed. This leads to symptoms such as cramping, numbness and pain in the back or legs. Complaints increase with prolonged standing and walking. In some cases, it may also cause complaints such as weakness in the legs. When a person presents to a physician with these complaints, the physician requests additional radiologic examinations after performing a physical examination. X-rays, MRI or CT scans are used to determine the exact nature of the spinal stenosis. Surgical intervention is performed in cases that are too advanced to benefit from medication or spinal injection therapy, or in patients with progressive leg weakness, bladder and bowel problems. With this procedure, known as lumbar decompression, the existing compression is removed and the canal diameter is widened again. Another surgical option is laminectomy. In this method, the relevant bone structure can be removed and the canal can be widened. Depending on the type of stenosis and the severity of the compression, the operation is performed to relieve leg pain and loss of function in the leg, if any.
Spondylolisthesis
When a vertebra slips forward or backward for various reasons, the soft tissues, spinal cord and nerves between them are compressed. This condition is known as spondylolisthesis in medical terms and is commonly known as slipped back. Depending on the severity of the slippage, the tissue between the vertebrae, spinal cord and nerves are compressed, causing complaints such as low back pain, pain in the hips and legs, tingling, burning and numbness. In advanced cases, it can also cause severe pain in the arms and legs, urinary incontinence and paralysis. Although slipped discs are mostly seen due to genetic predisposition, they can also occur due to advanced age, lifestyle and traumas. The slippage, which is mostly seen between the L5 and S1 vertebrae, may also be caused by weak tissue between the two vertebrae. After the patient presents to a physician with such complaints, the physician takes a detailed anamnesis and performs a physical examination. If necessary, the physician clarifies the diagnosis of spondylolisthesis by performing additional radiological imaging. Treatment options are evaluated according to the type and severity of the disease. In some cases, medication or physical therapy is sufficient, while in others surgical operation is required. The oppressed nerves are relieved and the spine is stabilized if necessary.
Spinal Trauma
Spinal trauma is defined as damage to the vertebrae caused by falls, bumps, work, home and traffic accidents. Depending on the severity of the trauma, many different disorders such as vertebral fracture and slippage can occur. Spinal trauma-related disorders that can affect vital functions are operated on by spine surgeons with different techniques depending on the size and severity of the trauma. The aim is to fully restore motor and sensory functions. Physical therapy and rehabilitation are often required after surgery.
Do not neglect to have regular health check-ups for a good life.