For most patients with spinal arthritis, surgery is not required. Typically, a regimen of conservative, or non-invasive, treatments can provide spinal arthritis patients sufficient pain relief after several weeks or months of application. However, in some instances, the condition does not respond well to non-invasive treatments, leaving a patient in chronic (long-lasting) and often debilitating pain. It is at this point that a doctor may suggest a surgical procedure to attempt symptomatic relief. Preparing oneself for spinal arthritis surgery may not necessarily be a simple task, but patients should keep a few key points in mind prior to consenting to any procedure.
Speaking with Your Doctor
Patients should always consult with a doctor or spine specialist about which procedure is best for their particular needs and situation. In fact, it can be helpful to obtain a second or third opinion to definitively confirm that a surgical procedure is the best treatment option available. Patients should never shy away from asking direct questions regarding what will happen before and after the surgery, such as:
• How should I physically prepare for the procedure?
• What exactly will occur during the surgery?
• What medications will be used?
• How long will the surgery last?
• Approximately how long will it take for me to make a full recovery?
• After the surgery, when should I be able to return to work, school, or my other daily activities?
• What risks or complications are associated with this procedure?
Additionally, patients should research the qualifications of the surgeon intended to perform the procedure before signing any consent form.
Researching Types of Spinal Arthritis Surgery
Before consenting to any surgery, spinal arthritis patients should also take time to thoroughly research the procedures that have been recommended for treatment. There are a number of methods available to surgically treat spinal arthritis, and each method has its benefits depending on the location and severity of the condition.
Surgery to Address Facet Joint Pain
Some surgical procedures address the pain that’s originating within one or more facet joints. The facet joints contain small nerve endings called medial branch nerves that enable pain signals within the joint. When a patient has spinal arthritis, the facet joints have lost their coating of protective cartilage, and as a result, the medial branch nerves become irritated and inflamed. When this occurs, a facetectomy may be recommended; this involves the complete removal of a damaged facet joint. Or, as an alternative, the patient may opt for a minimally invasive, outpatient procedure such as a facet thermal ablation. During this procedure, a small incision is made and the irritated medial branch nerves are deadened using an endoscope and a laser. The concept behind this procedure is similar to that of a root canal – by deadening a nerve ending, pain is eliminated, and yet the bone is still fully functional.
Surgery to Address the Compression (or “Pinching”) of Spinal Nerves
Nerve decompression surgery may be required in cases when facet joint deterioration has lead to the pinching of a nerve root or the spinal cord. For example, bone spurs (osteophytes) often develop in patients with spinal arthritis. These bony nodules form in response to weakened spinal stability as the cartilage wears away on the facet joints. If a bone spur impinges a nerve root or the spinal cord, symptoms of localized pain, as well as radiating pain, tingling, weakness, and numbness may occur. One type of decompression surgery used to treat spinal arthritis is a laminectomy, in which a portion of a vertebral lamina bone is removed. If a laminectomy is required to treat spinal arthritis, the bone removed will most likely have bone spurs attached to it.
Spinal Fusion Surgery
A spinal fusion surgery is often required if a large portion of spinal anatomy has been removed (for example, if a facet joint has been removed), or if spinal stability has been compromised by severe arthritis. However, another main goal of spinal fusion is to eliminate the facet joint movement that causes pain and other arthritis symptoms of stiffness, tenderness, and inflammation. In this procedure, a bone graft, rods, and screws are secured to two or more adjacent vertebrae in order to permanently immobilize and stabilize an arthritic facet joint.
Researching the various methods of spinal arthritis surgery can provide patients with important information about possible outcomes and expectations, which may allow people to feel more in control of their situation and may even result in a faster and less stressful recovery.