Open Spine Surgery: All You Need to Know

Oct 11, 2022

Back pain is quite a common medical condition; almost every person has groaned “oh, my back!” once in their lifetime. The reasons for the back pain can be numerous ranging from minor muscle pull to severe disc herniation. Surgical treatment is required for back pain that is chronic and persists for more than a month. In the following paragraphs, you will be explained why open spine surgery is required, how it is performed, and other related information to help you understand the procedure.

Choosing Open Spine Surgery as a Treatment Option

When patients come to doctors complaining about back pain, initially doctors try to cure them with conservative treatments (read about comparison between surgical and nonsurgical back pain treatments). These include using medications, physiotherapies, massage, and other non-invasive techniques. However, if the spine is damaged severely, for example, there is a fracture in the vertebra, and the doctor sees no use in giving nonsurgical treatments, he/she will recommend an appropriate surgery.

Now, choosing between open or closed surgery takes into account multiple factors;

• Personal preference of the patient
• The expertise of the doctor (Not every doctor has the expertise to perform minimally invasive surgeries)
• The success ratio of open vs closed surgery in the case under consideration
• The medical condition of the patient. Patients who are above 70 take more time to recover after surgery and thus they are not fit for open surgery.

Open Spine Surgery Procedure

Before we go on to explain the procedure for open spine surgery, let’s go through pre-op instructions.

Pre-Op Guidelines to Follow

• Six weeks before the day of surgery, you should stop consuming alcohol and smoking. Substances from alcohol and tobacco can get into your bloodstream and have an effect on your body's reaction to anesthesia.
• Two weeks prior to the surgery, you should not take any drugs or substances that can thin your blood. Increasing fluid intake and having plenty of sleep are recommended.
• Get reports for all the tests recommended by your doctor. These normally include blood tests and medical imaging.
• Get in good shape by engaging in a short course of physical therapy. It will improve your physical conditioning and elevate your activity level so as to expedite recovery after surgery.

Procedure

A standard open spine surgery starts with a large incision. There are two approaches used; Anterior and Posterior. Under the anterior approach, the incision is made in front of the body whereas, in the posterior approach, the surgeon accesses the vertebrae from the back of the body. The size of the incision is normally about six inches. After making an incision, the surgeon will get access to the vertebrae by dissecting the spinal muscles. This process of pulling spinal muscles away from the bone is called retraction.

Once the doctor has access to the affected region, he/she will perform necessary surgical procedures. These include removing a part or whole of the vertebra, fusing multiple vertebrae, etc. Following the procedure, the surgeon easily places screws or bone graft material to provide stability to the spine. After the surgery is complete, ligaments, skin, and muscles are stitched back as they were before.

The patient is transferred to an observation room where he/she is carefully monitored. The doctor and staff look for any signs of complication while the anesthesia wears off. Surgical drains can also be used for draining out any blood collected in epidural space during surgery.

Risks Involved in Open Spine Surgery

In the past, all the surgeries were open and therefore it is also called a traditional surgical method. However, with the advent of technology, it is now possible to perform some surgeries with the help of cameras and endoscopy instruments. This procedure is getting popularity as the traditional methods pose several risks;

• Damage to the soft tissues during retraction
• Excessive loss of blood
• Failed back syndrome - when the surgery performed couldn’t cure the pain
• Implant migration - a condition in which the implant installed by the surgeon shifts from the site it was placed.
• Dural tear - During surgery, the doctor can accidentally nick the covering over the spinal cord

Recovery after Open Spine Surgery

Recovery from open spine surgery entails great discipline in terms of taking recommended diet, doing appropriate exercises, and having prescribed medication. You will need to follow a new lifestyle for a couple of months after your surgery. Given below are some of the things you can do to make your recovery comfortable and fast;

• Twisting and bending after the surgery is contraindicated. Have a physical therapist assist you with learning how to get in and out of the bed.
• Use a reacher to grab things off the floor and walk with the help of a cane.
• While the wounds heal, you will experience a lot of pain that you can manage with prescribed medications.
• Mostly, patients do not need any back braces but it’s recommended to have yourself checked by the doctor to know if you need to use a brace.
• Drink plenty of fluids and stool softener to avoid constipation due to narcotic medications.
• Take special care of the incision area. Protect it from water and germs to avoid infection development.
• You will able to resume activities like driving, lifting light objects, sex, etc. after six weeks of the surgery. Complete rehabilitation can take anywhere between 2 to 6 months.
• Visit your doctor and physical therapist regularly to ensure everything is fine.

Consult a Spine Surgeon in Los Angeles

Being in a situation where you need open spine surgery can be quite stressful. However, an experienced and empathetic spine surgeon working in one of the best neurosurgical clinics in Los Angeles can make things easy for you. That’s what Moksha Ranasinghe MD offers. You can schedule an appointment with her simply by filling out the contact form or calling 213-369-4583.