After someone has suffered a spinal cord injury, it is important to stabilize the bones of the spine to prevent further injury. Sometimes just wearing a brace for several months while bones and ligaments heal can do this.
Often, however, surgery is needed to help keep the bones in the proper position while they heal. It should be understood that that surgery will not change how the spinal cord heals.
Procedural Details
The surgeon will decide what approach is needed based on how the bone injury looks on X-ray and other tests, such as CT scan or MRI.
Surgery to stabilize the spine can be performed from the back of the spine, called posterior spine surgery, or from the front of the spine, called anterior spine surgery. In some cases, both approaches may be needed, usually in two separate operations.
A fusion procedure involves attaching metal screws, plates or other devices to the bones of the spine to help keep them properly aligned. This is usually done when two or more of the spinal bones, also called vertebrae, have been injured. Small pieces of bone may also be attached to the injured bones to help them fuse into one solid piece.
The bone used for this procedure is usually taken from another bone in the body, most often from the hip. This does not damage the hip and makes the fusion more stable. If needed, a small surgery on the hip will be performed at the same time as the spine surgery.
After surgery
Some people will likely spend time in an intensive care unit after spine surgery, including those who need support for breathing from a ventilator or special intravenous (IV) medications for blood pressure. Sometimes an ICU is needed just for overnight observation.
People who were in an acute care unit before surgery will most likely return to the acute care unit. Members of your health-care team will tell you what to expect.
It is very common to need a cervical collar or other brace after surgery. The brace keeps you from putting stress on the healing muscles and bones. It will allow you to start getting out of bed about a day after surgery. If needed, physical and occupational therapists will also be able to work with you.
Your surgeon will tell you how long the brace must be worn, usually several months. You will learn what you need to know to live with the brace before you leave the hospital.
Risks
As with any surgical procedure, there are risks involved. For spinal stenosis surgery, the risks include:
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Infection
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Bleeding or blood clots
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A reaction to anesthesia during surgery
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A tearing of the covering of the spinal cord during the surgical procedure, called a dural tear
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Injury to the spinal cord
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A failure or breakage of the implanted fusion device, such as rods or screws
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A return of pain or other symptoms after surgery
Patients face greater risks from surgery if they are elderly, overweight, smoke or have diabetes. Talk with your health-care provider about any concerns you may have about surgery. UW Medicine experts are leaders in their fields and have many years of experience in treating your type of spinal condition.
Urgency
Surgery may be recommended without delay if a person has cauda equina syndrome, symptoms of which include numbness or weakness that interferes with walking or impaired bowel or bladder function.