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There are over 500,000 spine operations performed yearly in the United States. These surgeries can range from simple back surgery for a lumbar disc to more complex surgery, such as lumbar spine fusion surgery. Common causes of back pain include degenerative disc disease (herniated discs, slipped discs, spinal stenosis), spinal deformity, spinal trauma and tumors. While lumbar spine surgery makes up a minority of all operations, it helps to know the benefits that newer, minimally invasive techniques can deliver. In this video, Dr. James Doty covers the following topics about minimally invasive lumbar spine fusion surgery for serious back pain: conditions treated by lumbar spinal surgery, minimally invasive approaches to lumbar spine fusion, typical recovery from minimally invasive lumbar fusion, success rates for lumbar fusion, finding the right surgeon, and a patient success story.
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Transcript:
While there are approximately 500,000 spine operations done per year, and these are spectrummed from what we call simple back surgery for a lumbar disk to the more complex procedures such as lumbar spine fusion surgery. Lumbar spine fusion surgery makes up a minority of all of spine operations but at the same time it's one of the most serious operations you can do. Certainly, in that context, you want to be absolutely sure that you need that surgery.
The vast majority of patients get better with conservative measures such as physical therapy, lumbar spine injections, or other types of treatments. But for that small percentage of people who, in fact, do need spine surgery, and that's typically when they have persistent pain and x-rays or other types of radiographic studies demonstrate either abnormal movement or an injury to the elements of the spine that make it stable. In that instance, when all other measures fail, surgery is really indicated.
Typically, when one does a spinal fusion surgery, at least in "the old days", it would require a very large operation, disruptive of a lot of the elements of the spine itself. The muscles are pulled widely apart, there's a significant blood loss, and the recovery period can be six months to a year.
Over the last decade or so new techniques have been developed, and we're fortunate in that we have a number of surgeons at El Camino Health who specialize in spine surgery and specifically lumbar spine surgery. We are now able to do these surgeries in a manner we call minimally invasive. That's where small incisions are used, minimal blood loss, minimal tissue disruption, and many of these patients go home the same day or within a day or so after surgery, compared to what used to be five or seven, to even ten days to two weeks in the hospital prior to this time.
The period of time for the fusion to heal isn't changed. Typically, we use around 12 weeks, when the patient's bones have really healed and the fusion is solid. But for many of these people, they've begun a physical therapy regimen and start becoming quite active within 3 to 4 weeks after the surgery. Essentially all of them are up walking the night of the surgery.
For the right indications, the vast majority of patients, 85 to 90%, have what we say is an excellent to good result. That means they're able to return back to an active lifestyle, they're taking minimal medication or are completely off of medication, and they've returned to a full life.
Certainly, having appropriate training is important. Experience is important. I would say that they should feel comfortable with their surgeon, and because this is a major operative procedure, they should obtain more than one opinion regarding having such a surgery as this. The patient should also feel that the physician is interested in giving them all the information and will spend adequate time with them so that they feel comfortable with their decision. They should not feel rushed to make their decision.
One of the nurses at El Camino Health had sustained an injury at work and as a result had an unstable spine. While she was treated for about a year with conservative measures, it became obvious she was not going to get better. She ultimately underwent spinal fusion surgery and has now returned to work, is essentially off all medication and is back in the gym exercising every day. I would say that is more of a typical rather than an atypical story.
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