Minimally invasive spinal fusion
Mr Chris Brown, Consultant Orthopaedic Spinal Surgeon at Circle Reading, has expertise in a minimally invasive approach to Spinal Fusion. Here he gives us a better understanding of what that approach looks like.
Patients often tell me how debilitating their back pain can be, preventing them from doing many of the activities they love, severely affecting their quality of life. Fortunately, there are a number of options available to you, and if one method doesn’t seem to help, I can easily point you in the direction of an appropriate alternative.
Sometimes, lower lumbar/spine pain can be managed effectively through physiotherapy, pain medication and/or corticosteroid injections. However, if you have already tried these options and your pain has persisted with little to no improvement, spinal fusion surgery may present the best chance at improving your quality of life.
There are many reasons why you might require a spinal fusion; age-related structural changes to your spine, joint instability due to a previous surgery, a progressively deteriorating stenosis (narrowing of the spinal column), or even fractures in your vertebrae as a result of a trauma or accident.
Spinal fusion is a much bigger operation than other spinal surgeries, and the traditional approach involved a large cut down the length of the spine so as to allow full access to the spinal column. With my minimally invasive methods, my aim is to get into the spine, causing as little damage as possible to the surrounding muscles and tissue. I do this with multiple smaller cuts, avoiding the need to cut through the muscle. I also carry out the procedure alongside radiology specialists, using X-ray guidance to ensure the utmost accuracy and give greater visibility.
The method may be different, but the aim of the spinal fusion surgery remains the same, using a bone graft to ‘fuse’ two vertebrae together for stability, sometimes secured with metal rods and screws.
For you, the patient, the smaller cuts mean less blood loss during the operation itself, and results in a rapid recovery (as the smaller incisions heal quicker) with less pain, far better than the uphill battle faced when recovering from a more invasive open surgery.
With this minimally invasive approach, patients are often able to return home a few days after surgery. Of course, I always want to set expectations beforehand that despite the faster recovery times, it is still major surgery, and it can be tough afterwards. You will need to take it easy, especially in the first few days, avoiding any bending, lifting, or twisting. With this in mind, it would be wise to ensure before surgery that a family member or trusted friend will be able to stay at home with you and help out during the early part of your recovery.
I cannot stress enough how important rehab is in the weeks and months after the operation. Fortunately, through our multi-disciplinary approach at Circle, we have an expert physiotherapy team who will work closely with you during your rehabilitation period, and this is absolutely key in making the best possible recovery. After a couple of weeks, it is a good idea to get moving as soon as possible, as this will further aid in your recovery. My pain management specialists will also be able to offer advice on reducing any pain and stiffness, working in tandem with the physiotherapy team, and I will see you for a follow-up appointment to assess your progress. At this stage, we should be able to tell if the fusion has been successful, and I will happily address any concerns or issues you might have.
General complications of any spinal surgery can include blood clots and stroke, nerve damage, and infection (although this risk is reduced due to the ultra-clean air in our operating theatres). You may experience some pain around the site of the bone graft, and in some circumstances this can persist. There is also the small possibility of an unsuccessful fusion, failing to reduce your level of pain or improve your mobility, but this is rare, and many of my patients report that their symptoms have significantly improved having undergone the surgery. I commonly perform minimally invasive spinal fusions and it is generally a very safe procedure, with just a small percentage of patients who encounter difficulties.
If you are concerned about the ramifications of a traditional spinal fusion and open surgery, why not book a consultation to talk it over with me? I can determine whether or not a minimally invasive approach would be appropriate for you, advising you on the best possible treatment path. If you have any sort of recurring back or neck pain, it is important to get it seen to as quickly as possible so as to prevent any further damage and find appropriate pain relief for you. With no waiting lists, I can see you for a consultation at your earliest convenience and get you started on an effective treatment plan.