What are the risk factors?
As with any surgery, there's a risk of bleeding and infection.
In a microdiscectomy, usually performed to treat a herniated disc, there's a risk of a cerebrospinal fluid leak. This has been known to happen in about 2 percent of these surgeries. If you experience a leak, your doctor might ask you to lie still for one or two days to allow the leak to seal.
One in about 1,000 patients experienced nerve root damage during a laminectomy. There's also a small chance of a cerebrospinal fluid leak.
The most common risk factor for a spinal fusion surgery is failure to remove pain. This is commonly referred to as “failed back surgery syndrome.”
Another risk factor of spinal fusion surgery is pseudoarthrosis. This occurs when the vertebrae do not fuse together properly. This occurs in between 5 percent and 10 percent of these surgeries. People who smoke have a lower rate of successful spinal fusion procedures.
Also, the screws used to fuse vertebrae together can break or loosen and require additional surgery.
Most spinal fusion complications are not frequent. Research has found that obesity can increase risk factors.
Some doctors who perform minimally invasive surgeries see lower bleeding and infection rates. More research must be done to prove this.
Minimally invasive surgeries can take longer than traditional surgery. This means there can be a higher risk related to anesthesia. How long the surgery takes is, in part, related to how comfortable a surgeon is with minimally invasive procedures.
If a patient who has experienced trauma is receiving a spinal surgery, the risk for infection and bleeding are higher. Minimally invasive spinal surgery can sometimes be a benefit to these patients because it is less disruptive.
What's the recovery time?
It depends on the surgery.
If you receive spinal fusion surgery, the success of the surgery can be highly contingent on you following your doctor's orders. For example, it can take about three months for a fusion to successfully reach maturity.
Your activity level will be limited. You won't be allowed to run or participate in any type of vigorous activity. Your doctor might limit your driving, and you also might want to limit the length of trips you take.
Directly after a spinal fusion surgery, you might not be able to eat for a few days and be given nutrients through an IV.
Younger patients in good health who get spinal fusion likely will need to take four to six weeks off from work. Older patients who need more extensive surgery might need to take off work up to six months.
It is important to listen to your doctor's orders regarding rehabilitation. Your spine will be growing and changing, and it's important to complete your therapy to ensure your spinal fusion is as successful as possible.
You might be fitted for a back brace. When you're ready, your doctor or physical therapist might teach you exercises to strengthen your back muscles.
Some patients find that their recovery time is faster with minimally invasive surgery, but this isn't well documented yet in scientific research.
One theory for why patients might recovery more quickly relates to the fact that the surgeon isn't cutting the muscle off the bone and spreading it open.
It's important to call your doctor if you experience fever above 101 degrees, more pain where you had surgery, drainage that is green or yellow, a loss of feeling or change of feeling in your arms, legs or feet, chest pain or shortness of breath, or swelling. Also, you should call your doctor if you have difficulty urinating or controlling your bowels.
Are there follow-up procedures?
Hopefully, you only need one surgery.
However, future spine problems are possible. For example, for patients who get spinal fusion, part of their spine will no longer be able to move. This can cause added stress on other parts of the spine.
It's important to voice all of your concerns with your doctor and find a doctor you trust before making any major medical decisions. It's not a bad idea to get a second opinion, for spinal surgery can be a major commitment.
Source: Dr. Winston Fong,; Spine-Health.com; National Institutes of Health; American Academy of Orthopaedic Surgeons; American Association of Neurological Surgeons; The Mayo Clinic