Spine Surgery

What is Spine Surgery?

It is a surgical method aimed at loss of function, structural disorders or other pathologies in the nerve roots in the spine and spinal cord. Masses such as degenerative spine diseases, traumatic injuries, congenital injuries and tumors are included in the field of spine surgery. In all these cases, nerve loss, weakness, paralysis, and pain in the damaged area or other parts of the body may occur.

Progressive degenerations that do not respond to non-surgical methods are operated on with modern surgical methods. You should rest for 7 days after the surgery and avoid strenuous movements. After a week, the patient can take minimal walks to meet his/her needs and go through the recovery process with regular check-ups. Spinal cord disorders can originate from outside or inside the spinal cord. Damage outside the spinal cord, injury to the spinal cord results from spinal fractures or compression.

The spinal cord can become compressed due to a bone fracture, spinal degeneration, or abnormalities such as a hematoma, herniated disc, or tumor. Hernia, which occurs due to compression of the discs, may occur in the neck area or in the lumbar vertebrae. In a herniated disc, the person feels loss of strength in the legs, numbness and pain in the waist area. If deemed appropriate after the radiological and physical examination, a conservative treatment is applied with painkillers, corsets, physical therapy and rest, or the herniated disc pressing on the nerve root is removed with microdiscectomy.

What are Spinal Anomalies?

Structural disorders of the spine may be congenital or acquired. Congenital spine disorders occur in the embryonic period and are progressive. For this reason, the most effective treatment is spine surgery. Spina bfida, which occurs due to incomplete closure of the spinal canal, is usually seen in the sacral and lumbar vertebrae. This opening on the spinal cord can herniate and there are pieces of nerve and neurological tissue inside the disc. Meningocele or myleomeningocele formation is corrected by surgery.

 

Kyphosis and scoliosis may be congenital or may be due to idiopathic or neuromuscular causes. Scoliosis is the distortion of the healthy position of the spine and its curvature. Curvature is corrected with titanium screw implantation. The spine is curved to a certain degree due to its anatomical structure, but curvatures greater than 45 degrees become visible from the outside and cause back pain. Kyphosis causes the upper back to curve forward and appear more rounded. While muscle strength can be gained through exercises depending on the postural posture, surgery is preferred in cases of severe hunchbacks. Early treatment is very important to prevent deterioration in lung functions in children. If a vertebra slips forward and rests on the vertebra below it, this is called spondylolisthesis. This slip occurs with a bilateral fracture of the bone bridge called pars articularis. Depending on the degree of slippage, epidural steroid injections or invasive methods (laminectomy, posterior fusion with instrumentation, posterior lumber interbody fusion) are preferred.

What is Scoliosis?

Scoliosis is a condition characterized by abnormal curvatures of the spine, with a prevalence of up to 3%. On X-ray images, the spine may appear in an S or C shape. Scoliosis is typically classified into three main subtypes: congenital (present at birth), idiopathic (unknown cause), and neuromuscular (related to muscle or nerve disorders). If the patient is in a growth phase, the curvature tends to progress.

Scoliosis Treatment Options

Scoliosis treatment varies based on the patient's age, the type of scoliosis, and the severity of the curvature.

  1. Physical Therapy (Scoliosis Exercises): In the early stages of scoliosis, physical therapy may be applied to control the curvature and strengthen the muscles.

  2. Bracing: For moderate curvatures, a brace may be recommended to prevent further bending of the spine.

  3. Surgical Treatment: In severe cases of scoliosis, surgical intervention may be necessary to correct the curvature. Scoliosis surgery involves placing titanium screws in the spine to correct the curvature and provide stability.

What are Congenital Spine Anomalies?

Congenital spine anomalies are deformities that arise from developmental disorders during the embryonic period. These anomalies result from improper development of the spine and can manifest as spinal curvatures, fusions, or other structural abnormalities. Depending on the form and severity of the anomaly, the deformity can reach significant levels, leading to complications such as respiratory problems and paralysis. Additionally, these anomalies often occur alongside congenital abnormalities in other organs, particularly the chest.

What are Spinal Fractures?

Spinal fractures differ from fractures in the arm or leg as they can compress the spinal canal and cause damage to the spinal nerves. These fractures and dislocations of the spine are often caused by traffic accidents, falls, gunshot wounds, or sports injuries. Injuries can range from moderate muscle and ligament injuries to fractures and dislocations that cause paralysis.

What is a Cervical Herniated Disc?

A cervical herniated disc occurs when the rubbery cushions between the cervical vertebrae, known as discs, tear and compress the spinal cord in the spinal canal. The discs in the spine are composed of an outer rubbery layer and an inner jelly-like cartilage. The herniated disc occurs when the outer rubbery layer tears, causing the inner portion to protrude into the canal.

What is a Lumbar Herniated Disc?

A lumbar herniated disc occurs when the discs between the lumbar vertebrae lose their integrity and begin to compress or approach nearby structures. Similar to cervical herniated discs, the outer part of the disc is rubbery, while the inner part consists of a gel-like cartilage. When the disc tears, the inner part can protrude, pressing on nerve roots or the spinal cord, leading to symptoms associated with a lumbar herniated disc.

What is Spondylolisthesis?

Spondylolisthesis is a condition that alters the normal alignment of the spine, characterized by one vertebra slipping forward over another. This slippage causes pressure on surrounding tissues and nerves, leading to pain and other symptoms. Normally, the bones of the spine (vertebrae) are aligned vertically, supported by ligaments and joints. However, in spondylolisthesis, this structure is disrupted, and the vertebra slips forward.

 

Sacralization and Lumbarization

Vertebral anomalies in the lumbosacral region refer to variations in the alignment and structure of the spine, which can affect the biomechanical balance of the spine and lead to mechanical back pain. Notable vertebral anomalies include sacralization and lumbarization.

Sacralization

In sacralization, the 5th lumbar vertebra exhibits characteristics of a sacral vertebra, reducing the number of lumbar vertebrae to four. The 5th lumbar vertebra may fuse with the sacrum, and in some cases, only a transverse process fuses, known as unilateral sacralization.

Lumbarization

Lumbarization occurs when the 1st sacral vertebra transforms to exhibit characteristics of a lumbar vertebra, resulting in six lumbar vertebrae. In both conditions, the number of movable lumbar segments is affected, disrupting the biomechanical balance of the spine and leading to mechanical back pain.