Spinal stenosis

 

Feature Summary

Spine surgery is typically recommended only when a period of nonsurgical treatment — such as medications and physical therapy — has not relieved the painful symptoms caused by your back problem. In addition, surgery is only considered if your doctor can pinpoint the exact source of your pain, such as a herniated disk or spinal stenosis.

Minimally invasive techniques have been used for a wider range of spine procedures, such as decompression and spinal fusion since the 1990s. Decompression relieves pressure put on spinal nerves by removing portions of bone or a herniated disk. Spinal fusion corrects problems with the small bones of the spine (vertebrae). The basic idea is to fuse together the painful vertebrae so that they heal into a single, solid bone.

 

Overview

Spinal stenosis is a narrowing of the open spaces within your spine, which can put pressure on your spinal cord and the nerves that travel through the spine to your arms and legs. Spinal stenosis occurs most often in the lower back and the neck.

While spinal stenosis may cause no signs or symptoms in some people, other people may experience pain, tingling, numbness, muscle weakness, and problems affecting normal bladder or bowel function.

 

Features

Spine surgery is traditionally done as "open surgery," meaning the area being operated on is opened with a long incision to allow surgeons to view and access the anatomy. In recent years, however, technological advances have allowed more back and neck conditions to be treated with a minimally invasive surgical technique.

Minimally invasive spine surgery (MISS) was developed to treat spine problems with less injury to the muscles and other normal structures in the spine. Other advantages to MISS include smaller incisions, less bleeding, and shorter stays in the hospital.

 

Procedure

The surgeon accesses the spine using small instruments. Any bone or disk material that is removed exits through special retractors, and any devices necessary for fusion — such as screws or rods — are inserted through the retractor.

In order to see where to place the incision and insert the retractor, the surgeon is guided by fluoroscopy or O-arm navigation,. This method displays real-time x-ray images of the patient's spine on a screen throughout the surgery. The surgeon also uses an operating microscope to magnify the view through the retractor.

 

Notification

  • Infection: Antibiotics are regularly given to the patient before, during, and often after surgery to lessen the risk of infections.
  • Bleeding: A certain amount of bleeding is expected, but this is not typically significant.
  • Recurrence: Some patients may experience a recurrence of their original symptoms.
  • Nonunion Patients who smoke are more likely to develop a pseudarthrosis. This is a condition where there is not enough bone formation. If this occurs, a second surgery may needed in order to obtain a solid fusion.
  • Nerve damage: It is possible that the nerves or blood vessels may be injured during these operations; rather these complications are very rare.
  • Hematoma: Another uncommon complication is the formation of blood clots in the operation area and cause radiculopathy or cauda equine syndrome.

 

Estimated Cost

The cost depends on how many levels are being treated. On average, it will cost 17,000 NTD for each level. Prices are subject to change without prior notice, need to pay in accordance with the actual medical expenses.