Spine Surgery

Spine surgery covers a family of operations that share two aims: taking pressure off a compressed nerve, and steadying a segment of the spine that is moving in a way it should not. Many operations do one; some do both.

Decompression means removing whatever is pressing on the nerve. That may be a fragment of disc, a thickened ligament or an overgrown edge of bone, and the amount removed is kept to what is needed to free the nerve. Stabilisation means fixing two or more vertebrae to one another with screws and rods, together with bone graft that knits the segment into a single solid block over the following months. The metalwork holds the position while that biology happens.

The spine is reached from the back, the side or the front depending on the level and on what has to be removed, and your surgeon chooses the route that gives the safest access to the target. Most modern procedures use an operating microscope or an endoscope, which means a smaller incision, less disturbance of the muscles alongside the spine, and a faster early recovery. The work done inside is the same, so the size of the incision does not shorten how long the nerve or the bone takes to heal.

The operation is done under a general anaesthetic. You are positioned carefully, usually face down on padded supports with the abdomen free, which reduces bleeding, and pressure points are protected throughout.

Your surgeon uses X-ray in theatre to confirm the exact level before making the incision, which is a routine and important step. The muscle is moved aside instead of cut where possible, the microscope or endoscope is brought in, and the decompression or the implants are carried out under magnification. Where nerves are at particular risk, their function is monitored electrically during the operation. A single-level decompression commonly takes one to two hours; a fusion or a multi-level procedure takes longer.

This is an Inpatient procedure. Most people stay one to four nights depending on what was done. A drain and a urinary catheter are used in some cases and removed within a day. You will be sat up and helped to walk the same evening or the next morning, and walking early is part of the treatment instead of a test of toughness. A physiotherapist will teach you how to get in and out of bed, how to bend and lift, and what your limits are before you go home.

The wound is sore for around two weeks and the soreness in the back muscles settles over four to six. Nerve pain down the arm or the leg often improves immediately or within days, and that change is usually the first thing people notice. Numbness and weakness recover far more slowly, over three to twelve months, and where a nerve was compressed for a long time the recovery may be incomplete.

Walking is encouraged from the first day and built up steadily; a short walk several times a day beats one long one. Avoid bending, twisting and lifting anything heavier than a few kilograms for six weeks, and follow your surgeon's instructions on any brace.

Desk work is realistic at two to six weeks after a decompression and longer after a fusion. Manual or heavy work takes around three months. Driving usually resumes at two to six weeks once you can turn to look over your shoulder and brake without hesitation, and your surgeon confirms it. Where bone is being fused, it takes six to twelve months to knit fully, and the restrictions in the first three months protect that process.