Symptoms of spinal stenosis may necessitate bone spur back surgery if the cause of back pain is a physical obstruction rather than a problem which can be addressed by conservative therapies. Bone spurs (osteophytes) are abnormal bony growths which can occur in various parts of the body including the spine, although they are much easier to recognize in the hands or feet as they may actually alter the physical appearance of the extremities. To confirm the presence of bone spurs in the spine a patient will require an X-RAY or MRI scan, which can also show up any disc degeneration or spinal curvature that is contributing to their symptoms. The removal of bone spurs in the spine is far from straightforward however, as they may actually form an integral part of the spinal column which could lead to instability upon removal, unless spinal fusion surgery is also carried out. Bone also bleeds profusely when cut which leads to the formation of a callus that could actually make spinal stenosis worse. Care must be taken, therefore, to assess the necessity of bone spur back surgery in order to avoid future complications.
Symptoms of Bone Spurs
Back and neck pain due to bone spurs and spinal stenosis are usually a result of nerve and blood vessel compression, along with disc degeneration and possible cartilage problems. The initial symptoms of a pinched nerve due to bone spurs will often include pain upon certain movements, particularly those which further compress the spine such as bending forward, backward, or to the side. Over time the acute pain may become chronic and numbness and weakness may develop in the back and/or neck, and possibly in the shoulders, arms, hands, legs, or feet depending on the location of the compression. Long-term nerve compression from bone spurs can lead to muscle wasting and an observable difference between two limbs, along with mobility issues and coordination problems.
Is Bone Spur Back Surgery Always Necessary?
The mechanical obstruction presented by bone spurs means that anti-inflammatory medications provide little effective relief although they can reduce the severity of pain for some patients. Where a nerve root is irritated by a bone spur upon movement, but not actually compressed, NSAIDs and natural anti-inflammatory medications can be helpful in relieving any swelling around the nerve and any muscle inflammation that could be causing pain. If there are functional deficits however, such as myelopathy from spinal cord compression or severe nerve compression, or even from ischaemia caused by blood vessels being trapped by osteophytes, the patient will usually require bone spur back surgery.
Minimally Invasive Bone Spur Back Surgery
Perhaps the simplest back surgery for bone spurs is a microforaminotomy, which is minimally invasive and often carried out as an out-patient procedure and aims to open up the foramen through which the spinal nerves exit the spine. Bone spurs are commonly found in the foramen and the patient’s particular physiology will determine whether they become problematic or not as some people have congenitally narrowed foramen which leaves little room for extra bone growth. Similarly, nerve root compression can happen with congenitally narrow pedicles, problems of scoliosis, forward or backward curvature of the spine, and the collapse of vertebrae due to disc degeneration which may itself be affected by bone spur growth. Accurate diagnosis is key to the success of back surgery, as is the identification of all material likely to be causing obstruction in order for it to be removed during surgery. The number one reason for failed back surgery syndrome is inaccurate diagnosis leading to surgical procedures which fail to address the real root of a patient’s back pain.
Continue Reading –> Microlaminoforaminotomy, Fusion, and Discectomy for Bone Spurs