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By Patrick Foote
In more than 90 percent of cases, spinal pinched nerve surgery never becomes an option. Whether the associated nerve compression occurs within the cervical (neck) or lumbar (lower back) region, the pain, tingling, numbness, and/or muscle weakness caused by the compressed nerve normally can be managed conservatively (non-surgically). This can mean a course of prescription anti-inflammatory medication, or an exercise regimen supervised by a licensed physical therapist. It may also mean a series of corticosteroid injections to reduce inflammation in the spine and block pain signals, or daily applications of heat or ice.
There are many forms of conservative treatments available, and some are more effective than others. The bottom line is, a pinched nerve (more accurately known as nerve compression) typically is not going to land a patient on an operating table unless an emergency situation occurs such as cauda equina syndrome. This is, of course, a broad statement, and not everyone is fortunate enough to achieve relief using non-surgical methods.
Anatomy of a Pinched Nerve in the Spine
Any consideration of whether to undergo spinal pinched nerve surgery requires an understanding of the potential causes of a pinched nerve in the spine. There are 31 pairs of spinal nerve roots branching off the spinal cord, running the length of the spinal column. These nerve roots exit the spinal column at each vertebral level through openings known as intervertebral foramina. These openings are formed by the interlocking vertebra and allow room for the nerve roots to pass. This room can become constricted in the presence of degenerative spine conditions such as bulging discs, bone spurs, herniated discs, and spondylolisthesis (vertebral slippage). Traumatic injury that compresses the vertebrae might also affect the amount of space available for nerve roots.
If a spinal nerve root becomes compressed, the area of the body innervated by that nerve will be affected. Nerve compression can cause localized pain, but the truly problematic symptoms are known as radiculopathy – traveling pain, the loss of sensation, and muscular weakness in the extremities. The location of the pinched nerve determines the area of the body affected. A pinched nerve in the cervical (neck) region typically produces symptoms in the shoulders, neck, upper back, arms, and fingers. Nerve compression in the lumbar (lower back) region affects the lower back, the buttocks, the legs, feet, and toes.
Pinched Nerve Surgery – a Subjective Decision
The problem with deciding whether to undergo an elective surgical procedure to decompress a pinched nerve is that there often is no definitive moment at which the conservative options prove ineffective. Because there are so many non-surgical methods available, and because no two cases are alike, a period of trial-and-error may be necessary to formulate the correct combination of treatments. Meanwhile, the patient’s level of discomfort may fluctuate, and only he or she can decide whether the pain and other symptoms are bearable. This makes the decision whether to resort to elective pinched nerve surgery extremely subjective, but there are a number of factors that can help sway a patient’s thinking:
— Have all available conservative methods been attempted?
— Have the chronic symptoms dramatically affected a patient’s happiness and well-being?
— Is the patient’s overall health conducive to successful surgery and recovery?
— Has the patient received a second (or even a third) opinion about his or her long-range prognosis?
Understanding the Risks of Pinched Nerve Surgery
Finally, if a patient has decided that he or she simply can’t achieve meaningful relief from back or neck pain using conservative methods, it’s time to consider the potential risks and side effects of decompression surgery. Spine surgery takes two basic forms: open back or neck surgery, or minimally invasive procedures. Both types have their risks, although the minimally invasive option typically has fewer risks and a shorter period of recuperation. No patient should consent to any form of spine surgery before thoroughly discussing the options, risks, and potential side effects with a doctor.
About the Author: Patrick Foote is the Director of eBusiness at Laser Spine Institute, the leader in endoscopic spine surgery. Laser Spine Institute specializes in safe and effective outpatient procedures for the treatment of
and several other spinal conditions.