What is Spondylolisthesis Surgery?
As a back surgeon, Dr. Ernest Braxton performs spondylolisthesis surgery for patients suffering from spondylolisthesis degenerative spine disease. There are two parts to spondylolisthesis surgery, a decompression process known as a laminectomy and a prescribed form of lumbar interbody fusion, either anterior, posterior or transforaminal. Spondylolisthesis can affect the cervical, thoracic and lumbar sections of the spine. It is often the result of trauma in younger patients and normal wear and tear in patients age 50 and older. Most frequently, patients aged 60 to 65 are diagnosed with this condition.
With age, the spine is subject to normal degeneration impacting and weakening the bones, ligaments and joints that help align the spinal column. The spine can become less stable leading to a slipped vertebral body or degenerative spondylolisthesis. When a patient’s pain becomes disabling, or normal activities are impacted, spondylolisthesis surgery may be recommended. The goal of spondylolisthesis surgery is to realign the affected spinal area and alleviate the pressure on the spinal nerve to restore spinal stability.
How is Spondylolisthesis Surgery Performed?
Dr. Braxton has three main goals for spondylolisthesis surgery:
- Correct the pressure to the spinal nerve
- Restore the normal alignment of the spine
- Restabilize the spinal structure
To achieve the spinal nerve decompression, Dr. Braxton will first eliminate anything that is pressing on the nerve. A herniated or bulging disc may be removed or narrowing of the foramen, or passageway for the spinal nerve, may be corrected to open up more room for the spinal nerve. Central spinal crowding, known as central spinal stenosis, can be addressed by removing the lamina thus creating more spinal nerve space. Bony debris from degeneration of the facet joints may be removed to alleviate nerve interference.
After the joint has been cleaned, Dr. Braxton utilizes the fusion phase of the treatment to correct any gaps and realign the spine to improve spinal stability. The fusion fills the gaps, stabilizes the spine and promotes normal movement and function to the spine. The fusion bone graft material is used to promote optimal bone growth and spinal stability as quickly as possible for patient recovery. Spinal hardware including screws, cages and rods are used to restabilize the spinal structures.
What are the Advantages of Spondylolisthesis Surgery?
Patients experience two key advantages from spondylolisthesis surgery.
Nerve pain is relieved by the decompression portion of the surgery. Bone removal can result in loss of stability around the facet joints, discs and nerves. The spine can then move and shift in abnormal ways. This would set-up the spine for further degeneration and damage. By performing a fusion at the affected level, the spine is prepared for a healing process that results in a strong, fused spinal repair. It becomes less likely that the patient may need follow-up procedures to the same are. If facets or the disc are causing the pain, the fusion will correct pain producing movement at that spinal level and spinal stability is corrected.
The fusion also reduces any post-surgical deformities. Without fusion, some patients experience abnormal curvature of the spine post-operatively. An abnormal kyphosis, or outward curve, of the affected spinal section can develop and the spinal alignment becomes abnormal which can lead to further surgeries. The fusion portion of the spondylolisthesis surgery can prevent any potential kyphosis from developing, protecting healthy spinal alignment. Future wear and tear to the repaired area will be minimized and the need for future surgeries to the affected level is greatly reduced. Dr. Braxton’s advanced spondylolisthesis surgery is intended to restore spinal health and return the patient to preferred activities and lifestyle as quickly as possible.
What is the Recovery Like After Spondylolisthesis Surgery?
90% of patients report a decrease in pain and a successful return to normal activities after spondylolisthesis surgery. The rate of recovery is determined by the complexity of the specific treatment. The immediate recovery period is typical for any major surgery. Within the first day, patients begin basic leg motion, and within two to three days walking with assistance will be prescribed. Pain management will continue both in hospital and during the home care phase. A brace may be prescribed for spinal support and muscle relaxants may be used to reduce muscle spasm.
After hospital discharge, patients benefit from in-home help for the first week or two. Dr. Braxton will provide specific instructions to avoid lifting heavy objects, bending and twisting, and ensure the patient receives adequate sleep, rest, and good nutrition. Dr. Braxton will prescribe a light walking program, at-home stretching exercises and physical therapy at the correct time. Follow-up appointments and patient compliance to instructions is necessary to achieve optimal patient recovery. Dr. Braxton’s goal is to return the patient to their preferred lifestyle as quickly as possible.