Our Summary

This study looks at two types of surgery for lower back issues. One type uses screws on both sides of the spine (bilateral), and the other uses screws on just one side (unilateral). The researchers wanted to see if one method was better than the other in terms of how well the surgery worked, how many complications there were, how long patients had to stay in the hospital, and how much pain people had after the surgery. They also looked at how long the surgeries took and how much blood patients lost during the operations.

They reviewed a bunch of previous studies, including both observational studies and randomized controlled trials. They found that both types of surgery had similar results in terms of how well they worked, how many complications there were, and how long patients had to stay in the hospital. However, the surgery using screws on just one side was quicker and resulted in less blood loss. This was true regardless of whether the surgery was done using a traditional open approach or a less invasive method. So, the study suggests that the surgery using screws on just one side may be a better option.

FAQs

  1. What were the two types of surgeries the study investigated for lower back issues?
  2. What were the primary differences found between the bilateral and unilateral surgical methods?
  3. Did the study find that one surgical method was generally more effective or safer than the other?

Doctor’s Tip

One helpful tip a doctor might tell a patient about spinal surgery is to discuss with their surgeon the option of using screws on just one side of the spine (unilateral) instead of both sides (bilateral). This approach may result in a quicker surgery, less blood loss, and similar outcomes in terms of effectiveness and complications. It’s important to have an open and informed conversation with your surgeon to determine the best approach for your specific situation.

Suitable For

Patients who are typically recommended spinal surgery are those who have tried conservative treatments such as physical therapy, medication, and injections without success, and who are experiencing severe back pain, leg pain, numbness, weakness, or difficulty walking due to conditions such as herniated discs, spinal stenosis, spondylolisthesis, or spinal deformities. Patients with spinal fractures, tumors, or infections may also be candidates for spinal surgery. It is important for patients to discuss their specific condition and treatment options with their healthcare provider to determine if spinal surgery is the best course of action for them.

Timeline

Before spinal surgery:

  1. Patient experiences chronic back pain or other symptoms that do not improve with conservative treatments such as physical therapy or medication.
  2. Patient undergoes imaging tests such as MRI or CT scans to determine the cause of their symptoms.
  3. Patient meets with a spine surgeon to discuss surgical options and risks.
  4. Patient undergoes pre-operative testing such as blood work and a physical examination.
  5. Patient is instructed to stop taking certain medications that may increase the risk of complications during surgery.

After spinal surgery:

  1. Patient is admitted to the hospital on the day of surgery.
  2. Surgery is performed, either using bilateral or unilateral screws depending on the surgeon’s recommendation.
  3. Patient wakes up in the recovery room and is monitored closely for any complications.
  4. Patient is given pain medication to manage discomfort.
  5. Patient is encouraged to start moving and walking with the help of physical therapy.
  6. Patient is discharged from the hospital once they are able to walk, eat, and urinate independently.
  7. Patient follows up with the surgeon for post-operative appointments to monitor recovery and address any concerns.
  8. Patient continues with physical therapy and gradually resumes normal activities as instructed by their healthcare team.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with spinal surgery?
  2. How long is the recovery process and what can I expect in terms of pain and discomfort?
  3. What are the success rates of both bilateral and unilateral spinal surgery in treating my specific condition?
  4. How long will I need to stay in the hospital after the surgery?
  5. What is the difference in surgical time and blood loss between bilateral and unilateral spinal surgery?
  6. Are there any specific factors that would make me a better candidate for one type of surgery over the other?
  7. What is the expected outcome in terms of pain relief and improvement in mobility after the surgery?
  8. Are there any alternative treatment options to consider before undergoing spinal surgery?
  9. Will I need physical therapy or rehabilitation after the surgery, and if so, for how long?
  10. What is the long-term prognosis and potential need for additional surgeries or treatments after undergoing spinal surgery?

Reference

Authors: Phan K, Leung V, Scherman DB, Tan AR, Rao PJ, Mobbs RJ. Journal: J Clin Neurosci. 2016 Aug;30:15-23. doi: 10.1016/j.jocn.2016.01.013. Epub 2016 Apr 7. PMID: 27068653