Our Summary

This study looked at how closely three surgeons followed guidelines from the Society of British Neurological Surgeons for using x-rays during spine surgery. They also wanted to see if following these guidelines affected how long the surgery took and if there were any complications.

The guidelines suggest taking an x-ray before the first cut, another after the spine is exposed but before the pressure is relieved, and a third after the surgery to check if the pressure was properly relieved.

The study looked at 301 patients who had spine surgery over a year. There weren’t any cases where the surgery was done on the wrong level of the spine. However, in 13 cases (4.3%), the wrong part of the spine was initially exposed. This happened most often when only the second x-ray was taken.

The study found that taking all three recommended x-rays might help identify when the wrong part of the spine is exposed before the pressure is relieved. This could also possibly shorten the length of the surgery.

FAQs

  1. What are the recommended guidelines from the Society of British Neurological Surgeons for using x-rays during spine surgery?
  2. Does following these guidelines affect the duration of the surgery or the occurrence of any complications?
  3. How can taking all three recommended x-rays during spine surgery help surgeons?

Doctor’s Tip

Therefore, it is important for patients to ask their surgeon about following these guidelines during their spinal surgery to ensure the procedure is done accurately and efficiently.

Suitable For

Patients who may be recommended for spinal surgery include those with:

  1. Chronic back or neck pain that has not improved with conservative treatments such as physical therapy, medication, or injections
  2. Herniated or bulging discs causing nerve compression and resulting in symptoms like sciatica or arm pain
  3. Spinal stenosis, a narrowing of the spinal canal that can lead to nerve compression and symptoms like leg pain with walking
  4. Scoliosis or other spinal deformities causing pain or neurological symptoms
  5. Spinal fractures or instability due to trauma or degenerative conditions
  6. Tumors or infections affecting the spine
  7. Failed previous spinal surgery requiring revision surgery

It is important for patients to discuss their symptoms, medical history, and treatment options with a spine specialist to determine if surgery is the best course of action for their specific condition.

Timeline

Before spinal surgery:

  1. Patient consults with a spine surgeon to discuss symptoms, options, and risks of surgery.
  2. Patient undergoes pre-operative testing, such as imaging studies and blood tests.
  3. Patient is admitted to the hospital on the day of surgery and meets with the surgical team.
  4. Anesthesia is administered, and the surgery begins.

During spinal surgery:

  1. Surgeon follows guidelines for x-ray usage before, during, and after surgery to ensure proper alignment and placement.
  2. Surgeon performs the necessary procedure to address the spinal issue.
  3. Anesthesia is monitored throughout the surgery to ensure patient comfort and safety.

After spinal surgery:

  1. Patient wakes up in the recovery room and is monitored for pain and any potential complications.
  2. Patient is moved to a hospital room for further observation and recovery.
  3. Physical therapy may be initiated to help with mobility and strength.
  4. Patient is discharged from the hospital and provided with instructions for at-home care and follow-up appointments.
  5. Follow-up appointments are scheduled to monitor healing and address any concerns.

What to Ask Your Doctor

  1. What specific type of spine surgery do you recommend for my condition?
  2. What are the potential risks and complications associated with this surgery?
  3. How many times have you performed this type of surgery before?
  4. Will I need to undergo any pre-operative testing or evaluations before the surgery?
  5. What is the expected recovery time and rehabilitation process after the surgery?
  6. How will my pain be managed during and after the surgery?
  7. Will I need to have any follow-up appointments or imaging studies after the surgery?
  8. How do you ensure that the correct level of the spine is being operated on during the surgery?
  9. Are there any alternatives to surgery that I should consider?
  10. What is the long-term outlook for my condition after undergoing this surgery?

Reference

Authors: Dablouk MO, Sajjad J, Lim C, Kaar G, O’Sullivan MGJ. Journal: Br J Neurosurg. 2019 Jun;33(3):352-356. doi: 10.1080/02688697.2018.1562030. Epub 2019 Feb 11. PMID: 30741019