SURGERY
Spinal surgery improves with a multidisciplinary approach
Providing reliable results, based on decisions that are tailored to the needs of the patient and in accord with the most up to date medical evidence.
24 YEARS OF EXPERIENCE IN SPINAL SURGERY
Studies are published daily that influence, and should modify, everyday medical practice. We, the members of Barcelona Spine Institute, participate actively in these studies, and we attach great importance to analysing the results and the proven efficacy of the treatments. We offer up-to-date healthcare which is in line with the latest scientific evidence.
The medical research in which we take an active part periodically provides significant data that help identify which treatments are effective and which are not. We only offer treatments that have been proven to be effective in similar cases.
The results of this research are published daily in scientific journals and we have been instrumental in the field of medical publishing in recent years.
Spinal surgery has proven effective in the treatment of pain caused by nerve compression (slipped disc, spinal stenosis), abnormal movement of the vertebrae that cause pain or deformities (spondylolisthesis, scoliosis). It also enables fractures, tumours, and certain spinal infections to be treated successfully. A large number of treatments on the market are unproven and lack scientific evidence.
INTRAOPERATIVE NEUROPHYSIOLOGICAL MONITORING (IONM)
Intraoperative neurophysiological monitoring (IONM) consists of running different neurophysiological tests to assess how the nervous system (mainly the brain, spinal cord and peripheral nerves) is functioning during surgical operations that may involve a risk of neurological damage.
The risk and the type of tests required are decided by the entire surgical team, and this is always tailored to each patient.
This is how we optimise surgical strategy and ensure better safety, as the potential for nerve damage is kept to a minimum.
FAQs
WHEN SHOULD YOU OPERATE ON A PATIENT WHO IS IN PAIN?
Surgery is rarely needed in patients with back pain.
The latest scientific evidence demonstrates that most patients with degenerative back pain do not benefit from surgery. However, the clinical practice guidelines in most advanced countries state that pain resulting from nerve compression does tend to improve after surgery. Our multidisciplinary team offers non-surgical treatment to patients who do not require surgery, and surgical treatment to those who can benefit from it.
Approximately 80% of the adult population will experience back pain at some time in their lives. In 90% of cases, the pain can be relieved without resorting to surgical treatment.
Where surgery is recommended, a detailed preoperative assessment must be conducted. The surgery must be performed by an experienced surgical team, which maximises the likelihood of achieving good end results.
Poor patient selection and surgical techniques that do not adhere closely to the medical evidence are unlikely to achieve the expected results. At the Quirón Spine Unit, we attach great importance to the strict selection of patients and treatments, to prevent unnecessary surgery or follow-up surgery.
When the pain is due to nerve compression (brachialgia, sciatica), it is usually felt in the limbs. If conservative treatment fails in these cases, and once all the non-surgical treatment alternatives have been exhausted, surgery generally gives very good results.
Decompression of the nerve immediately relieves the discomfort. Decompression uses micro-surgical techniques and may sometimes require the use of spinal instrumentation (bars and screws).
The stricter the selection of patients for surgery, the better the results.
WHEN SHOULD YOU OPERATE ON A PATIENT WITH SCOLIOSIS?
The aim of scoliosis surgery is to prevent progression and correct the deformity in the torso.
Scoliosis can appear at all ages, but it is most common in teenagers and older adults.
Scoliosis surgery may occasionally be recommended for aesthetic reasons, if the deformity alters the patient’s self-perception, self-esteem and body image.
In adults, scoliosis often causes back pain. In carefully selected cases, surgery has been proven to improve pain.
WHAT IS SLIPPED DISC SURGERY?
There are several techniques to treat slipped discs, but the most effective is discectomy. Discectomy consists of making a small incision in the back, accessing the spine, and disengaging the nerve that is being compressed and removing the piece of herniated disc, without breaking or removing the vertebral bone. If this surgery is carried out on suitable patients, i.e., those who are suffering from nerve compression and who have tried all the conservative treatments, we know that this surgery gives good results in 95% of patients.
POSTOPERATIVE FOLLOW-UP FOR SLIPPED DISC SURGERY
The postoperative period in slipped disc surgery is normally very simple and does not usually involve any complications. After surgery, the patient usually remains in bed for a few hours, and the next day they can stand up and walk. In some cases, hospital discharge may be considered a few hours after surgery, and all patients who have undergone surgery tend to have returned home after 2 or 3 days.
Once at home, patients are advised to live as active a life as possible.
With regards to a return to work, this will depend on the type of work the patient does. If they have a sedentary job, they could return to work in a couple of weeks, otherwise, after 6-8 weeks.
WHEN SHOULD YOU OPERATE ON A PATIENT WITH A VERTEBRAL FRACTURE?
The majority of vertebral fractures can be treated without surgery, but
it is advisable to operate on fractures that involve spinal cord compression and those that cause a significant spinal deformity. The aim of surgery would be to decompress the spinal cord or fix the fractured vertebrae to prevent spinal deformity.
The surgery can use minimally invasive techniques, by injecting a bone cement (PMMA) in carefully selected patients.
WHEN SHOULD YOU OPERATE ON A PATIENT WITH A SPINAL TUMOUR?
The purpose of vertebral tumour surgery is to excise (remove) the tumour, stabilise the spine and decompress the spinal cord.
The decision as to whether to opt for surgery should be made on a multidisciplinary level, after detailed discussion of the case with other specialists (oncologists, therapeutic radiographers). The Quirónsalud Hospital in Barcelona has one of the best Medical Oncology Departments.
MINIMALLY INVASIVE SPINAL SURGERY
This usually gives the same results as traditional techniques, but with more advantages.
Spinal surgery?
You can benefit from the experience we have accumulated over more than 18 years devoted especially to complex spinal operations, with 100-150 cases of complex surgery a year, including scoliosis, tumours, reconstructive surgery and revision surgery.
