Spinal surgery is a complex procedure. It is often done for the treatment of pain which can exist in a multitude of forms such as primary axial pain, radicular pain and stenosis or claudication. Revision surgery becomes necessary when pain continues to persist or recurs after a period of time. It can be due to a variety of reasons such as pseudoarthrosis (failure to achieve an adequate fusion), recurrent disc herniation or stenosis, scar tissue formation, or adjacent level disease / breakdown.
What are typical symptoms?
Symptoms can vary from pain, weakness, numbness, tingling or - in severe cases - paralysis. An adequate evaluation consists of thorough evaluation often requiring a combination of MRI, CT and Xrays. Additional testing may include a myelogram, nerve testing such as EMG or nerve conduction testing.
What treatments options are there?
Treatment forms consist of a combination of conservative and surgical options. Conservative options include physical therapy, injections, accupuncutre, chiropractic treatments, aquatherapy. Surgical options may include re-exploration, fusion or lateral transpsoas approach for adjacent segment fusion.
Lateral Transpsoas Approach
This approach involves approaching the adjacent segment to the previous fusion through a lateral retroperitoneal approach. This avoids the risks and potential difficulties in manipulating and dissecting the previous scarred surgical area. This results in reduced blood loss, shorter hospital stays, and faster recoveries.
Revision surgery is a complex entity and the management involves individualized evaluation and treatment plans. A number or factors will help determine the optimal treatment paradigm. Our team of neurosurgeons can aid in navigating among the options and provide a treatment plan tailored to you.