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Since I was 18 years old, I have had a sore back, but nothing more than most of us are bound to suffer from time to time. I’m 60 now. However, in the last 10 years or so, the pain in my lower back had increased to such a level that I found it all very intrusive and debilitating. Sometimes I even lost control of my legs, and twice actually fell over. I could hardly walk for more than 100 metres and was continually bending and twisting to try and undo the compression I felt. I had always been uncomfortable taking painkillers (just the normal over the counter stuff), but eventually had to go to my GP. He examined me, organised an x-ray, and, from the results of that, arranged for me to have an MRI scan. The scan showed quite clearly that two of my vertebrae (lumber 3 and 4 I think) were slipping forward, causing my spinal canal to be restricted. Of course, since the spinal canal carries all of the nervous system, it followed that my nerves were being pinched at this point, and it was for this reason that the pain and loss of control were evident. I was admitted to Edinburgh’s Western General Hospital on a Wednesday in August last year, had the operation on Thursday and was discharged on Friday. Six weeks later, I was playing golf, and never once did I feel the old pain from which I had suffered so long. Apparently there are now two ways to perform a laminectomy. The old way, where there is much cutting of bone followed by stainless steel being screwed into place to align the vertebrae correctly, or the new way where a tube is inserted into the canal, supported by adjacent vertebrae. The old operation has a three to four month recuperation period, the new style op, half of that. Please don’t quote me on the methods described above, this is only my most basic understanding of procedures. I think I was the third person to have the new style surgery in Edinburgh, and my experience seems to be similar to the others. My consultant was enthusiastic from the start and, so far, I could not be more delighted with the result. I would urge anyone suffering from back pain not to simply accept it and stagger through life bearing it nobly, but to do something about it as I did, even although I should have sought help 10 years earlier. Don’t forget….it’s never too late. Response Alan Gardner FRCS, Consultant Spinal Surgeon. Delighted that Mr Nobbs has had such a satisfactory result from his spinal surgery. While the principles of spinal surgery, namely relieving nerve compression and stabilising painful motion segments (discs and joints), remain unchanged, the means of achieving these ends have developed substantially over the last decade or two, becoming much more patient-friendly. Evidently Mr Nobbs's problem was one of longstanding and increasing nerve compression in the low back, a well-known condition called spinal stenosis (Greek = narrowing). Characteristically the sufferer can only walk a certain distance before the legs start to pack up (known as claudication, the Roman emperor Claudius had a limp), although leaning forward on a supermarket trolley often helps. This condition, easily identified on MRI scanning, is relieved by removing the compressing bone and soft tissue either at open operation, laminectomy, or, if suitable, by a so-called 'minimal intervention' technique in which the surgeon, after appropriate training and practice, is able to remove the compressing tissues with instruments through a narrow tube guided by a fine telescope. This causes much less damage to surrounding tissues resulting in rapid recovery. The main downside of this type of surgery is that it requires expensive and specialised equipment and takes, depending on the surgeon, considerably longer anaesthetic and operating time. | ||
