Surgery For Low Back Pain in Dubai
Lower back or lumbar pain is one of the most common spine problems. Back pain affects all age groups – from children to the elderly. Genetics play an important role in whether or not any given individual develops back pain, but a sedentary lifestyle and nutritional deficiencies also increase the risk.
Low back pain is defined as pain felt anywhere from the bottom of the ribcage to the buttocks. Most often, it is self-limiting, resolving within a few days or weeks, perhaps with the aid of anti-inflammatory medication or physiotherapy. Dr Sherief Elsayed also offers facet joint injections which can be useful in a certain group of patients.
Surgery for a prolapsed disc (slipped disc) causing sciatica (leg pain) is associated with very high patient satisfaction rates. Surgery for back pain is not as guaranteed however, unless there is a clear pain generator visible to the surgeon.
When is it an option?
Surgery can be considered an option for low back pain treatment in Dubai in the following cases:
- Spondylolisthesis – slippage of one vertebra over another
- Tumors – benign or malignant (cancer)
- Spinal stenosis (compression of the nerves in the lower spine)
Dr Sherief thoroughly assesses and examines his patients to determine whether they may be a candidate for lumbar surgery. Some important factors to be considered before planning spine surgery for low back pain treatment in Dubai include:
- Co-moribidities – obesity and diabetes, amongst other co-morbidities, can affect the outcome of surgery
- Osteoporosis – patients with severe osteoporosis are prone to additional complications. This group of patients may have an alternative surgical treatment or if time allows, their osteoporosis is treated first
- The patient needs to be aware of the aims and risks of the surgery, and both doctor and patient need to feel confident that surgery will offer a good outcome
What are your surgical options?
Low back pain is caused by a number of reasons. 90% of low back pain is what we call ‘non-specific’ low back pain – in other words we cannot identify the exact pain generator and surgery would not be an appropriate option.
Where there is a clear pain generator, options include:
Decompression surgery removes nerve-root compression. Broadly speaking, there are two types of decompression surgery, namely:
- Microdiscectomy – a minimally invasive surgery to remove a prolapsed disc which is causing nerve compression and sciatica. Sometimes these disc prolapses are large enough to cause weakness or loss of bladder and bowel control.
- Laminectomy – in this type of decompression surgery, more extensive amounts of bone are removed from the back of the spine, relieving pressure on the nerves of the cauda equina. This operation is typically used in patients with spinal stenosis, and may or may not include instrumentation (screws and rods) in addition to the decompression.
Fusion surgery aims to fuse two or more adjacent vertebrae into one structure. By eliminating motion at this level, back pain emanating from this level is reduced. Fusion surgery is typically undertaken for spondylolisthesis, fracture, infection, or spinal tumours.
Fusion surgery may be undertaken by way of:
- Postero-lateral fusion, with or without screws
- Transforaminal lumbar interbody fusion (TLIF) – screws, rods and a cage
- Posterior Lumbar interbody fusion (PLIF) – screws, rods and a similar type of cage to that used in TLIF surgery
- Anterior lumbar interbody fusion (ALIF) – approaching the spine from the front to remove the disc and insert a fusion cage
Fractures, due to osteoporosis or otherwise, may be treated by way of vertobroplasty. This is a minimally invasive procedure which involves Dr Sherief inserting a large needle into the vertebra and injecting a special bone cement. This immediately ‘solidifies’ the fracture and helps to reduce back pain. Vertebroplasty is also used in the treatment of some spine tumors, with or without decompression and fusion surgery.
Disc replacement surgery
In this approach, degenerate discs are replaced with an artificial disc to mimic the function of the original disc. Disc replacement is an alternative to fusion surgery in select patient groups. By maintaining a range of motion at the level of the lumbar disc replacement, it is thought the discs either side are protected.
Are there any risks involved in surgery to eliminate lower back pain?
As with every surgery, risk is present in lumbar spine surgery.
You can read more about complications of spine surgery here: