Spine Structure
Much of the spine’s strength comes from its structure. When viewed from the side, the spine should curve in a gentle S shape. When viewed from the front and back, it should look like a straight line. This construction is optimal for distributing weight evenly, enabling flexible mobility, and ensuring internal organs have sufficient space to function.
What Is a Spinal Deformity?
Spinal deformities are conditions that alter the shape of the spine. They can occur for several reasons, including birth defects, poor posture, wear and tear, or a poorly healed injury or surgery. The types of deformities are categorized by their shape:
- Scoliosis: The spine curves abnormally to one or both sides
- Kyphosis: Part of the spine features a more exaggerated front-to-back curve than normal.
- Lordosis: Part of the spine features a shallower front-to-back curve than normal.
- Flat back syndrome: The curve in the lumbar spine flattens almost completely.
If the spine loses its original shape, it cannot function as well as it should. Spinal deformities impact weight distribution, mobility, and even organ function, potentially leading to severe lifestyle limitations. These complications do not improve with time. Medical treatment is the only way to correct any kind of spinal deformity, allowing for a higher quality of life.
How Spinal Deformities Affect the Body
Most spinal deformities are mild. These conditions cause almost no symptoms, and it is possible for patients to go for years before realizing they have a deformity at all. Severe conditions, however, may cause a range of symptoms that make everyday life difficult. The specific symptoms depend on the type and location of the deformity, but may include:
- Neck, chest, or back pain
- Visible changes in posture
- Radiating nerve pain, tingling, or numbness
- Muscle weakness in the core, arms, or legs
- Loss of control in the arms or legs
- Persistent or recurring muscle fatigue
- Difficulty standing upright
- An inability to turn, twist, or bend
- Breathing problems
- Sexual dysfunction or impotence
- Loss of bowel or bladder control
- Body insecurities
Most spine deformity symptoms develop during childhood, though some may appear later in life. Once symptoms begin, they are likely to get worse. Body deformities are progressive diseases, meaning that they become more severe over time. Deformities that start mild may become increasingly severe, with new symptoms to manage and a heavier impact on a person’s life.
What Is Complex Spinal Reconstruction?
Complex spinal reconstruction is the surgical approach to treating severe misalignments in the spine. It is a complicated operation involving a combination of several procedure types, primarily spinal fusion, that impacts at least six of the patient’s vertebrae. There are multiple types of reconstruction, differentiated by which part of the spine is operated on:
- Cervical spinal reconstruction: This treats deformities in the cervical spine, or neck.
- Thoracic spinal reconstruction: This treats deformities in the thoracic spine, or the upper back.
- Lumbar spinal reconstruction: This treats deformities in the lumbar spine, or lower back.
Most reconstructive surgeries are performed to correct spinal deformities. The technique may be used to treat other conditions as well, however. Other conditions that may require complex spinal reconstruction include:
- Failed back syndrome
- Degenerative disc disease
- Degenerative joint disease
- Spondylosis (arthritis)
- Serious spine injuries
If a patient struggles with persistent pain, mobility problems, fatigue, or other complications caused by the above conditions, then they should speak with their physician about surgery. Spinal reconstruction may help them get back to a normal, pain-free lifestyle.
What Are the Alternatives to Complex Spine Reconstruction Surgery?
If a spinal deformity does not cause symptoms, then treatment may not be necessary. Minor symptoms can be managed with non-surgical interventions to help patients avoid the stress and long recovery of surgery. Pain management methods for spinal deformities can include:
- Taking pain medications
- Getting steroid injections
- Making activity modifications
- Doing physical therapy
- Wearing a back brace
However, these treatments cannot correct the deformity itself. With the cause of the pain still unaddressed, patients require constant symptom management to maintain the same level of mobility. Becomes less effective over time. Because spinal deformities are progressive, formerly helpful treatments will eventually stop providing relief.
Surgery is the only permanent solution for spinal deformities. This treatment approach addresses pain and other symptoms at their source, directly and fully eliminating the cause. After surgery, patients no longer rely on medications and external support to maintain a fulfilling lifestyle.
When to See a Doctor About Spine Reconstruction
Deciding when to pursue surgery is a personal decision that may be affected by a variety of factors, including the severity of current symptoms, the patient’s overall physical condition, their finances, and whether other treatments have been attempted. When complex spine reconstruction is needed, however, the signs are usually clear. Patients should reach out to a healthcare professional if they:
- Are experiencing symptoms of scoliosis or another spine deformity
- Have a deformity with a curvature of 50 degrees or higher
- Have a known deformity that is causing new symptoms
- Experience symptoms that are interfering with everyday movements and activities
- Have tried conservative treatments that are not working
- Have sustained a serious spine injury
If the patient needs treatment but is not sure about surgery, then they should ask for medical advice. Their doctor can help them come to the right decision.
Diagnosing Spinal Deformities
Complex spine reconstruction is not a standardized procedure. Instead, it is highly personalized to meet the unique needs of each individual patient. To plan an effective treatment, surgeons must first form a full understanding of the condition. They do this with a series of diagnostic tests, including:
- Physical examination: The doctor examines the patient’s body and tests their flexibility. Patients may be asked to stand up straight or bend forward to measure asymmetry.
- Medical history: By reviewing the patient’s medical history, doctors learn more about their overall health and other conditions that may influence their choice of treatment.
- Medical imaging: A computed tomography (CT) or magnetic resonance imaging (MRI) scan is used to examine internal structures and create a picture of the deformity.
These tests are used to diagnose a spinal deformity and determine its location and severity. It may also identify any co-occurring conditions, such as slipped spinal discs or spinal cord compression, that may affect treatment.
How Is Complex Spine Reconstruction Performed?
After completing the diagnosis, the spine surgeon will have a clear understanding of the patient’s unique condition. The surgeon uses this to design a fully personalized operation to correct the deformity. This operation combines multiple different surgical approaches, which may include:
- Laminectomy: A laminectomy involves removing all or most of the lamina, or the back section of the vertebra. This creates space around the spinal cord to relieve compression.
- Foraminotomy: A foraminotomy involves removing bone material from around the foramen, a narrow opening that allows root nerves to branch off from the spinal cord.
- Corpectomy: A corpectomy involves removing the main body of a vertebra to decompress the spinal cord. A spacer cage is inserted into the gap to take the vertebrae’s place.
- Osteotomy: An osteotomy involves cutting or reshaping bone to create a “wedge” that realigns the vertebral stack, helping to correct the curve and reduce stress on cartilage.
- Discectomy: A discectomy involves removing one or more spinal discs. These pads of tissue help to absorb shock, but they may not function correctly in a deformed spine.
- Disc replacement: If the vertebrae on either side of a removed disc are stable and correctly positioned, the surgeon may replace the disc with a medical-grade rubber implant.
- Lumbar spinal fusion: If the vertebrae are not stable or correctly placed, the surgeon will use implants and bone graft material to fuse them into a single solid bone.
Complex spine reconstruction makes heavy use of implants and bone grafts. The grafts may be taken from the patient’s own body, such as a rib, or from a donor bank. Because spinal reconstruction is so extensive, it is important for patients to seek a physician who is qualified for the job. Not every spine surgeon has experience with this type of operation. By working with a surgeon who specializes in complex procedures, like Dr. Branko Skovrlj at NU-Spine, patients gain the most benefit from their treatment while minimizing the risk of complications.
Recovering From Complex Spinal Reconstruction
Spinal reconstruction is an extensive procedure. Patients can expect to spend several hours under anesthesia while the surgeon is at work. Afterward, they should plan for a multiple-day hospital stay. During this time, they will begin recovery under close observation by trained nurses and medical staff. This helps ensure that there are no immediate complications following surgery.
Patients are cleared to leave the hospital as soon as the surgeon decides it is safe to recover at home. The surgeon will provide guidance that patients should follow to ensure they heal successfully. The instructions will cover topics such as:
- Keeping surgery sites clean and protected with dressings
- Bathing before the incision is fully healed
- Walking a little bit every day to encourage blood flow
- Wearing a back brace to immobilize the spine while it heals
- Taking prescribed medications to reduce pain and inflammation
- Transitioning to over-the-counter (OTC) medications
- Taking a full round of antibiotics to prevent infection
- Participating in a physical therapy program to regain full mobility
The length of recovery depends on a variety of factors, including the patient’s age, their overall health, how extensive their reconstruction surgery was, and how well they follow recovery instructions. Their surgeon will help them know what to expect. Most individuals can resume normal activities within three to six months, though spinal fusions can take over a year to completely solidify. Patients will need to avoid heavy lifting until their spine is fully stable.
Are There Complications of Complex Spinal Reconstruction?
Spinal reconstruction is a well-established treatment. It has proven results with high rates of satisfaction and low risk of failure. As with any surgery, however, there is a small chance of complications. Rare problems that may arise with complex spinal reconstruction include:
- Infection
- Excessive bleeding
- Blood clots
- Nerve damage
- Limited mobility
Following recovery instructions is key to preventing complications. So long as patients work with an experienced surgeon and make sure to follow all guidance for healing safely, they should have nothing to worry about with their spinal reconstruction surgery.
Choosing the Right Spinal Reconstruction Doctor
As with any spine surgery, choosing the right doctor is key to achieving the best results. Surgeries at NU-Spine are performed by our lead neurosurgeon, Branko Skovrlj, MD. Dr. Skovrlj is a world-renowned spine surgeon who has received multiple awards for the quality of care he provides. He is also one of the only board-certified neurosurgeons in New Jersey to focus solely on spine treatments. He has expertise in all areas of the spine but specializes in performing complex procedures like reconstruction.
Though Dr. Skovrlj is recognized around the globe, he is down to Earth. He treats patients with compassion, taking the effort to get to know each person as an individual rather than a diagnosis. This approach helps patients feel confident in the care he delivers. They find Dr. Skovrlj approachable, making it easy to open up about difficult topics like spine deformity.
Find Expert Spine Care Near You in New Jersey
Though spinal deformities may seem inescapable, a pain-free future exists. Patients can transform their lives with a touch of care at NU-Spine: The Minimally Invasive Spine Surgery Institute. We provide cutting-edge spine treatments at multiple locations near you in New Jersey, helping patients live without pain. Contact us to learn more about complex spinal reconstruction or to schedule a consultation.