My Spine - Lumbar
There are generally only two indications for an operation . The first is ongoing disabling back pain that is not relieved by any conservative measure and a definite loss of quality of life . The second indication is impending permanent nerve damage . This is usually indicated by sciatica ( radicular pain ) or dysfunction of the nerves that supply the bladder and the bowel as well as sexual function ( see the chapter Back Pain ). The sacral nerves supply the outonomic ( automatic ) function of bowel , bladder and sexual function and can be compressed if the listhesis is severe .
The first part of the operation is a decompressive laminectomy to free the nerves and this is supplemented by a pedicular screw spinal fusion . This is necessary because the spine is even further destabilised by doing the laminectomy . Please see the relevant chapters for a description and explanation of these operative procedures .
Does this treatment have any complications ?
The only complication of conservative therapy is the fact that it might be unsuccessful and therefore not prevent a spinal operation . It should , however , in the absence of impending permanent nerve damage , be the first line of treatment . See the chapter Your Back Operation for the list of potential complications of spinal surgery .
What are the long-term expectations ?
For Grade I and II spondylolisthesis conservative therapy can be successful in up to 80 % of cases . Surgical treatment can be successful in up to 90 % of people . There has to be an ongoing commitment from the patient to strengthen their back and to apply good back habits for the rest of their lives ( see the chapter Everyday Life ).
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