Traditional outcome after
spine reconstruction surgery may be measured based on
symptomatic relief and the presence of a solid bony fusion.
Contrary to intuitive thinking though, the presence of
a solid fusion does not necessarily correlate completely
with the resolution of symptoms. Such factors as the
correct primary diagnosis as well as technical considerations
about the surgery may improve the overall results over
the short term.
Short term resolution of symptoms
though should not be the complete criteria by which
spinal reconstruction surgery is judged. Also, symptoms
may be relieved for a short period of time by adequate
fusion surgery and results may degrade over time if
the reconstruction is not performed in a way which
either recreates or corrects sagittal plane imbalance. |
A
physician trained specifically in spine surgery may be
better adapted to adhere to certain principles than his
counterpart who have either trained as a general neuro
or orthopedic surgeon. Careful handling of nerve tissue
which will ultimately reduce postoperative scarring and
reduce the chances of intraoperative tissue damage are
more likely for the individual who is well versed in
the use of micro-instruments techniques and visualization
with illumination. Most spine surgeons now agree that
the use of high powered magnification either through
a microscope or special magnifying glasses is essential
for handling tissue around the spine. The well trained
spine surgeon will also have at his disposal a complete
array of techniques which can be individualized to patients.
A surgeon which utilizes a narrow range of techniques
applied to all spine pathology should be viewed with
suspicion. Every patient presenting with a spine problem
necessitating surgery will have some unique quality which
will require adaptation of all known surgical techniques.