Usually, these operations are chosen by the doctor when conservative treatment does not bring relief of symptoms, such as pain or restoration of normal daily functionality, and are performed by a specialized spine surgeon.

They require great precision and specialized techniques, while they are applied to simpler diseases such as disc herniation, or more complex problems, such as spinal deformities (scoliosis or kyphosis), slipped vertebrae, spinal canal narrowing and many others, especially when there is instability of the spine, or pressure on neurological structures, spinal cord or roots.

Why should I not fear surgery on my spine?

“The decision to have a patient undergo spinal surgery must be based on clear scientific data to ensure its appropriateness and effectiveness. For this reason, the assessment of patients must be complete, done with care and take into account, after appropriate medical examinations, the functional needs of each patient, in combination with their medical history, in order to confirm that they can proceed in surgical treatment of his problem”, points out Mr. Panagiotis Zoumboulis Director of Spinal Deformities Clinic at Metropolitan Hospital and continues:

“We must of course mention that advances in surgical techniques, including minimally invasive methods where they are indicated, such as endoscopic techniques, have improved outcomes and reduced recovery times for many patients.

However, spinal operations are still treated with fear and caution, as they remain complex, requiring detailed preoperative assessments, precision in execution, and careful postoperative care. But despite the challenges, the truth is that they have changed the lives of many people, offering pain relief and restoring mobility, but also allowing them to continue their daily activities with an increased quality of life.

The use of powerful tools and implants in recent years has made it possible to correct major spinal deformities. In the area of ​​spinal surgery safety, intraoperative monitoring of nerve and spinal cord function (neuromonitoring) has been an important milestone. Especially in operations to correct deformities, it has contributed significantly to the prevention of neurological complications and to achieving better results with increased safety.”

What are the common spine procedures?

• Discectomy: Removal of the piece of disc that is pressing on a nerve.
• Decompression: Removal of bony or ligamentous elements, which press on neural structures. Depending on the type of decompression, a petalectomy, foramectomy, arthrectomy, with or without bone fixation may be performed.
• Vertebral ligation: Surgical technique aimed at stabilizing two or more vertebrae. “When we aim for the final complete synossification of the vertebrae, we speak of bony fusion, while when we materially stabilize two vertebrae, but allow movement between them, we speak of dynamic fusion. While there is also the combination of these techniques, so we refer to hybrid spinal fusion”, explains Mr. Zoumboulis.
• Kyphoplasty/Spondoplasty: This is a minimally invasive technique of injecting an acrylic material, called bone cement, into a vertebral body. The goal is stabilization by treating pain and restoring the morphology of the vertebra. It is mainly used in vertebral fractures caused by mechanical failure, i.e. osteoporotic fractures, or fractures caused by spinal metastases.

What are the most common causes for which surgery may be needed?

• Degenerative diseases of the spine: This is the most common reason for surgery on the spine. It refers to diseases caused by wear and tear of the spine, such as disc herniation, spinal stenosis, arthropathy, spondylolisthesis, etc.
• Trauma: Related to spinal fractures, such as after car accidents or falls, which often require surgical repair.
• Tumors of the spine and spinal cord: Benign or less commonly malignant tumors can occur in the spine and spinal cord, which may press on the spinal cord and nerves within the spinal canal. Also, the bones of the spine are a relatively frequent focus of metastatic tumors, such as those originating from breast or prostate cancer.

Conservative or surgical treatment: Which is better for the patient?

In non-urgent spine procedures, it is usually best to start a series of conservative methods first, such as medication, physical therapy, and rest. There is no specific duration for the application of this conservative treatment, as it depends on the severity of the symptoms, but it is usually recommended for a period of at least 6 to 12 weeks. In the event, however, that, despite conservative treatment, the symptoms still persist and affect daily functionality and quality of life, then the possibility of surgery can be considered.

What should I prefer? Open or minimally invasive techniques?

In the past, spine surgery usually required large incisions and a long recovery period as it was performed through an open procedure. Such operations are still necessary today and face a wide range of problems, particularly in significant spinal deformities.

“Modern technology, however, now allows us to use minimally invasive techniques, where they have a medical indication to be used. These techniques do not involve large incisions and avoid damage to the muscles and tissues surrounding the spine. This results in less post-operative pain and faster recovery,” he says.

Is there a robotic treatment of spinal diseases?

Spine surgery using robotic navigation represents a modern and promising approach, which has been developed and applied in recent years, following the progress in robotic hip and knee surgery. Spine surgery is gaining more and more recognition in the medical field, having already been applied to a number of adults and children, providing advantages for both patients and doctors who choose it.

“The main benefit is the better preoperative planning, the greater precision in the placement of the medical materials and therefore the reduction of chances of surgical complications related to them, as well as the more complete intraoperative assessment of the final result of the surgery. However, we must not forget that it is not operated by a robot, but by people, specialized surgeons, who plan, implement and evaluate the final result, collecting and utilizing every valuable help from modern technology” he notes.

What are the advantages of this method?

“Robotic navigation in spine surgery can ensure speed and accuracy in implant placement and therefore reduce the overall operation time. In addition, it reduces the risk of neurological complications, significantly reduces blood loss and also reduces the stress of the patient, as well as the doctor, both during and after the operation. These reflect in a shorter duration of hospitalization in the hospital and ultimately a faster recovery”, concludes Mr. Zoumboulis.

*In Metropolitan Hospital operates one of the most modern Orthopedic departments in the country, fully equipped with all modern technological means, but above all, fully staffed by a multitude of experienced specialized surgeons, who deal with the entire range of orthopedics.