Could Back Surgery Without Anesthetic Save Lives

Millions of Americans suffer from chronic back pain every single year. In fact reports in the British Medical Journal (BMJ)  suggest that almost 80% of people will suffer from back pain at some point in their life and somewhere between one third and two-thirds of the population suffer from chronic back pain. A significant proportion of back pain is the result of herniated discs in the spinal cord. Many people require surgery for this. But emerging research reported by MedScape.com last month suggests that new techniques could provide better outcomes for patients undergoing back surgery.

What is a herniated disc?

In between these bones are the intervertebral discs, effectively the cushions that stop the bones from bashing into each other. They are made up of cartilage and contain two important parts. The internal cartilage is known as the nucleus pulposus. This is surrounded by a tougher outer layer known as the annulus fibrosus. When the nucleus pulposus bulges out of a weak area of the tougher outer layer it is known as a herniated disc. This bulge can press on nerves in the area which think they are being activated by pain in the body and shoot messages up the brain saying that there is damage somewhere in the body.

What are the symptoms of a herniated disc?

Patients suffer a number of symptoms including:

• Back pain
• Buttock pain
• Neck pain
• Shooting or tingling pains
• Weakness in limbs

How is it treated?

This can sometimes be managed conservatively with a family doctor, although many will need injections and go to specialist spine clinics to find pain relief. If this does not work, available treatment options include a discectomy a surgery where the surgeon removes parts of all of the disc to stop it bulging and compressing the nerves.

Could back surgery without anesthetic save lives?

In most discectomies, the surgeon places the patient under a general anesthetic. If you’ve ever had an operation you will know that general anesthetic completely knocks the patient out, meaning they can’t feel a thing. However, A new study presented at the Anesthesiology 2017 conference of the American Society of Anaesthesiologists suggests this might not be the best option. They suggest that spinal anesthesia could provide better outcomes. Spinal anesthesia is where the spinal cord is bathed in local anesthetic via an injection, allowing the patient to have pain relief by without completely knocking them out cold. The results seem to be better. The surgeons report that patients who had spinal anesthesia had significantly less postoperative pain than those with a general anesthetic. They also find that patients who had spinal anesthesia spent less time in the operating room and seemed to recover faster. This could be big news for sports stars or active people who don’t want lengthy recovery times.  Whether this translates to lives saved is still to be seen – but the results are positive.