Some Thoughts on Back Surgery

Yesterday I had the opportunity to see a spine surgery up close and personal. The procedure is known as a spinal fusion, and is the final stop up the totem pole when it comes to treating lumbar instability. I am very grateful to the surgeon who let me in his OR--he was quite gracious the entire time, and introduced me to the OR staff as a new chiropractor in town who wants to see what goes on in a surgical setting in order to better serve my patients, which is true. All the OR staff seemed interested in the fact that I was invested enough to come and observe, and several asked me questions about what I do. Nobody acted like I had nine heads when the word "chiropractor" was used to describe me, either. A good sign.

I met this surgeon years ago, and he made the offer way back then to see a surgery if I ever wanted. I had to use Facebook to track him down, but when I finally got in touch with him he was still just as willing to let me in his world for an afternoon. We met at the hospital and he led me through the maze of behind the scenes hallways and rooms to the OR. Before that, I should mention, was a trip through the surgeon's suite, complete with drinks and buffet style food set up all for free. Free!

Just outside the OR was the "scrub in" area. We talked about his first day to ever go through the procedure, which is radically different now with all the germ killing disinfectants made for these situations. Then we went in. There, all laid out in a very organized way, were all the tools and accoutrements needed to fuse someone's lumbar spine together. It was an impressive display that took up two tables to hold it all. There was also a full time tool-getter handing off one thing and cleaning the blood and bone chips off the other.

The only word that describes the procedure itself is a word that I think is largely overused, and consequently a word I tend to avoid: surreal.

There was Christmas music, which was changed to classic rock being piped into the OR as the incision was made that revealed someone's spine. There were some rather gruesome sounds coming from the procedure itself--the muscles and soft tissue attached to the spine have to be moved out of the way to insert hardware, and there's no amount of onomatopoeia in my power to type out what that sounds like. There was also a great deal of hammering with a chisel to get the hardware inserted and aligned. Hearing Steve Miller playing Rock' N' Me while that hammering was going on may just stick in my mind forever.

To be sure the hardware was lined up in all the necessary angles and orientations, a fluoroscope was brought in. A fluoroscope is an x-ray unit that runs continuously to see things in motion. I should mention that the surgeon nailed it on the first try.

Just before closing I was invited to take a look at table side, so after even more sterilization procedures I got a look at everything from inches away. With Jefferson Airplane's White Rabbit in the background, I got an intimate view of the amazing anatomy underneath our skin: The lumbar spine that had failed this patient to the point where this entire process was necessary, the muscles around it and the sacrum below it. Although it appears that the lumbar spine is fairly close to the surface, it's actually buried farther down than you might think. This patient was petite, and her spine was about six inches deep.

The take home points for me were these:
1. The stability of the lumbar spine is important. Doing core work shouldn't be considered a fad, it should be considered a necessary component to having a healthy spine. Look for some core stability posts soon.
2. Spine surgery is hard work. The good doctor had to use some muscle several times during the procedure. He was also exceptionally focused. He has his share of back problems himself, and has even had a fusion, so he could definitely sympathize with the patient.
3.Classic rock is superior to seasonal holiday music for surgical interventions.