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What is Complex Spinal Reconstruction?

Complex spinal reconstruction is a major surgical procedure to correct spine deformities and associated symptoms such as pain, numbness, and instability in your back, shoulders, arms, or legs. It is a challenging procedure and requires the utmost care and precision to obtain satisfactory results.

Complex spinal reconstruction involves spine decompression followed by stabilization of the spine using prosthetic implants such as rods, metal screws, and hooks. These are used to replace the diseased area of the spine and provide stability to your spine.

What are the Indications for Complex Spinal Reconstruction?

Complex spinal reconstruction is recommended for the following conditions:

  • Spinal stenosis
  • Degenerative disc disease
  • Spondylolisthesis (displaced disc)
  • Spine deformity such as severe:
    • Scoliosis
    • Lordosis
    • Kyphosis (curvature of the upper back)
  • Vertebral fracture
  • Spine trauma
  • Metastatic spinal tumors

Pre-Surgical Preparation for Complex Spinal Reconstruction

Before undergoing complex spinal reconstruction surgery, your doctor will perform a thorough medical examination which includes a review of your medical history, physical examination, blood tests, and other diagnostic tests.

  • Inform your doctor if you have a history of bleeding disorders or if you are on any blood thinners (anticoagulant medications), aspirin, or other medications that affect blood clotting. You may need to refrain from these medications prior to the procedure.
  • Inform your doctor about any allergies and your current medications.
  • You should not consume any solids or liquids at least 6-8 hours prior to surgery.
  • You should refrain from smoking, as tobacco affects blood circulation and increases the risk of complications.
  • Improve your fitness levels by performing regular exercise. This allows quicker post-operative recovery.

A written consent will be obtained after the procedure and the associated risks and benefits have been explained to you.

Complex Spinal Reconstruction Procedure

Complex spinal reconstruction surgery is performed under general anesthesia. A sleep-inducing medication is administered to make you unconscious so that you don’t feel pain during the procedure.

  • You are placed in supine (on your back) or prone (on your chest) position depending on the approach/technique your surgeon will adopt for your surgery.
  • Your surgeon makes one or more small cuts along the marked regions to access your spine.
  • The first step is spinal decompression. This is done to relieve the pressure off your spinal nerves while maintaining the strength and flexibility of your spine.
  • Spine decompression can be performed through any of the following approaches:
    • Laminectomy - a section of bone is removed from one of your vertebrae (spinal bones) to relieve pressure off the pinched (compressed) nerve
    • Discectomy – a section of a damaged disc is removed
  • After the bones have been removed, your surgeon aligns the remaining bones in the vertebral column correctly.
  • Then, the aligned bones are stabilized using internal fixation devices such as rods, pins, screws, or plates to hold the bones together.
  • Spinal fusion may also be performed depending on the extent of spinal damage and to increase spinal stability. If your surgeon plans to go ahead with fusion, it would typically involve joining 2 or more vertebrae together using a bone graft.
  • X-ray imaging may be done to ensure that the vertebrae are aligned correctly.
  • After the spinal column has been successfully aligned, your surgeon closes the incision using sutures or surgical staples.

Post-Surgical Care and Recovery for Complex Spinal Reconstruction

You will be required to stay in the hospital for 3-7 days depending on the area of the spine affected and your recovery.

  • Your doctor will prescribe pain medications.
  • You may also be recommended to wear a brace or cast upon discharge.
  • You will be referred to a physical therapist to help you with your daily activities and teach you spine strengthening exercises.
  • Avoid twisting your spine while getting out of bed, sitting, standing, and walking.

Complete recovery may take several months. Make sure to keep all of your follow-up consultations with your doctor so your healing progress can be monitored.

What are the Risks and Complications of Complex Spinal Reconstruction?

Complex spinal reconstruction is a major surgery. It may have the following risks and complications:

  • Failure of spinal fusion
  • Delayed healing
  • Wound infection
  • Deep vein thrombosis
  • Pulmonary embolism
  • The George Washington University
  • University of Wisconsin–Madison
  • UC San Francisco
  • Alpha Omega Alpha Honor Medical Society
  •  North American Spine Society
  • AO Spine
  • SMISS-Society for Minimally Invasive Spine Surgery
  • The Wisconsin Orthopaedic Society
  • American Academy of Orthopaedic Surgeons