Tiger Woods will undergo his sixth back surgery in 2024. How does that happen?

Tiger Woods underwent six separate spinal surgeries 2004 to 2024. He is a professional athlete who performs at peak physical performance. How is that possible? In my spinal deformities practice, I have performed operations on patients with between one and nineteen previous operations by other surgeons. Why would anyone – especially a healthy athlete – need so many procedures?

First, the spine is complex. Anatomy is critical. The spine is actually made up of 33 bones stacked on top of each other by joints and cushioned by a soft shock absorber called the intervertebral disc. Together, this serves as a suspension bridge that protects the spinal cord while carrying nerve messages from the brain to the rest of the body. Over the years, just like with the suspension bridge, parts of the spine can wear out.

It is possible for a problem to be solved at one level and for a new problem to develop at another level. It is also possible that a patient may require another operation at the same level as the previous operation.

One of the most common spine surgeries is a discectomy. Woods has undergone this surgery several times. The surgeon removes a small part of the disc, or shock absorber, which has squirted out and is pressing on a nerve and causing pain. It’s like the jelly coming out of a donut, except it’s human tissue, and the human jelly pushes crucial nerve fibers into motion. When a surgeon performs this surgery, he or she does not remove the entire disc. He or she only removes the sprayed-out part. The chance that the intervertebral disc will herniate again is high 5%and it usually happens in the first six weeks before the scar tissue has a chance to form. That’s why we often tell our patients to avoid BLT (bending, lifting, and twisting) immediately after surgery.

Another common spinal surgery is a merger A surgery in which a doctor places various types of instruments, such as rods, screws, plates, or cages, so that the bone can heal together at one or more levels of the spine. This is a more intensive operation with specific indications. Woods had it performed in 2017.

The challenge with a fusion is ensuring that the bone heals. If this is not the case, it is called a pseudoarthrosis, which causes pain. The idea of ​​the instruments in spine surgery is to provide an internal foundation for the bone to grow or heal. If the bone does not grow around the instrumentation, it will eventually move, break, or cause pain. This may result in the need for further surgery.

It is important to realize that any type of spine surgery, especially fusion surgery, changes the biomechanics of the spine. Fusion surgery changes the way forces are distributed to the levels above and below because certain parts become stiffer. This adjacent segment disease, or problems at the level above or below another operation, can occur in up to 20% of patients for 10 years. That doesn’t mean every patient needs surgery, but it is always a consideration.

The final and most difficult part for the surgeon is correct spinal alignment or overall position. We want our patients to stand upright. The spinal bones are not connected in a simple straight line, but rather in a complex collection of the right amount of forward (kyphosis) and backward (lordosis) swing, a large majority of which depends on the connection of the vertebral column to the vertebral column . beaks.

Spine surgeons painstakingly measure angles in the spine, as well as in the hips, pelvis and even the knees, to get the body’s alignment correct. In fact, the vast majority of today’s spine surgery research And product development address the issue of correct patient alignment. If the patient has gross malalignment, yes miserable. They cannot stand upright. But if the alignment is even slightly off, the patient is at significant risk for re-operation due to biomechanical stress. A leading one article in the news Neurosurgery illustrated this in 2017. If a surgeon properly aligns the spine, the chance that the patient will need another operation is 6%. If the surgeon can’t get within a 10 degree angle to be correct, that number jumps to 75%.

I am obviously not aware of the immediate nuances of Woods’ cases. But it’s critical to understand that spine surgery comes on a spectrum. It is always a serious operation, but the results can be incredible. Spine surgery dramatically helps people live normal and functional lives. Bos won The Masters in 2019 after its merger. American hero Astronaut Michael Collins underwent spinal surgery on his neck in 1968 before going to the moon on Apollo 11 in 1969.

However, it is important to realize that for most spinal pathologies, surgery is the last option. Back pain is a common problem; 40% of patients experience back pain every year and more than 13% of patients have chronic back pain that lasts longer than three months. But surgery is absolutely not necessary in all cases. The indications for surgery specifically for back pain are very limited.

So how does the average patient avoid surgery?

Take care of your body.

This starts with lifestyle adjustments. This includes weight loss, specific spinal exercises and a good diet. Anti-inflammatory diets eating little sugar or refined carbohydrates can help reduce both weight and inflammation. Weight loss means that the joints and intervertebral discs are put under less strain. Exercise helps, especially water therapy and swimming, because it reduces the axial load or weight shared on the spinal joints during movement. Stretching can improve flexibility, and core-strengthening exercises can build the muscles needed to help with posture. Be careful when looking at your phone all day as it can irritate your neck muscles and disrupt the natural alignment of your body. Try to stay in a neutral position, rather than leaning forward, while sitting at your desk. Bend your knees when lifting heavy objects. If something hurts or hurts, that’s your body’s way of telling you to reduce that activity position.

Patients should have some peace of mind. Thanks to the dedication of surgeons, researchers and patients, spine surgery has undergone tremendous improvements over the past two decades. It’s safer than ever and getting better, and these advances have led to solid life-changing results for patients of all athletic abilities.