What Are the Surgical Options for MS? Is Surgery Even Safe?

Experts don’t understand what causes MS. Some research has looked at genetics, infections, and even head trauma. Some researchers think that prior surgery may be associated with the possibility of developing MS.

One study found that people who had a tonsillectomy or appendectomy before they were 20 years old were more likely to develop MS. The increase in risk was small but statistically significant. The researchers called for larger studies to look at the possible connection between these two events and MS.

MS is a relapsing-remitting condition. That means it may cause periods of few symptoms and low impact followed by increased activity and greater problems. The times when symptoms increase are called flares.

Each person has different triggers for flares. Some events, conditions, or substances can increase flare-up risk. Avoiding these can help you manage MS symptoms.

Trauma and infection are two possible causes of MS flares. This makes surgery seem like a tricky proposition for people living with MS. However, the National Multiple Sclerosis Society says that the risks of general anesthesia and local anesthesia for people with MS are about the same as for people without the condition.

There’s one exception. Those with advanced MS and a severe level of disease-related disability may be at a greater risk for complications. Recovery may be harder and they may be more likely to develop respiratory-related problems.

If you’re considering surgery for MS-related treatment or other conditions and you have MS, you shouldn’t have problems. However, talk with your doctor. You’ll want to make sure you have a plan in place to avoid infection.

A fever can cause a flare. Likewise, being confined to a hospital bed after surgery may lead to muscle weakness. That can make recovery more difficult. Your doctor may request that you work with a physical therapist during your time in the hospital.

With these cautions in mind, it’s safe to have surgery if you have MS.

While there’s no cure for MS, some surgeries can ease symptoms and improve quality of life.

Deep brain stimulation

Deep brain stimulation is a procedure used to treat severe tremor in people with MS.

During this procedure, a surgeon places an electrode in your thalamus. This is the part of your brain responsible for these issues. The electrodes are connected to a pacemaker-like device by wires. This device is implanted on your chest under the skin. It passes electrical shocks into your brain tissue surrounding the electrodes.

The electrical shocks render this part of your brain inactive. This can help decrease or stop tremors entirely. The level of electrical shock can be adjusted to be stronger or less intense, depending on your reaction. You can also turn the device off entirely if you begin a type of treatment that may interfere with the stimulation.

Opening blood flow

An Italian doctor, Paolo Zamboni, used balloon angioplasty to open up blockages in the brains of people with MS.

During his research, Zamboni found that more than 90 percent of patients he saw with MS had a blockage or malformation in the veins that drain blood from the brain. He speculated that this blockage was causing a backup of blood, leading to a high level of iron in the brain. If he could open those blockages, he believed he might be able to relieve symptoms of the condition, possibly even cure it.

He performed this surgery on 65 people with MS. Two years after the surgery, Zamboni reported that 73 percent of participants had experienced no symptoms.

However, a small from the University of Buffalo couldn’t replicate Zamboni’s findings. Researchers in that study concluded that while the procedure is safe, it doesn’t improve outcomes. There was no positive impact on symptoms, brain lesions, or quality of life.

Likewise, a follow-up study with Zamboni in Canada found no difference after 12 months between people who had the blood flow procedure and people who didn’t.

Intrathecal baclofen pump therapy

Baclofen is a medication that works on the brain to decrease spasticity. This is a condition that causes muscles to be in an almost constant state of contracture or flex. The medication can decrease the signals from the brain that tell the muscles to engage.

However, oral forms of baclofen can cause some significant side effects, including headache, nausea, and sleepiness. If it’s injected near the spinal cord, people with MS have better results, require lower doses, and see fewer side effects.

For this surgery, a doctor will implant a pump near the spinal cord. This pump is programmed to deliver the medication on a regular basis. For most people, the surgery is easily managed. Some people may experience soreness around the incision site. The pump will need to be refilled every few months.

Rhizotomy

One severe complication or symptom of MS is intense nerve pain. It’s a consequence of the damage to the nerves in the body. Trigeminal neuralgia is neuropathic pain that affects the face and head. Mild stimulation, such as washing your face or brushing your teeth, may be very painful if you have this type of nerve pain.

Rhizotomy is a procedure to cut away the portion of the spinal nerve that causes this severe pain. This surgery provides lasting relief but it’ll also make your face numb.

If you have MS, talk with your doctor about your treatment options, including surgery. Some surgeries for MS are still in the clinical trial phase, but you may be a candidate.

Likewise, if you’re considering an elective surgery and find out you need one for another reason, work with your doctor to make sure you recover well from the procedure.

While surgery is as safe for people with MS as it is for people who don’t have the condition, some aspects of recovery are more important to people with MS. That includes watching for signs of infection and getting physical therapy to prevent muscle weakness.