Multiple Sclerosis Surgery: Safety, Options, and Risks

Multiple sclerosis (MS) is a lifelong disease in which the immune system attacks the protective myelin sheath that surrounds healthy cells in the brain and spinal cord. Because the brain communicates with every system in the body to function, MS can have many symptoms that affect different areas of the body.

There is no cure for MS, but treatment and a long, healthy life are possible. Treatment options can include behavior and lifestyle changes, medications, and non-drug therapies such as physical therapy. In some cases, surgery may be an option.

Learn about MS, surgical treatment options, when to speak to a healthcare provider, and more.

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Is surgery safe for people with MS?

Safety is a legitimate concern when it comes to surgical procedures in MS. People living with MS do not have an increased risk of complications after surgery. However, they may face unique surgical challenges such as:

  • infection and fever are potential complications for anyone undergoing surgery. In people with MS, infections and fever can make MS symptoms worse.
  • muscle weakness is a common symptom in people with MS. This can make it harder to recover from surgery, especially if you can’t get out of bed and move around.
  • anesthesia used during surgeries as a drug to put people to sleep, reduce pain, or reduce sensation and consciousness. People with MS who have trouble breathing may be at increased risk of complications from anesthesia.

Can surgery cause an MS flare-up?

MS can alternate between periods of high disease activity and symptoms (relapses) and periods of little or no symptoms and low disease activity (remission). A common concern with surgery is whether it can cause MS flare-ups.

Research shows that surgery does not increase the risk of MS flare-ups. However, people with MS may have greater difficulty recovering from surgery or complications because of MS and MS-related symptoms.

Surgical Treatments for MS

People with MS may consider surgical options to manage specific symptoms. For example, electrical treatments are used for bladder problems in people with MS, and that option may be surgical.

deep brain stimulation

Deep brain stimulation (DBS) is a surgical treatment in which electrodes are placed in the brain to allow electrical charges to correct brain activity. This procedure can treat tremor (extreme shaking) that can interfere with daily life. DBS improves tremors in people with MS.

rhizotomy

rhizotomyalso called removal or neurotomy, is a minor surgical procedure used to treat pain. It works by locating the nerves that communicate with the brain to signal pain and then burning the nerve fibers so they can no longer send pain signals.

This option is effective in treating nerve pain in people with MS, but is usually used after other treatments have been tried because it damages nerves.

Baclofen Pump

Spasticity is an MS symptom characterized by extremely stiff, tense muscles. Lioresal (Baclofen) is an antispasmodic drug that relaxes muscles. It treats spasticity in people with MS. It can also relieve pain caused by spasticity.

Lioresal is an oral medication and has the following side effects:

People with MS can avoid the side effects of spasticity by undergoing surgery to implant a baclofen pump. The pump is placed in the abdomen and connected to a needle in the spinal canal to deliver a smaller dose of medication directly into the spinal fluid.

Opening the blood flow

Percutaneous transluminal angioplasty (PTA), also called deliverance therapy, is a surgical procedure to open blood flow. It works by inserting a tube with a balloon on the end into the blocked area and then inflating the balloon.

This procedure was introduced as an MS treatment because it was believed that the damage to the MS nervous system could be caused in part by problems with the flow of blood from the brain and spinal cord.

PTA for MS

The safety of using PTA to treat MS is controversial, and the Food and Drug Administration (FDA) has warned of safety concerns. Research has shown that it does not improve MS outcomes and is therefore not a recommended treatment option.

operational risks

There are risks with every surgical procedure. People with MS do not have an increased risk of complications if they choose to have surgery; However, they may face challenges recovering from surgery due to MS symptoms such as muscle weakness and mobility difficulties.

The specific risks of surgery depend on the procedure and the person receiving the surgery. Anyone considering surgery or other treatment options should work with their medical team to determine their risks and the best options.

Benefits of the surgery

The benefits of surgery to treat MS depend on the procedure. Everyone is different and may respond differently to treatments, including surgery.

Some potential benefits of surgical treatment options for MS include:

  • Baclofen Pump: improvement of spasticity
  • deep brain stimulation: Improvement of tremor
  • rhizotomy: Less nerve pain

When to speak to a healthcare provider

If you have symptoms of multiple sclerosis or are considering surgery to treat MS, you should see a doctor. Treating MS is important to prevent the disease from progressing.

MS symptoms can occur at any time and are different for everyone. Some early and common signs and symptoms to look out for are:

  • balance problems or dizziness
  • bubble challenges
  • changes in vision
  • fatigue
  • Muscle cramps or extremely stiff, tense muscles
  • Pains
  • Sensations such as numbness or tingling

summary

Multiple sclerosis is a lifelong disease with symptoms that can interfere with daily life. Surgery is a viable treatment option for people with MS. Surgical procedures include deep brain stimulation, rhizotomy, and a baclofen pump. Opening the blood flow is not recommended because it is ineffective and may not be safe for people with MS. It is important to speak to a healthcare provider about concerns related to MS.

A word from Verywell

Considering surgical treatment of MS is a big decision. If you have MS symptoms that don’t improve with less invasive treatments, or if you experience adverse side effects from other treatments, surgery may be a viable option for you. Talk to your doctor for more information.

frequently asked Questions

  • Can MS be operated on?

    People with MS can have surgery. Surgery carries risks for everyone, and people with MS can face unique challenges in recovery. It’s important to talk to a doctor about the benefits and risks when making the decision.

  • How does multiple sclerosis affect anesthesia?

    In general, MS does not pose additional risks to anesthesia. However, people with MS may have difficulty breathing initially, which can lead to other risks with anesthesia.

  • What can trigger an MS flare-up?

    The triggers of MS flare-ups are not fully understood. External factors such as smoking, stress and infections can increase the risk of flare-ups.

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