Multiple Sclerosis Surgery: Safety, Options, and Risks

Multiple sclerosis (MS) is a lifelong medical condition in which the immune system attacks the protective myelin sheath covering healthy cells in the brain and spinal cord. Since the brain communicates with every body system for functioning, MS can have many symptoms that affect various areas of the body.

There is no cure for MS, but treating it and living a long, healthy life is possible. Treatment options may include behavior and lifestyle changes, medications, and non-medicinal therapies like physical therapy. In some cases, surgery may be an option.

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

Is Surgery Safe for People With MS?

Safety is a valid concern when considering surgical procedures for MS. People living with MS are not at an increased risk of complications from surgery. However, they may face unique surgical challenges such as:

• Infection and fever are possible complications for anyone who has surgery. For people with MS, infection and fever can make MS symptoms worse.
• Muscle weakness is a common symptom among people with MS. This may make it harder to recover from surgery, especially if you cannot get out of bed and move around.
• Anesthesia is used during surgery as a medication to put people to sleep, to dull pain, or to decrease sensation and awareness. People with MS who have breathing problems may be at an increased risk of complications from anesthesia.

Can Surgery Cause an MS Flare-Up?

MS can shift between phases of high disease activity and symptoms (flare-ups) to phases of little or no symptoms and low disease activity (remission). A common concern about 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 more difficulty recovering from surgery or complications due to MS and MS-related symptoms.

Surgical Treatments for MS

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

Deep Brain Stimulation

Deep brain stimulation (DBS) is a surgical treatment to place electrodes in the brain so that electrical charges can correct brain activity. This procedure can treat tremors (severe shaking), which can interfere with daily life. DBS improves tremors in people with MS.

Rhizotomy

Rhizotomy, also called ablation or neurotomy, is a minor surgical procedure used to treat pain. It works by locating the nerves communicating 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 among people with MS, but it is typically used after other treatments are tried because it does damage the nerves.

Baclofen Pump

Spasticity is an MS symptom characterized by extremely stiff, tight muscles. Lioresal (baclofen) is an antispasmodic medication that works to relax muscles. It treats spasticity in people with MS. It may also decrease 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 with a surgical procedure to implant a baclofen pump device. The pump is placed inside the abdomen and connected to a needle in the spinal canal to deliver a smaller dose of medication directly into the spinal fluid.

Opening Blood Flow

Percutaneous transluminal angioplasty (PTA), also called liberation therapy, is a surgical procedure to open blood flow. It works by placing 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 thought that MS nervous system damage might be partially caused by issues with blood draining from the brain and spinal cord.

Surgery Risks

There are risks with any surgical procedure. People with MS are not at an increased risk of complications if they choose to undergo surgery; however, they may face challenges recovering from surgery due to MS symptoms like muscle weakness and difficulty with mobility.

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 healthcare team to determine their risks and the best options.

Surgery Benefits

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

Some possible benefits of surgical treatment options for MS include:

• Baclofen pump: Improvement of spasticity
• Deep brain stimulation: Improvement of tremors
• Rhizotomy: Decreased nerve pain

When to Talk to a Healthcare Provider

If you are experiencing symptoms of multiple sclerosis or considering a surgical procedure for MS treatment you should see a healthcare provider. Getting treatment for MS is important to prevent the disease from progressing.

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

• Balance issues or dizziness
• Bladder challenges
• Changes in vision
• Fatigue
• Muscle spasms or extremely stiff, tight muscles
• Pain
• Sensations such as numbness or tingling

Summary

Multiple sclerosis is a lifelong medical condition 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 blood flow is not recommended because it is ineffective and may not be safe for people with MS. It is important to talk to a healthcare provider about any MS-related concerns.

A Word From Verywell

Considering surgical treatment for MS is a big decision. If you are experiencing MS symptoms that aren’t improving with less invasive treatments or experiencing adverse side effects from other treatments, surgery may be a viable option for you. Talk to your healthcare provider for more information.