Are some spinal surgeries more successful than others?

Spine Surgery

Are some spinal surgeries more successful than others? The short answer is yes, but that doesn’t tell the entire story. Any spinal surgeon will tell you that every patient’s case is unique, and that post-operative recoveries and long-term outcomes also vary from patient to patient.  In addition, every operation is different, whether dealing with a traumatic spinal cord injury of a degenerative condition like spinal stenosis. For that reason alone some spinal surgeries are more successful than others. Some patients may work harder at their recovery, while others may benefit from an extremely skilled surgeon. Patients don’t always define success in the same terms, and thus rate clinically identical outcomes differently. But beyond these differences in individual cases is the undeniable fact that some surgeries carry more risk or have a lower rate of clinical success than other procedures, and that some are proven to provide superior outcomes than others for treating the same condition. Spinal decompression surgery, a relatively common procedure, is an excellent example of differences in the success rates of spinal surgeries.

Spinal decompression is performed to relieve pressure on a nerve within or emanating from the spinal column, the cause of common back problems such as sciatica. The spinal decompression procedure, which involves cutting away portions of a vertebra impinging on a nerve, can dramatically reduce pain and restore mobility in many cases. However, the procedure leaves the vertebral segment weakened and in need of stabilization. Traditionally, spinal fusion surgery was performed in conjunction with spinal decompression therapy to stabilize the spine at the segment where the decompression was performed. Today the TOPS™ (Total Posterior Solution) System is available as an alternative to spinal fusion back surgery. In clinical studies around the world, the TOPS Solution has been found to deliver superior clinical outcomes than spinal fusion surgery. And that’s a definition of success in just about every patient’s and doctor’s book.

Can Acupuncture Relieve Back Pain?

Spine Acupuncture

Not all advances in treating spinal disorders are necessarily new. Acupuncture has been practiced for thousands of years, and researchers and medical experts have now established that this ancient healing art can relieve chronic back pain. One recent study funded by the National Institutes of Health found that acupuncture can be more effective than standard treatments such as medication or physical therapy for relieving back pain – even for conditions such as very mild incidents of spinal stenosis and slipped disc. In the study, patients were divided into four groups. In one group patients received customized acupuncture treatments. Another group received acupuncture treatments generally recommended by practitioners for chronic lower back pain. A third group received only a treatment that mimicked acupuncture, using a toothpick that never actually penetrated the skin. The fourth group simply continued the course of therapy they were already pursuing, without acupuncture.

Researchers found that all three of the acupuncture groups – even the simulated acupuncture group – reported more “meaningful” improvement in their ability to engage in everyday activities than did the group that continued their usual back pain therapy without acupuncture. Moreover, the study authors found that the superior improvements in pain reduction reported by the acupuncture group participants persisted after a year.

This study certainly doesn’t suggest everyone with spinal problems should stop their current treatment regimens in favor of acupuncture. After all, not all participants in the study benefited from acupuncture. But the study concluded that acupuncture is a reasonable option to be considered when selecting therapy for back pain. This is one more example of new thinking about treatments for chronic back pain, which has witnessed major advances in recent years. For example, spinal decompression surgery, which can dramatically reduce back pain by relieving pressure on pinched nerves emanating from the spinal column, was traditionally followed by spine fusion surgery, to stabilize the vertebral segments where the decompression procedure was performed. Today the TOPS™ (Total Posterior Solution) System can be implanted as an alternative to spinal fusion. Unlike spinal fusion, the TOPS solution allows the individual vertebrae to maintain their full range of independent motion.

If you have chronic back pain, make sure you know all the treatment options available – from acupuncture to spinal decompression surgery. And always work with qualified physicians specializing in spinal problems to find an appropriate treatment protocol.

What is Degenerative Joint Disease?

Degenerative Joint Pain

“What is degenerative joint disease, and what did I do to come down with it?” That’s a common reaction from spinal patients after receiving a diagnosis of osteoarthritis, also known as degenerative joint disease. The degeneration usually results from the normal process of aging, typically beginning in middle age with the breakdown of cartilage, the rubbery tissue that serves as a cushion between bones and around joints. Degenerative joint disease is the most common joint disorder, and is frequently seen in the joints of the spinal column due to the many stresses and strains put on these joints. Occupations that involve physically demanding kneeling or squatting can also predispose one to degenerative joint disease, and injury or disease can also contribute to degenerative changes in the affected area later in life. Excessive weight, lack of exercise, smoking and a poor diet can also exacerbate the degeneration.

Degeneration in the spine is characterized by a breakdown of the cushioning spinal discs. This leads to bones rubbing against each other, resulting in pain, stiffness, swelling, reduced motion of the joint and other associated symptoms.

A number of treatment options are available for degenerative joint disease of the spine, including physical therapy, medications and injections. For patients with moderate to severe osteoarthritis not improved by conservative approaches, spinal decompression surgery may provide relief by reducing pressure on pinched nerves resulting from the reduction in cushioning the degenerative joint disease causes. The decompression procedure has historically been performed in tandem with spinal fusion surgery, to stabilize the spine by fusing two vertebrae together at the point where the decompression procedure was performed. Today the TOPS™ System provides a clinically proven superior alternative to spinal fusion, enabling patients to maintain the full range of motion of each individual vertebra. You may not be able to stop natural degenerative changes, but a range of effective medical options are available to treat them. A qualified specialist can help you choose the one that’s right for you.

What is Endoscopic Spine Surgery?

Endoscopic Spine Surgery

The last several years have seen great strides in developing advanced surgical solutions for spinal problems. Many of these advances involve minimally invasive procedures that leave surrounding tissue undisturbed, allowing faster recovery times and eliminating many of the complications associated with invasive back surgery operations.

Minimally invasive spine surgery is taken one step further by state-of-the-art miniaturized medical equipment, such as fiber optic cameras and microscopes. These procedures, often referred to asendoscopic spine surgery, lend themselves to treating a variety of spinal conditions and disorders including slipped disc and pinched nerves. These minimally invasive spine surgery procedures can remove tissue exerting pressure on nerve roots emanating from the spine, providing dramatics relief for back pain and restricted mobility. However, like any form of surgery, endoscopic spine surgery should be performed only if non-surgical treatment options have been exhausted and these restricted access techniques can adequately address the patients’ diseases. Conservative treatments include physical therapy, epidural injections, and medication to control pain and discomfort. If you and your physician conclude that an endoscopic back surgery may be appropriate, the decision on which procedure is best should be made only after thorough evaluation of all aspects of your case. In some situations where bone must be removed from a vertebra as part of the surgical procedure (as in a laminectomy or spinal decompression surgery procedure), the endoscopic procedure does not provide adequate access or visualization to perform a proper decompression. Suboptimal removal of pain generators, especially when followed by he fusion of adjacent vertebrae, can have adverse outcomes. Moreover it is irreversible as spine fusion surgery eliminates the independent flexion and rotation of the fused vertebrae. But another advance of recent years, the TOPS™ System, has proven to provide a better clinical outcome than spinal fusion. An implant device, the TOPS, or Total Posterior Solution System, preserves the independent motion of the individual vertebrae.

If you suffer from back pain or other symptoms of spinal problems, don’t let outdated ideas about back surgery keep you from seeking treatment. Today a host of conservative treatments such as medication and physical therapy can often provide relief, and when surgery is called for, it can often be performed without complications.

Causes of Back Pain in Adolescents vs. Adults

Back pain

Though the majority of spinal problems appear between the ages of 35 and 55, wrought by natural processes associated with aging, you don’t have to be an adult to have back problems. Back pain can also affect adolescents and even children. As many as half of all young people will have experienced back pain by age 20. It may be a sharp and shooting pain, or a burning or aching. It may be felt anywhere in the back. These are the same symptoms adults experience, but the causes of adolescent back pain are usually different than those that afflict their elders. That said, benign musculoskeletal diseases and trauma are responsible for most cases of back pain in adolescents just as they are for adults. Any strenuous or straining activity – sports or play, carrying a heavy backpack, or falling – can sprain muscles in the back and cause pain. Such strains and trauma account for around 50 percent of the younger patients seen in hospital emergency rooms suffering from back pain.

Fortunately, most cases of adolescent back pain resolve on their own. In fact, the exact cause of the back pain is never identified in at least half the adolescents seeking treatment. However, adolescents can exhibit serious spinal conditions capable of causing long term problems. These include stress fracture of the spine, known as spondylolysis, spondylolisthesiswhich is forward slippage of one vertebra on another, and lumbar disc herniations. Infections, inflammatory diseases, and tumors can also cause back pain in children and adolescents, as can other congenital or acquired conditions. As in adults, spinal decompression surgery can relieve pressure on pinched nerves and the concomitant pain and restricted mobility these conditions can cause. A TOPS™ System implant can be used following decompression spine surgery, rather than the spinal fusion procedure typically performed. Whereas spine fusion surgery eliminates the independent movement of fused vertebrae, the TOPS System preserves the full range of flexion and rotational motion of each individual vertebra. And that’s welcome news for spine decompression patients.

What is XLIF?

XLIF Procedure

Thanks to advances in spinal medicine, patients today can benefit from treatment regimens and procedures tailored to their individual needs and specific conditions. Among these recent advances on the surgical front is eXtreme Lateral Interbody Fusion, or XLIF. XLIF is a form of spine fusion surgery in which the surgeon accesses the intervertebral disc space approaching from the side (lateral) rather than from the front (anterior) or the back (posterior) of the spine.

XLIF is one of the endoscopic spine surgery procedures performed with microsurgery tools and techniques. The procedure utilizes electromyography, or EMG, a form of neuromonitoring, allowing the surgeon to test the nerves emanating from the spine during surgery to ensure they are not harmed or irritated. Nerves from the spinal column lie in close proximity to the psoas muscle surrounding the spine, which can be compromised during surgery. Requiring only small incisions, XLIF minimizes tissue damage, blood loss and scarring, and has a relatively quick recovery time. XLIF falls in a category of back surgery in which the disc in the front of the spine is removed and replaced with an implant containing a bone graft. The bone graft enables the two vertebrae to fuse through the disc space. XLIF offers a spinal fusion option for treating various types of lower back disorders including lumbar degenerative disc disease,spondylolisthesis, scoliosis and types of spinal stenosis.

A drawback of the procedure is that it involves fusing vertebrae, eliminating independent movement between adjacent levels. Today, thanks to another advance in spinal medicine – the TOPS™ System – in some cases a TOPS implant can be used in place of traditional spine fusion surgery. Unlike fusion, the TOPS System preserves the full range of motion of individual vertebrae, and the TOPS System has been proven to provide better outcomes than spinal fusion in clinical studies conducted around the world. This adds up to two breakthroughs in the treatment of spinal conditions, promising effective relief for many patients with back problems requiring a surgical solution.

Why are some spinal surgeons more successful than others?

Surgeons

It’s a fact that some spine surgeonshave higher success rates for the operations they perform than their colleagues. What accounts for these differences in surgical outcomes of spinal procedures? A number of factors influence surgical success rates and should be considered when interpreting what the rates say about a particular spinal surgeon’s abilities.

Spine surgery is a highly complex endeavor requiring years of training and experience to perfect. Surgeons with more experience tend to have more successful outcomes than less experienced surgeons. The success rates of board certified or board eligible spine surgeons are also typically higher than those of non-board certified or eligible surgeons. Another factor to consider: some surgeons specialize in specific areas of the spine – such as lumbar spinal surgery – and some specialize in treating particular conditions – such as slipped disc or spondylolisthesis – while other back surgeons do not specialize in any one type of treatment. Specialists have higher success rates than those of their colleagues who do not focus on the type of surgeries they perform.

Beyond the skill of the surgeon, success rates are also linked to the type of procedure chosen to treat a particular problem. The decision to utilize one procedure – perhaps because the surgeon is more familiar with it – rather than an alternative treatment, can also affect a surgeon’s success rate. For example, there is a choice in surgical stabilization procedures to employ following decompression spinal surgery, which is performed to treat conditions including spinal stenosisspondylosis, and spinal cord injuries. In the past, spinal fusion back surgery has been virtually the only surgical stabilization option, but today an alternative procedure, the TOPS™ (Total Posterior Solution) System has been proven in clinical trials around the world to provide better success rates that spinal fusion. Thus, a back surgeon might have a better than average success rate performing spinal fusion procedures, but still not reach the success rates achieved with a new procedure. That’s why it’s important to be familiar with the full range of available treatment options when evaluating the success rates of any spine surgeon.

Choosing a Spinal Surgeon

Surgeon

Choosing a spinal surgeon is among the most important medical decisions a patient can make. A spinal surgeon does more than perform an operation. A spinal surgeon consults with you, explains options and answers questions, and plans your treatment and recovery. You need to trust your spine surgeon, and to feel free to discuss all medical matters frankly.

You should choose a spinal surgeon who is board certified or board eligible, and trained in a fellowship program. If possible, choose a surgeon who specializes in the area of the spine that requires treatment– for example, a lumbar spinal surgery specialist if your problem is in the lower back. Alternatively, choose a spine surgeon who specializes in treating the specific condition affecting you, such as spondylolisthesis or spinal cord injuries.

Recent years have witnessed tremendous advances in treatment of spinal conditions, such as minimally invasive procedures that provide better outcomes than traditional open back surgery. It is essential that you choose a back surgeon that has experience with advanced procedures, to ensure you have access to the very latest treatments and the greatest spectrum of surgical options. For example, surgery to treat spinal stenosisslipped disc and a variety of other conditions that can result in pinched nerves, have often utilized spinal fusion back surgery as a means of stabilizing the spine, following spinal decompression therapy. Today the TOPS ™ (Total Posterior Solution) System provides a clinically proven superior alternative to spinal fusion surgery. Moreover, the TOPS implant preserves the full range of movement of the spine’s individual vertebrae, whereas spinal fusion eliminates the spine’s natural motion between fused vertebral segments. Examples like this illustrate why it’s important to work with a spine surgeon who can offer a complete range of surgical options. Thoroughly investigate all your treatment options as well as the qualifications of the specialists you consider working with, and you’ll be sure to make a wise choice when it comes to selecting a spinal surgeon.

Advantages of Medical Tourism

Medical Tourism

Can you really travel to a foreign destination for a vacation, and get quality medical attention and surgery at the same time? That’s the question many people raise when the subject of medical tourism comes up. The skepticism is understandable, given the images many people have of some of the locations associated with medical tourism –India,Thailand,Singapore,Latin America and Eastern Europe. But there are indeed many advantages medical tourism can offer that make it well worth considering for some people. Of course the quality of medical care should always be the primary consideration, and the fact is there are first-rate medical facilities and physicians, surgeons, and other health care professionals in all the places mentioned above, as in many other areas of the world, such as Germany, the UK,Turkey,Israel, and Cyprus. Given the fact that the quality of medical care can be excellent, and the cost often well less than half of prices in your own country, medical tourism can indeed make great sense. The New England Journal of Medicine recently reported the case of a self-employed carpenter and cardiac patient who faced charges ranging from $40,000 to $200,000 vs. less than $7,000 in India for a cardiac procedure. The carpenter had the surgery in New Delhi and the operation was a complete success.

Another benefit of medical tourism is that you can get treatments that have been proven effective and used in parts of the world for years but have not yet, or only recently been approved for use in your country. The TOPS™ (Total Posterior Solution) procedure, performed in association with spinal decompression surgery, is an example of a procedure that has been used extensively in Europe. TOPS is an alternative to spinal fusion back surgery that preserves the full range of motion between the individual vertebral segments, unlike spinal fusion.

So go ahead and consider medical tourism. For some patients and medical conditions, it could be the ticket to quality, low cost healthcare.

How long after a spinal surgery before I can return to athletics?

Surgery Recovery

Near the top of the list of questions from almost every spinal surgery patient is how long they will have to wait following surgery before they can resume their normal activities. When those normal activities include athletics – golf and tennis, bowling and the like, pastimes that put tremendous strain on the back – the answer becomes more complex. The factors influencing the time before they can get back in the game include the level of the patient’s physical condition and health. Just because one engages in strenuous physical activity doesn’t mean he or she is in good physical condition or healthy. Recovery times are faster for surgery patients in good physical shape because their bodies heal faster. Of course the operation itself will play a large role in deciding when you’ll be back on the tennis courts, golf course, taking a job or engaging in a simple walk. The post-operative physical therapy program also plays a large role. But the type of back surgery is the primary factor affecting the time required to get back into sports action.

Athletics

In some cases the surgical treatment chosen for a given spinal condition will affect not only the time needed to get back on the playing field, but the degree to which you will ever be able to recover your old form. Take the stabilization procedure following spinal decompression surgery, for example. Spinal decompression is performed to relieve pressure on nerves within or emanating from the spine caused by conditions including spinal stenosisspondylolisthesis, and other degenerative changes, or as a result of spinal cord traumaSpinal fusion back surgery has been the primary stabilization procedure. But the fused vertebrae lose their independent motion following stabilization, and often patients are restricted from physical activity for up to 6 months while waiting for the biological fusion process to complete. However, today the TOPS™ (Total Posterior Solution) System provides an alternative to spinal fusion. The TOPS System, a surgical implant, stabilizes the spine while preserving each vertebra’s independent motion – and good news is that there are no restrictions on your physical activity after surgery. That’s going to ensure better performance whenever it’s time to get back in the game.