What is Spondylolisthesis?

Spondylolisthesis

You’ve probably heard the common medical term, “a slipped disc,” but what exactly does that mean? A slipped disc, or more precisely “spondylolisthesis,” is a condition in which one of the vertebrae – the bones in the spinal column – becomes displaced and moves forward or backward in relation to its proper position. This malpositioning can put pressure on the spinal cord and on the nerves that emanate from the spinal column at the position of the slipped disc. The most common cause of spondylolisthesis is degenerative changes in the joints and cartilage of the vertebrae due to aging.. Spondylolisthesis can also result from trauma – a sports injury or an accident, for example.

The most frequent symptom of a lumbar slipped disc is lower back pain. The pain is typically worse after exercise. Decreased range of motion and tightness of the hamstring muscles are also common slipped disc symptoms. The nerve compression may also result in pain, numbness, tingling or weakness in the legs, and in cases of severe compression, loss of bowel or bladder control. Slipped disc can also be associated with spinal stenosis, one of most common spinal problems, characterized by a narrowing of the spinal canal. A physician specializing in spinal disorders can diagnose spondylolisthesis using radiographs and X-ray imaging. The severity of the slipped disc is graded on a scale based on the degree of slippage from its normal position. After the diagnosis, a physician can recommend appropriate treatments for spondylolisthesis.

Treatments for slipped disc include physical therapy, exercises for relieving pressure on the affected spinal nerves, medication, and injections. In many patients these treatments are sufficient to alleviate the symptoms of slipped disc. For patients with moderate to severe spondylolisthesis or attendant spinal stenosis who do not respond to conservative therapies, spinal decompression surgery may be recommended. Spinal decompression involves removing portions of the vertebrae that impinge on the spinal cord and nerve roots. Spinal decompression can have a dramatic affect, relieving pain and other symptoms caused by the slipped disc and spinal stenosis. However, removing portions of the vertebrae reduces the stability of the spinal column. Traditionally spinal fusion back surgery is performed after spinal decompression; screws and rods are implanted to permanently join adjacent vertebrae and restore spinal stability. One drawback is that spinal fusion eliminates the natural independent motion that gives the spine its flexibility. Fusion has also been shown to promote deterioration of adjacent vertebrae.

Now there is an alternative to spinal fusion, the TOPS™ System, developed here at Premia Spine. The TOPS System restores stability while preserving the spine’s full range of motion after decompression and has been clinically shown to provide better outcomes than spinal fusion surgery in trials conducted around the world.

We encourage anyone afflicted with back problems to consult a physician who specializes in spinal disorders, and to learn about all treatment options.

What is Spondylolysis?

spondylolysis

It’s not as common as spinal stenosis or a herniated disc, but when it comes to the conditions that can cause lower back pain, spondylolysis deserves a place near the top of the list. Spondylolysis is a defect in a vertebra – a bone in the spinal column – at the point where it connects to the vertebra above it. The defect can lead to small stress fractures that allow a vertebra to move out of position and press against, or compress the spinal cord. This condition is called spondylolisthesis, or slipped discA slipped disc can cause several symptoms, with lower back pain being the most common. The good news is that many people with spondylolysis remain asymptomatic – they have no symptoms and are usually unaware they even have the condition. When the spondylolysis does cause lower back pain, it usually spreads across the lower back and feels like a muscle strain, and is generally exacerbated by exercise or vigorous activities.The weakness at the root of spondylolysis occurs in the pars interarticularis, the thin piece of bone that connects the upper and lower segments of the facet joints, which link the vertebrae and allow the movement of the spine. The cause of the weakness in the vertebrae that characterizes spondylolysis is unknown. Genetics is believed to play a role, and repetitive trauma to the lower back may also be a causal factor. The condition is not rare, affecting an estimated three to seven percent of Americans, many of them younger than traditional spinal patients. In fact, spondylolysisis the primary cause of low back pain in people under 25 years of age.

Simple over-the-counter non-steroidal anti-inflammatory drugs (NSAID) such as ibuprofen can often relieve mild symptoms of spondylolysis. In moderate to severe cases that don’t respond to conservative treatments, spinal decompression surgery to remove the portion of the defective vertebra compressing the spinal nerve may be recommended. Typically, spinal fusion surgery is performed following the decompression procedure in order to stabilize the spine. Recently an advanced alternative to spinal fusion, the TOPS Posterior Arthroplasty procedure, has been proven to provide better clinical outcomes than fusion, while preserving the patient’s full range of back motion.

Back pain is one of the world’s most common and debilitating medical conditions. As pioneers of advanced surgical treatments for spinal disorders, we at Premia Spine encourage anyone suffering from back pain to learn about all the treatment options available today.

What is Laminoplasty?

Laminoplasty

Laminoplasty is a surgical procedure for treating spinal stenosis, an unnatural narrowing of the spinal canal and a common cause of mild to severe lower back pain and restricted mobility. A variety of conservative methods of therapy for spinal stenosis are available, including spinal stenosis exercises, medications and injections. These therapies are often successful in relieving the symptoms of spinal stenosis, but if they prove ineffective, spinal surgery may be recommended. Numerous surgical procedures are available. Tools and therapies have undergone great advances in recent years, providing better outcomes and fewer complications. Laminoplasty is one example of these advances in treatments for spinal stenosis.

Laminoplasty is a surgical procedure performed through a small incision. The spinal surgeon makes two cuts almost opposite each other through the lamina, or outer sheath of the vertebra affected by spinal stenosis. One cut is made completely through the lamina, and the second cut is simply a groove that acts as a hinge, allowing the lamina to swing open like a door. In fact, this procedure is often referred to as an “open door laminoplasty.“ The tips of the spinous processes may be removed to create room for the bone to pull open. This spinal stenosis surgery procedure immediately relieves pressure on the spinal cord. The lamina is then closed, using small pieces of bones as wedges to ensure the spinal cord is no longer compressed at that level. Spinal fusion back surgery may be performed in conjunction with laminoplasty to stabilize the vertebra. But spinal fusion eliminates the natural flexion and rotation on the individual vertebra. Today there’s a new option, the TOPS System, which stabilizes the vertebrae while permitting natural flexion and rotation of the individual vertebra. It’s proven to provide superior clinical outcomes to spinal fusion surgery.

Spinal problems and back pain are among the most common and debilitating medical ailments. If you suffer from the symptoms of spinal problems, you have a variety of treatment options. Make sure you’re familiar with all the medical procedures available to you.

What is Interspinous Process Fusion?

Interspinous Process Fusion

As we noted in our last blog, X-Stop, an implant deployed in the surgical treatment of mild spinal stenosis, was approved by the FDA in 2005 as a safe and effective treatment for symptoms of lumbar spinal stenosis. This procedure illustrates the advances that make spinal medicine such an exciting field. Today, there are devices similar to the X-Stop in design but that do allow motion at the operative segment. These devices are used to create a spinal fusion between the adjacent vertebral segments. This procedure is more commonly referred to as an interspinous process fusion. As with the X-Stop, a device is inserted in a small incision made between adjacent spinous processes, which are the bony protrusions of the vertebrae that can be seen and felt along the back of the spine. Interspinous process fusion is another form of spinal fusion back surgery that eliminates the natural flexion and rotational ability of the individual vertebrae.

Interspinous process fusion is typically performed in about one hour, either under general anesthesia or using intravenous sedation with local anesthesia, and can be performed as an outpatient procedure. The procedure is relevant for patients who have mild spinal stenosis and require only a minimal removal of bone and soft tissue to achieve pain relief. This represents an advance in spinal care, but any spinal surgery has the risk of complications, and not every technique is right for every patient. Before considering surgical intervention including interspinous process fusion, patients should try more conservative treatments such as exercises, physical therapy, epidural injections, and pain medications. When surgery is recommended, interspinous process fusion is most appropriate for people over 50 years of age with mild spinal stenosisconfined to one or two levels of the spine, and who experience relief from symptoms when bending forward at the waist or when sitting. With more advanced spinal stenosis disease, patients should consider the option of avoiding fusion surgery and opting for a solution, such as TOPS Posterior Arthroplasty, that preserves motion of the spine at the operative level while stabilizing the segment after decompression surgery. Here at Premia Spine, developers of advanced surgical treatments for spinal stenosis and related spinal problems, we think it’s important for anyone suffering from ongoing back pain or restricted mobility to know all their treatment options.

What Causes Back Pain?

Back Pain

Ancient medical experts believed back pain was brought on by a fluid imbalance. Many patients were therefore treated with bloodletting. Today we know that back pain can have a variety of causes. Muscle and ligament sprains cause many episodes of back pain. Problems in the internal organs or tumors can also cause back pain by affecting nerves that emanate from the spinal column. Even stress can result in back pain, by causing muscles in the back to tighten. Many people also suffer back pain as a result of traumatic and degenerative spinal disorders such as spinal stenosis and disc diseases including bulging disc and herniated disc. These spinal disorders put pressure on nerves within or emanating from the spinal column, and this pressure on the nerves – commonly referred to as a pinched nerve – causes the pain and other problems associated with the conditions. In cases where pinched nerves do not resolve with conservative treatments, such as physical therapy or medications, spinal decompression surgery can relieve pressure on spinal nerves, and dramatically reduce pain and associated symptoms. In the past, spinal fusion back surgery was routinely performed in conjunction with spinal decompression surgery to stabilize the spine by fusing adjacent vertebrae at the site of the surgery.  Spinal fusion back surgery not only produces inconsistent results but also eliminates the independent motion of the fused vertebrae. Today, patients no longer need to surrender spinal motion to benefit from decompression spinal surgery. The TOPS™ System from Premia Spine enables spinal decompression patients to maintain their full range of spinal motion. Instead of fusing adjacent vertebrae during surgery the surgeon implants the TOPS System and preserves pain-free flexion, extension, lateral bending, and axial rotation at each vertebra.

From simple conservative treatments to advanced surgical procedures, whatever the cause of your back pain, it’s comforting to know effective treatment is available from qualified spine specialists.

Causes of Back Pain in Women

Back Pain in Women

Back pain is a universal and non-discriminatory malady, and the problems that cause back pain in women are often the same as in men. That said, some causes of back pain – menstruation, pregnancy, and osteoporosis, for example – are either unique or more prevalent among women. Menstruation often causes back pain, and cramps associated with menstruation put additional stress on back muscles. Pregnancy also often causes back pain, particularly in its latter stages. The added weight of carrying the fetus puts significant stress on the spine and supporting muscles and ligaments. While being overweight for any reason can cause back pain, the rapid weight gain of pregnancy compounds the problem. Moreover, mental stress is known to cause or contribute to back pain, in part by the concomitant involuntary tightening of muscles in the back. Pregnancy, as with any major life change, is a time of great psychological stress. Later in life, the bone building process in our bodies loses its balance and calcium is depleted from our bones. The more brittle bone is prone to breakage. This phenomena of osteoporosis is more common among women than men.

Common spinal conditions such as degenerative disc disease and spinal stenosis also affect women, just as they do men. Whatever its origin, there’s no reason to live with back pain, as a variety of treatment options exist for all their causes. Physical therapy, medication, or even a change of lifestyle can alleviate back pain caused by spinal conditions. Among women for whom spine surgery is recommended, advanced microsurgical techniques and stabilization systems provide effective treatments for these potentially disabling conditions. Decompression spinal surgery, in which a portion of a vertebra impinging on a spinal nerve is removed, can have a dramatic and immediate impact on reducing back pain associated with these conditions. Spinal fusion surgery has traditionally been performed in conjunction with spinal decompression, fusing adjacent vertebrae at the affected segment to stabilize the spine. Today the TOPS™ System from Premia Spine provides a clinically proven superior outcome than spinal fusion back surgery. Unlike spinal fusion, the TOPS System preserves the vertebrae’s range of motion. In use since 2005, the system has enabled patients around the world to maintain their full range of activities following decompression surgery, further advancing the treatment of common but potentially debilitating spinal conditions.

Is There a Cure for Lower Back Pain?

Cure for Back Pain

Lower back pain is one of the most common medical problems affecting the human population. One reason this problem is so common is because back pain can have many different causes. So if you’re wondering if there’s a cure for your lower back pain, the answer depends on what is causing it. Muscle and ligament strains can cause intense back pain. Many times these strains can be cured with simple rest. Where rest alone won’t relieve the back pain, non-invasive treatments such as medications, steroidal injections, and physical therapy will often ameliorate the symptoms, if not provide an outright cure. For spinal conditions such as spinal stenosis and related disorders of the spine – common causes of lower back pain, with onset typically after the age of 35 – non-invasive treatments may also provide relief. In some cases decompression spinal surgery may be performed to relieve pressure on affected spinal nerves. During this surgery, a surgeon trims away portions of a vertebra that impinge on a nerve. (This impingement is commonly referred to as a pinched nerve.) Spinal decompression surgery can have a dramatic and immediate impact on reducing back pain, providing patients with some level of a “cure.” Traditionally spinal fusion back surgery has been performed in conjunction with spinal decompression, to stabilize the vertebrae where the operation was performed. But spinal fusion eliminates the natural flexion between the fused vertebrae, and can contribute to deterioration of adjacent vertebrae. Today spinal decompression patients have a superior alternative to spinal fusion. The TOPS System from Premia Spine preserves the natural motion of the spine, and has been proven to provide superior results to spinal fusion in clinical trials conducted worldwide.

If you experience lower back pain, the first priority is to identify its cause. Whatever the root of the problem, you will likely have a number of options for effective treatment that will relieve the pain, and in many cases cure the condition.

Can You Get Blood Clots From Spinal Surgery?

Spine Surgery

Spinal surgery has made significant advances in terms of both its safety and efficacy in correcting a multitude of back problems, from traumatic spinal cord injury to degenerative diseases like spinal stenosisspondylosis and slipped disc. Many of these advances in spinal surgery have come in recent years as a result of minimally invasive microsurgical tools and techniques. Nonetheless, back surgery is a serious operation, and surgical candidates need to be aware of all facets of the operation they’re considering – not only the benefits of the surgery, but the potential risks. One of the risks of spinal surgery is that of developing blood clots.

Any injury to the body increases the risk of a blood clot, as the injury stimulates the clotting process. Surgery constitutes an injury or trauma, and the body responds accordingly. In fact, spinal surgery – which the body interprets as an injury to the spinal cord – can lead to the formation of blood clots within the veins. Should such clots become dislodged, they can clog a blood vessel as it narrows, causing a stroke or heart attack, possibly resulting in paralysis or death. Proper postoperative care, medications, and the patient’s active role in the recovery process can minimize the risks of blood clots.

Anyone considering back surgery should also be aware that some procedures for treating a spinal problem may present lower risks or provide better outcomes than others. For example, the TOPS™ (Total Posterior Solution) procedure, which may be performed after spinal decompression surgery in order to stabilize the spine, provides better clinical outcomes than spinal fusion surgery, which was the traditional choice for spine stabilization before the introduction of the TOPS system. The TOPS solution has the added benefit of preserving the spine’s full range of motion, unlike spinal fusion, which permanently fuses adjacent vertebrae. If you’re a candidate for back surgery, make sure you understand not only the upsides and downsides, but also all the alternative surgical solutions that can help you minimize the already low risks associated with advanced spinal procedures.

How much physical therapy do I need after spinal surgery?

Physical Therapy

Whether a patient is having open back surgery for a spinal cord injury or a minimally invasive procedure for a condition such as a slipped disc or spinal stenosis, the operation itself is only the first part of a successful outcome. The post-surgical recovery period is critically important for long-term success, and the proper physical therapy program plays a large role in this process.

Patients for both open and minimally invasive back surgery will require physical therapy. Physical therapy strengthens the muscles in the back and helps heal the tissues in the area where the surgery was performed. In fact, back problems are often caused in part by muscle weakness. Even in otherwise well conditioned individuals, the back muscles around areas exhibiting spinal problems have been shown to be weaker than surrounding muscles, and weak muscles also contribute to poor spine and spinal joint functioning. Thus, one of the goals of post-operative therapy is to strengthen muscles that support the spine. Some of these muscles are in the back, but specific abdominal muscle groups also provide back support. Biofeedback devices can help patients learn how to activate, control and exercise these abdominal muscles, thereby strengthening them.

The amount of physical therapy required will vary based on the procedure performed, and this is one area where surgical options are important to consider. For example, patients undergoing spinal decompression surgery typically have a secondary procedure performed in conjunction in order to stabilize the vertebral segments where the spinal decompression was performed. This secondary operation following the spinal decompression procedure may be spinal fusion or the TOPS™ (Total Posterior Solution) implant. The TOPS Solution preserves the full range of motion of individual vertebra whereas spinal fusion surgery eliminates this independent movement. More important from a recovery perspective, The TOPS solution places no restrictions on patients.  You can do whatever you feel like pursuing.

The amount of physical therapy required after spinal surgery will vary from patient to patient, and from procedure to procedure. Make sure you’re aware of the physical therapy associated with the procedure you’re considering.

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.