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What is Lumbar Fusion?

Lumbar Fusion

Anyone who’s had chronic lower back pain has probably heard the term lumbar fusion. But what is lumbar fusion? Lumbar fusion is a surgical procedure performed on the lower, or lumbar, portion of the spine. Its goal is to stabilize the back after spinal decompression surgery to relieve pain, restore mobility, and/or relieve other symptoms of pinched nerves in the lower back. The procedure is also called lumbar spinal fusion, or simply spinal fusion, and takes its name from the fact that two (or occasionally more) adjacent vertebrae are fused as a result of the procedure.

Spinal problems such as traumatic injuries or natural changes in the spine associated with aging, such as spinal stenosis and degenerative disc disease, can put pressure on the nerves of the spinal column. The lower back is a common site for these problems because of the bending, twisting and other physical stresses the lower back is subjected to over our lifetime. These spinal conditions cause symptoms of tingling, numbness, pain, restricted mobility and, even, paralysis. Physical therapy, medication or spinal injections can relieve many of these symptoms, but when these interventions are not effective, a spinal decompression procedure to relieve pressure on these nerves may be recommended. During spinal decompression, the surgeon trims away portions of a vertebra impinging on the pinched nerve. This compromises the strength of the vertebrae, so lumbar spinal fusion surgery has traditionally been performed in conjunction with spinal decompression therapy to stabilize the spine. The drawback is that lumbar fusion eliminates the natural independent movement of the vertebrae. But today the TOPS™ (Total Posterior Solution) System provides a clinically superior alternative to spinal fusion, which allows the individual vertebrae to maintain their full range of independent motion. That’s just one reason it’s important for candidates of lumbar spinal decompression to know exactly what lumbar fusion is, as well as the full range of treatment options available.

How Long Does it Take to Recover From Spinal Surgery?

Spine Surgery Recovery

For people with moderate to severe spinal problems that do not respond to conventional conservative therapy, spinal surgery can provide dramatic relief. For example, spinal decompression can remove pressure on nerves, relieve pain and restore mobility in many such patients. If you’re a candidate for spinal surgery, it’s important to understand all aspects of the procedure and its aftermath. One of the most important questions these patients should have answers to is the length of time required to recover from spinal surgery.

Recovery time from back surgery depends on the form of surgery. Broadly speaking, there are two forms of back surgery: procedures where vertebrae are fused together versus procedures that do not immobilize the spine. Recovery from fusion surgery can take longer than the recovery time from back surgeries that only involve a decompression or a surgery that preserves motion. Your physician can tell you more about the recovery time required for a particular procedure. But it’s important for patients to consider outcomes as well as recovery time. For example, spinal decompression surgery has traditionally been performed in conjunction with spinal fusion back surgery. As part of the recovery process, restrictions on motions and activities are placed on the patient to allow the previously independent vertebral bodies to biologically fuse together and become one long rigid segment devoid of motion. In contrast, with the TOPS™ (Total Posterior Solution) System, an alternative to spinal fusion following a spinal decompression procedure, there are no restrictions placed on the patient.  You maintain full range of independent vertebral motion after surgery, and the speed of recovry from this back surgery is dictated by the patient.   You can increase you activity level as quickly as you want.

Back surgery treatment does not end when the surgeon completes his or her operative work. The recovery period is of critical importance in restoring spinal health. Whatever the recovery period required, make sure you carefully follow your physician’s instructions. And be aware of all your options for spinal surgery, so you’ll not only have as short a recovery time as possible, but also the best possible outcome to your back surgery.

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.

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.