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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.