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How to Prepare for Spinal Stenosis Surgery, Part III

 

Back Surgery

Spinal stenosis, an unnatural narrowing (or stenosis) of the spinal canal, is an all too common cause of back pain and restricted mobility, which results from pressure the narrowing column places on spinal nerves. For those who don’t respond to more conservative treatments, surgery may be recommended to correct spinal stenosis, and it’s important for such patients to prepare for the procedure properly. The preparations starts by ascertaining that back surgery is indeed called for.

Pain in your leg that is greater than the pain in your back caused by a pinched nerve (as measured by standard pain scales), is one indication that surgery is appropriate for a given case of spinal stenosis. Leg pain that does not decrease and interferes with your quality of life, and radiological scans confirming that the pain is likely due to nerve compression, are also indications that surgery may be beneficial.

Much of the advice on preparing for any back surgery applies to a spinal stenosis operation, as well. As in other back surgeries, you should stop smoking and, if overweight, shed excess pounds. Get your blood pressure down. Walk, or engage in other moderate activity that gets your muscles moving. This is important to speed your recovery process.

Check the medications you’re taking and discuss them with your physicians to ensure the medications will not interfere with your surgery or recovery. For example, blood thinners can interfere with blood clotting. Among women, birth control pills and hormone replacement therapy can also interfere with surgery.

Traditionally, spinal fusion back surgery has been performed in conjunction with spinal stenosis surgery to stabilize the spine at the site of the operation. A drawback of spinal fusion is that the procedure eliminates the independent motion of the fused vertebrae, and is also physically demanding. Now there is an alternative to spinal fusion following spinal stenosis surgery. The TOPSTM (Total Posterior Solution) System can be used instead of spinal fusion, and has better outcomes. Investigating whether this alternative procedure makes sense for you could be one of the best ways to prepare for your surgery for spinal stenosis.

How Soon Can I Get Out of Bed After Spinal Fusion Surgery?

How Soon Can I Get Out of Bed After Spinal Fusion Surgery?

In recent blogs we’ve addressed preparations for back surgery – specifically surgery for spinal stenosis, and spinal fusion operations. Yet the recovery process is just as important as the back surgery itself to your long-term health, so it’s important prepare for postoperative routines and realities well before the surgery is performed.

Among the first questions patients often ask about the spinal fusion back surgery recovery process is how soon they will be able to get out of bed following the operation. Patients typically get out of bed the day after their surgery – with the help of attendants, who will assist you in sitting up, getting your legs over the side of the bed, standing up and walking. You’ll be glad you spent time getting in shape before your operation. The preparation pays off at times like this, as being in good health will help throughout your healing and recovery, as the body responds to the trauma of surgery and works to repair itself.

Movement is indeed critical to proper healing, and since you’ll spend a good deal of time in bed in the first days after the spinal fusion operation, its important to learn how to move correctly in bed. You’ll be shown the best way to turn over, sit up, and move in ways that will promote proper healing, strengthen muscles and minimize pain.

Your caregivers will have plenty of useful tips for helping ensure a smooth, steady recovery from spinal fusion. For example, using slip on shoes, eliminating the need to bend over and tie laces; having pajamas with button tops, so you don’t have to lift arms and pull the PJs over your head; and drinking liquids from a squeeze bottle so there’s no need to bend the neck as when drinking from a cup, are among simple tips that will help you recover more quickly and with less discomfort.

Today many candidates for spinal fusion surgery can opt for the TOPSTM (Total Posterior Solution) System instead. The TOPS implant has been shown to have better clinical outcomes and fewer post-surgical complications than spinal fusion. And unlike spine fusion procedures, the TOPS device preserves the full range of each vertebra’s motion. Patients concerned about how soon they can get out of bed following spine fusion back surgery should make sure they’re familiar with all their surgical options, as the choices they make can also affect their recovery.

When to See a Doctor for Types of Severe Back Pain

 

Lower Back Pain

Back painslows down millions of Americans each year, with symptoms ranging from nuisance soreness to back pain so severe and debilitating that a visit to the emergency room becomes the first step on a path leading to a spinal surgeon’s care. According to the American Association of Neurological Surgeons, back pain is the second most common reason that adults see a doctor.

Back pain can occur anywhere on the back, from the neck (cervical area) to the middle of your back (thoracic area) to the lower back (lumbar area) with the lower back often being the most common location of severe and lifestyle-limiting pain, since the lower back bears most of your weight. That weight can compress the cartilage cushion between your vertebrae. And, over time, you might experience a degeneration of that cushioning cartilage, causing your discs to compress or slide out of place.

Walking, bending, lifting, twisting, even sitting and standing can then become excruciating. Back pain flares up and then goes away on its own after a few days for some people. But for others, sharp pains and limited motion becomes a bigger, more longer-lasting problem requiring medical care.

Here are some of the more severe back pain conditions:

* Disc degeneration. Discs in the spine can deteriorate with age, and the deterioration of discs can lead to inflammation and irritation in the spine, which can cause great pain.

* Sciatica. While many people associate the term ‘sciatica’ with pain in the buttocks area, sciatica can be a painful condition in the back. Sciatica is caused when the sciatic nerve (a bundle of lumbar nerves) become irritated by a herniated disc. This condition is known as spinal stenosis. The sciatic nerve also can be irritated by an abnormality in a vertebra that puts pressure on it. Sciatic pain may be felt in the lower back or buttocks, and may also be felt in the calf and the foot. Sciatica pain can be mild with tingling, or it can become severe, growing worse at night. You might experience worse sciatica pain when you have long stretches of standing or sitting.

* Lumbar spinal stenosis. When spinal degeneration occurs the canal through which spinal nerves travel can narrow. As part of the aging process, discs can dry out and shrink. When these two conditions occur, you might experience painful pressure on a spinal nerve. This can happen with a minor injury, as a symptom of osteoarthritis of the spine, or simply as a symptom of aging. The resulting back pain can be severe.

* Osteoarthritis. Arthritis anywhere in the body can be painful, but when osteoarthritis occurs in the back, you may experience pain and muscle spasms. Osteoarthritis can affect the cartilage in the discs, the vertebrae or both anywhere along the spine, pinching the nerves and causing pain.

*Herniated disc. Also called a ‘slipped disc,’ this condition occurs when a damaged or bulging disc pinches or irritates a nerve root.

When severe back pain occurs, your physician will assess you for any or all of these conditions, and you will likely start on a back pain reduction plan that aims to reduce your discomfort, return your mobility, and manage your back pain flare-ups. Perhaps you and your doctor will decide that spinal surgery is the best solution to remedy the internal causes of your severe back pain, returning you to better quality of life.

The TOPS™ System is one such solution. The TOPS™ (Total Posterior Spine) System provides an alternative to spinal fusion for patients undergoing spinal decompression back surgery. Unlike spinal fusion, TOPS preserves the full range of the spine’s natural motion, and has been shown to provide better outcomes than fusion in clinical studies performed around the world.

Sleep Tips for Back Pain Sufferers

Sleep Tips for back pain

Sleep provides important healing and rejuvenation to your back. When you’re suffering from back pain, it can be difficult to get a solid and healthy good night’s sleep. Lying down can be painful, and sleep simply doesn’t come. One of the many unpleasant symptoms of inadequate rest is being even more sensitive to pain. So it’s essential to take the smart steps necessary to improve your ability to sleep.

It may seem to be an impossible goal, but there are ways to improve your sleep quality while dealing with back pain:

  • Get a new mattress. A soft, old mattress that sags and provides inadequate lumbar support may be the culprit causing your back pain. When you sleep with your back arched on a mattress with the slope downward right at your hip level, you’re creating a terrible arch in your spine that can compress nerves and even cause disc damage. Upgrading to a top-quality new, medium-firm mattress that has no sag or slope and can cradle your body in a more natural and healthy position. Yes, a quality mattress is often pricy, but it’s worth the investment to improve your back pain.  Add in a posture-correcting orthopedic-approved pillow for your neck and head.  It will properly position your spine for better sleep and potentially less pain.
  • Sleep in a back-supporting position. One preferred position is lying flat on your back, and placing one or two pillows beneath your knees so that your spine is in a neutral, non-arched position while you sleep. If you prefer to sleep on your side, place one pillow between your slightly-bent knees while you lie on your side, and place another pillow against your chest, with your arm draped over it. This second pillow position prevents you from twisting your upper body and keeps your spine in neutral alignment as you sleep. Don’t sleep on your stomach, since this position arches your back and aggravates the spine, nerves and muscles affected in your back pain condition. Some frequent stomach-sleepers place a tennis ball in their pajama front pocket to prevent them from rolling over onto their stomachs during the night.
  • Reduce stress. Stress is a cause of chronic back pain, so focus on eliminating the sources of your stresses through meditation or deep breathing methods, journaling, limiting exposure to stressful people, lightening your load of life obligations such as running committees and other stressful jobs, or even getting short-term psychotherapy to deal with larger stressful issues in your life.
  • Limit or eliminate caffeine. You might be more sensitive to caffeine than you realize, and even moderate use can affect your sleep quality.
  • Don’t eat before bedtime. Limiting your snacking can help prevent nighttime indigestion or acid reflux, and it can also help keep your weight at a healthy level, which is better for your back.
  • Talk to your doctor about nighttime pain medications that can help you sleep. Your physician will assess your best pain medication regimen, which might include muscle relaxants, over-the-counter pain relievers, such as aspirin, Tylenol (acetaminophen), or Advil or Motrin IB (ibuprofen) which can be effective for short-term use and might be available in a ‘PM’ formula that can help you sleep.  Naproxen sodium (Aleve) is long-lasting and may offer pain relief throughout the night. Use these medications only as directed and with a doctor’s care.
  • Talk to your doctor about gentle exercises. Always consult with your doctor about recommended back pain-calming exercises. Never look online for ‘back pain exercises’ to do on your own, since your back might not be strong enough at this time for some exercises like planks or resistance band work. Your doctor will start you off slowly with a few exercises that can calm your back pain before bed, and then work with you to progress your back-improving movements over time.
  • Practice a good bedtime routine. Turn off the television and computer, dim the lights in your room to ready your body for sleep, cool your bedroom with a fan to help you sleep better, and avoid reading or working in bed before sleep. Winding down can prepare your mind, as well as your body, for a deep, restful sleep that lets your body heal better, and after a good eight hours of healthy sleep can make your pain levels easier to tolerate in the daytime.