Back pain affects an estimated eight out of 10 people over the course of their lives. So, it’s no surprise that this widespread medical condition sparks many questions among patients.
One of the most prevalent questions that spine specialists receive from back pain patients is whether or not they’ll need surgery. Understandably, most patients want to avoid back surgery and the risks that it involves.
In this article, we’ll answer some of the most common questions about back pain and back surgery. With this information, we aim to give you peace of mind in the range of treatments available for back pain today.
If you’re experiencing ongoing or severe back pain, you may be wondering if you’ll need back surgery to finally eliminate that constant backache. To answer this question and get on the path to relief from debilitating back pain, you’ll likely need to consult a spinal surgeon.
Your spinal surgeon will need to assess your back symptoms, take a full medical history, and review your general health. But, don’t start worrying about the prospect of surgery. Back surgery is generally only needed in a small percentage of back pain cases.
According to the UT Southwestern Medical Center, only 10% of back pain cases require surgery. Additionally, among back pain patients who require surgery, minimally-invasive procedures are widely successful.
So, for most patients, back pain can be resolved with a range of non-surgical options. These trusted treatments can keep you off of the operating table and quickly restore your quality of life.
When conservative treatments don’t help, your physician may recommend back surgery. This is often the case when the doctor is looking to provide relief from severe, disabling back pain that’s limiting your lifestyle, interrupting your sleep, and preventing you from being active.
The most common non-surgical treatment options available for back pain include:
In some cases, patients may benefit from epidural steroid injections, which can alleviate pain and inflammation in the spine. Unfortunately, steroid injections can also trigger tissue damage if they’re used in excess. Most physicians recommend that patients undergo no more than three to four injections per year.
Additionally, lifestyle changes are often very helpful in treating back pain without surgery. Specifically, changing your diet to lose weight can help remove pressure from the spinal nerves. This can help the irritated tissue heal and recover, as well as lessen neurological symptoms.
Your physician may recommend rest for back pain after your initial diagnosis. However, it’s important to stay active with low-impact activities to prevent stiffness and maintain strength. Once back pain and inflammation have decreased, you’ll likely be able to increase your activity level.
Exercise is beneficial for back pain because it prevents stiffness in the ligaments and tendons. It can help you maintain mobility in the back while increasing circulation to the injured tissue.
However, high-impact, strenuous exercise can do more harm than good for back pain patients. So, it’s crucial to choose your activities wisely.
Some of the best types of exercise for back pain include:
While exercising with back pain, remember to start slowly with short periods of activity. Make sure to rest in between your workouts. If you feel any pain or other concerning symptoms, such as numbness or tingling in the extremities, stop exercising and consider other activities.
The most common lower back pain causes include:
Strains and sprains are the most common causes of lower back pain. Strains involve stretching or tearing of the muscles or tendons, while sprains involve stretching or tearing of the ligaments.
The causes and treatments of strains and sprains are similar. Overexerting the back while lifting a heavy object, suddenly twisting the back, or falling are possible causes. To treat lower back sprains and strains, physicians typically recommend rest and at-home care, such as heat/cold therapy.
Patients may benefit from physical therapy for sprains and strains. A physical therapist can recommend stretching and strengthening exercises to alleviate tension while improving support for the back.
The spinal structures, including the vertebrae, facet joints, and intervertebral discs, naturally degenerate with age. This degeneration can contribute to spinal conditions like a herniated disc, spinal stenosis, spondylolisthesis, degenerative disc disease, and osteoarthritis. All of these spinal conditions can lead to chronic lower back pain.
Lower left back pain and lower right back pain can be caused by any of the common back pain causes listed above. However, if you have one-sided back pain along with other symptoms, such as fever and/or pain while urinating, the pain could be stemming from an internal organ. So, in this case, make sure to receive a medical evaluation promptly.
Especially in young adults, participating in sports is a key risk factor for lower back pain. According to Medscape, 7% to 13% of all sports injuries in college athletes are lower back injuries. Additionally, certain sports are more likely to trigger back pain than others.
The sports that present the highest risk of lower back pain include gymnastics, soccer, and dance, according to a 2009 study published in Sports Health.
Here are the symptoms and conditions that might make back surgery an optimal solution for you:
Back injuries and conditions that compress your spinal nerves can cause debilitating back pain and/or numbness, tingling, and weakness in the legs.
With a bulging, ruptured, or herniated disc, the rubbery discs that cushion and separate the bones in your spine are injured. So, the spinal structures are subject to more impact with day-to-day movements.
A fractured vertebra typically causes back pain and spinal instability. Many vertebral fractures heal on their own, while others require surgery. or other damage to your spinal column from a back injury. A fractured disc will cause pain, and also leaves your spine unstable, often causing additional back pain.
You may also be diagnosed with a condition that causes back pain and additional progressive nerve compression:
For lower back pain relief in severe cases, spinal surgeons may recommend one of the following types of lower back surgery:
Spinal decompression is the most common lower back pain surgery. It involves alleviating pressure on the spinal nerves by removing certain spinal tissues.
Several procedures fall under the umbrella of spinal decompression, including:
During fusion surgery in the lower back, your surgeon will secure bone graft material in between one or more vertebrae. This process permanently fuses the targeted vertebrae to prevent spinal instability.
Unfortunately, lower back fusion eliminates all independent motion of the vertebrae. This significantly diminishes patients’ back flexibility and may keep them from performing certain activities. Fusion also largely prolongs the recovery time for lower back surgery.
Recent innovations in spinal surgery, such as the TOPS™ System from Premia Spine, can prevent spinal instability after decompression surgery without compromising the patient’s mobility. The TOPS™ System is a non-fusion spinal implant that moves with the spine, protects neighboring segments from degeneration, and preserves spinal mobility.
Your spinal surgeon’s primary goal is to eliminate your back pain and restore your quality of life. When a progressive condition is diagnosed through testing and examination, back surgery may certainly move to the forefront of your surgeon’s mind. It’s their job to consider the best, most individualized treatment options to eradicate back pain before it becomes worse.
Whether to treat a slipped disc from age-related spinal degeneration or a traumatic spinal cord injury, spinal surgery is never taken lightly. When lower back surgery is selected as the preferred treatment option, it indicates that the condition being treated is severe.
Spine surgery comes along with the expectation that it will provide a meaningful improvement in the targeted medical condition. This improvement generally includes a reduction in the patient’s pain, as well as restored movement.
With these improvements in mind, there’s actually much to look forward to while you prepare for spine surgery! To ensure that the procedure and recovery go as smoothly as possible, consider these tips:
So, what’s our top tip for how to prepare for spinal surgery? Get in the best shape you can – mentally and physically.
To improve your physical fitness, exercise thoughtfully and eat a healthy diet. Exercising can be difficult when you’re dealing with a spinal condition. However, maintaining muscle strength and flexibility, as well as reaching a healthy weight, will aid in your spinal surgery recovery.
Additionally, exercising boosts endorphins, the body’s natural “feel good” chemicals. Endorphins can help you manage stress, pain, and your general mental well-being leading up to spinal surgery.
Certain physical activities are safer and more beneficial for patients with spinal conditions than others. These activities include:
We recommend speaking to your physician before starting any new exercise regimen. Your physician can inform you of any exercises to avoid as you prepare for spinal surgery.
Additionally, as a general rule of thumb, avoid high-impact activities, like running and jogging, while you’re recovering from a spinal condition. High-impact activities can place added stress on the spine and may impede its recovery process.
Extra weight places stress on the back. In fact, excess weight leads to increased impact on the spine with each step that you take, potentially complicating back surgery recovery.
A 2017 study published in the International Journal of Environmental Research and Public Health found that intervertebral disc disorder and chronic lower back pain are connected to obese and overweight body status. With this in mind, losing weight can support the outcome of your spinal procedure and recovery.
However, lose weight sensibly! Extreme and unhealthy weight loss can compromise your condition leading up to the surgery.
Here are our top tips for losing weight healthily:
If you smoke, it’s in your best interest to quit before spinal surgery. Smoking is detrimental to the success of spinal surgery, as well as the body’s healing process, even for minimally-invasive spine surgery.
Nicotine constricts the blood vessels. This means that when you smoke, the circulation throughout your body decreases. As a result, all of your cells, including those in your spine, will receive less of the oxygen and nutrients that they need to heal.
Decreased blood flow from smoking can also prevent surgical wounds from closing and increase the risk of infection. The infection risk after spinal surgery is further increased in smokers because smoking hampers the immune system.
Smokers are also at a higher risk of complications from surgery, including stroke, heart attack, shock, and even death.
Several clinical studies illustrate the risk of smoking for patients with spinal conditions:
If you don’t quit smoking, you’ll be required to stop approximately four to six weeks before the lower back herniated disc surgery and other spinal procedures. You’ll also need to abstain from smoking for two weeks after the procedure.
Quitting smoking can be difficult, to say the least. Here are a few tips that may help you quit before spine surgery:
Talk to your doctor about all of the medications that you’re taking long before undergoing spinal surgery. Be very thorough, as even herbal supplements can impact your recovery or interact with other medications prescribed for surgery.
There are a few different types of drugs that you generally must stop taking before surgery. These include:
Anticoagulants are also known as blood thinners. This type of medication prevents the formation of blood clots. But, before surgery, blood thinners also raise your risk of bleeding. So, it’s crucial to talk to your prescribing physician and surgeon about the right time to stop taking anticoagulants before surgery.
Common prescription anticoagulants include warfarin, NSAIDs, enoxaparin, ticlopidine, clopidogrel, and dipyridamole. Additionally, there are several over-the-counter and herbal anticoagulants, including aspirin, NSAIDs (like ibuprofen), vitamin E, ginger, garlic, and ginkgo biloba.
MAOIs remove specific neurotransmitters from the brain. This category of drugs includes certain antidepressants and anti-Parkinson drugs. Unfortunately, MAOIs also interfere with the medications utilized during anesthesia and should be stopped about a week or two before spinal surgery.
All MAOIs are prescription medications. Examples include tranylcypromine, phenelzine, rasagiline, and isocarboxazid.
Prepare for lower back surgery by learning as much as you can about the facets of your spinal condition, as well as the available treatments. There are numerous lower back surgery types, especially with recent advances in the medical field. Different types of lower back surgery may offer unique benefits and drawbacks.
One essential aspect of education before lumbar spine surgery is to understand the expected recovery period. Spine surgery recovery can last anywhere from a few months to a year if you undergo lower back fusion surgery.
Learning about the recovery time for lower back surgery well in advance of your procedure will streamline your healing process. With this knowledge, you can better plan how much help you’ll need around the house, how much time to take off of work, and when you can expect to return to your favorite activities.
The last few years have seen dramatic advances in spinal procedures that can provide significantly improved clinical outcomes and shorter recovery periods. The TOPS™ (Total Posterior Solution) System, often used in the treatment of spinal stenosis, spondylolisthesis, and other back problems involving a pinched nerve, is one such advanced procedure.
TOPS™ is an implant system approved for use as an alternative to lumbar spine fusion surgery after spinal decompression. The TOPS™ System preserves the independent flexion and bending of the individual vertebrae. This is in contrast to fusion surgery of the lower back, which eliminates this independent motion and can contribute to the deterioration of adjacent vertebrae.
The TOPS™ System has also been shown in clinical studies to provide better short- and long-term outcomes than spinal fusion.
Before undergoing spinal surgery, make sure to learn everything that you can about your condition and surgical options. By thoroughly discussing your treatment plan with your physician and asking any questions that come to mind, you’ll be far better prepared for your back surgery.
Back pain is one of the most complex and confounding conditions in medicine. There are several types of back pain, typically classified by their cause. These forms of back pain may originate in the back muscles, ligaments, and spinal structures, or even as a result of problems in other parts of the body.
Below, we’ll discuss some of the most prominent types of back pain, along with the causes of each.
Muscle strains are one of the most common lower back pain causes. A strain is a type of injury that affects muscle or tendon tissue. Tendons attach muscle to bone.
With a strain, the affected muscle or tendon has either been pulled, torn, or twisted. This injury is usually caused by overuse, such as engaging in strenuous physical activity that your body isn’t accustomed to. For example, you may sustain a back strain if you lift more weight than your body can safely handle.
Symptoms of muscle strains include muscle weakness, inflammation, cramping, and spasms. You may also experience a reduced range of motion in the back.
A back strain can result in severe lower back pain. However, the pain will remain localized and won’t radiate down to the legs. This is in contrast to back pain caused by certain spinal conditions, which can cause pain that spreads to the extremities.
Sprains and strains are commonly mixed up as back pain types. However, while strains involve muscle or tendon tissue, sprains involve injury to a ligament. Ligaments attach bones within a joint and provide stability to that joint.
With a back sprain, the ligaments in the spine are forced out of their usual position. This is typically caused by a fall, sudden trauma, or forceful twist.
Symptoms of ligament sprains are similar to muscle strains but take longer to heal. While a mild strain typically heals within three to six weeks, a sprain may take between six to eight weeks (or even several months) to heal. If you don’t allow a back sprain to heal properly, it can give rise to chronic back pain.
Although anyone, at any age, can sustain a back strain or sprain, you may be at a higher risk of developing one of these injuries if you:
Back strains and sprains can hamper your day-to-day activities and cause significant pain. To reduce your risk of developing these common back injuries, follow these tips:
Patients who are only experiencing pain on one side of the back often wonder about the cause of their pain. Both lower left back pain and lower right back pain can be caused by injuries to the muscles or ligaments that uphold the spine. One-sided back pain may also be triggered by spinal injuries and conditions.
However, one-sided back pain can also indicate an issue with the kidney, intestines, or reproductive organs. If this is the case, you’ll likely experience additional symptoms, such as nausea, pain while urinating, and/or fever.
Stress-related back pain isn’t an official diagnosis. But, there’s no denying that stress can play a significant role in the development of back pain.
Your body’s natural reaction to concerning, unpleasant, or scary situations is stress. When you feel stressed out, your body releases various chemicals and triggers physical reactions to protect you. These chemicals include cortisol and adrenaline, which tends to cause an involuntary tensing of your muscles.
This is a primal response that’s largely unhelpful against the stressors that people experience today, such as a deadline at work or a complicated social situation.
Frequent stress can lead to significant tension in the back. This may lead to chronic lower back pain when left unaddressed.
A 2021 study published in Scientific Reports confirmed that the severity of stress is directly correlated to chronic lower back pain. Specifically, severe stress was associated with a 2.8-fold increase in the risk of chronic lower back pain.
Spinal conditions are common types of lower back pain. Many of the most common spinal conditions trigger back pain by exerting pressure on the spinal nerves. This typically leads to what’s known as a pinched nerve. A pinched nerve can cause localized pain, much like a muscle strain, but may also involve other parts of the body.
Pinched nerves in the lower, or lumbar region of the spine, can cause burning lower back and leg pain. Surprisingly, a pinched nerve in this region can also have far-reaching effects on the bladder, appendix, large intestine, sex organs, knees, and prostate.
While several different spinal conditions can trigger back pain, the most common include:
A herniated disc occurs when the soft interior of an intervertebral disc protrudes through a damaged portion of the disc interior. The injured disc may push on spinal nerves, causing back pain and other symptoms.
Spinal stenosis develops if the space in the spinal canal becomes more limited. This may result from thickening spinal ligaments, a bulging or herniated disc, and osteoarthritis, among other factors.
Degenerative disc disease refers to symptoms of gradual, age-related spinal disc deterioration. As people grow older, the spinal discs become drier, thinner, and weaker, making them more prone to damage.
Spondylolisthesis occurs when spinal instability causes a vertebra to slip out of its normal position onto the vertebra beneath it. This can cause back pain and neurological symptoms. Although there are many possible causes of spondylolisthesis, the most common are degenerative spinal changes and spinal defects.
Osteoarthritis is also known as wear and tear arthritis. This condition occurs when the cartilage that cushions the joints starts to deteriorate. If osteoarthritis impacts the facet joints in the spine, it can lead to back pain.
When someone has scoliosis, it means that their spine is abnormally curved. This curve may cause back pain in a few different ways. It may cause spinal stenosis, disc degeneration, and facet joint damage. The curved spine can also press on nerves, leading to neurological symptoms.
Several factors can lead to the development of spinal conditions that cause lower back pain. The most prevalent of these factors include age-related spinal degeneration, spinal injuries and disorders, and congenital spinal defects. To understand exactly what’s causing your lower back pain, you’ll need a diagnosis from a qualified physician.
Numerous approaches exist for lower back pain relief in patients with spinal disorders. Almost always, physicians will start with a non-surgical treatment plan for six to 12 months before considering surgery. Most patients don’t need surgery to recover from the symptoms of various spinal conditions.
Simple rest, lifestyle modifications, medications, and physical therapy are among the beneficial non-invasive approaches to alleviate different types of lower back pain.
When patients continue to experience debilitating back pain after months of non-surgical treatment, surgery may be required. Additionally, spinal specialists may recommend surgery if the patient is experiencing significant disability as a result of their condition.
Thankfully, even serious spinal conditions can today be effectively treated with advanced microsurgical procedures. Innovative approaches to spinal decompression surgery use endoscopic techniques for smaller incisions, less blood loss, and less tissue damage.
Advanced, minimally-invasive spinal procedures offer relief from conditions that have condemned previous generations to crippling pain and restricted mobility.
After spinal decompression, spinal fusion is often performed to stabilize the affected portion of the spine. The fusion process involves positioning bone graft material in between the affected vertebrae. The graft will, in the months following the procedure, permanently join the adjacent vertebrae.
Though decompression spinal surgery can dramatically alleviate pain and other symptoms of compressed or pinched nerves, spinal fusion eliminates the independent motion of the fused vertebrae. This limits patients’ activities and increases the risk of degeneration in the surrounding vertebrae.
Today, the limitations of spinal fusion have been surmounted. The TOPS™ System from Premia Spine provides a clinically proven superior alternative to spinal fusion. This non-fusion spinal implant replaces the tissues removed during decompression surgery while preserving the full, independent motion of each vertebra.
If you’re experiencing back pain, don’t hesitate to see a qualified physician. You can achieve relief with the variety of treatment options available today.
Can you really travel to a foreign destination for a vacation and receive high-quality medical care at the same time? That’s the question many people raise when the subject of medical tourism comes up.
Many people are skeptical of medical tourism, and understandably so. When you receive medical care in your home country, you’ll naturally feel more comfortable with the treatment process. However, there are many advantages that medical tourism can offer.
For some patients, traveling to a different country for medical care is a worthwhile task. Keep reading to learn more.
Medical tourism is a term used to describe the action of traveling internationally for medical care.
The following benefits are attributed to the popularity of medical tourism for USA patients:
This is the key benefit of medical tourism. Many people can attain high-quality medical care at a fraction of the cost by traveling overseas. This particularly applies to patients in the U.S., which lacks a public healthcare system.
The quality of care should always be the primary consideration in medical tourism. There are first-rate medical facilities and health care professionals in many areas across the globe. Some of these areas, which are widely considered to be the best countries for medical tourism, include Germany, the United Kingdom, Turkey, Israel, India, Thailand, Singapore, Latin America, Eastern Europe, and Cyprus.
Different areas of the world have different medical regulatory bodies. Here in the United States, the FDA (Food and Drug Administration) protects Americans’ health by regulating drugs, biological products, medical devices, food, cosmetics, and even certain electric products.
In many instances, medical innovations have been developed, proven to be successful, and used for many years in other areas of the world. But, with the FDA’s regulatory processes, it can take a long time for those proven medical solutions to become available in the United States. This can also apply to residents of other countries who don’t have access to many of the advanced medical treatments in the United States.
Medical tourism can give patients access to the latest medical technology and, as a result, a higher quality of care.
The United States has the most expensive healthcare in the world. So, while few people would consider medical tourism to the U.S., many Americans contemplate international travel to lower their medical expenses.
When considering traveling internationally for a procedure, it’s wise to consider medical tourism examples and statistics.
Consumers who are interested in medical tourism value a variety of factors. The most prominent of these factors include:
Finances are arguably the most important factor to medical tourism consumers. In fact, in a study from the Medical Tourism Association, 85% of surveyed patients who traveled overseas to a hospital reported that the cost of medical care was a very important deciding factor.
The healthcare system in the United States leaves an estimated 9.6% of residents without health insurance, as of 2021. Even among individuals who do have health insurance coverage, high co-pays and deductibles can make it difficult to afford medical care.
With these facts in mind, it’s unsurprising that cost is a crucial factor for medical tourism consumers. Above all, these consumers want to secure an affordable price for medical care by traveling overseas.
Quality of care is paramount for many medical tourism consumers. By traveling to other countries, patients can attain a higher quality of care (at a lower cost) when compared to the medical treatment available in their home countries.
However, without the assurances that Americans are accustomed to under the FDA, consumers must consider the laws and regulations surrounding medical care in the country that they’re traveling to, as well as the foreign practice’s certifications.
While discussing the benefits of medical tourism, we mentioned that it can grant patients access to advanced treatments that aren’t available in their home country. With this in mind, the treatments available in other countries are a key consideration for medical tourism consumers.
Waiting lists for health care services are another consideration among medical tourism consumers. As of 2022, in the United States, 28% of patients sometimes, rarely, or never receive a response from their primary physician on the same day. This is a high percentage when compared to many other areas of the globe. However, 27% of patients in the U.S. wait one month or more for a specialist appointment, which is a lower percentage than in many other countries, including Norway and Canada.
With that said, long wait lists are primarily a concern for medical tourism consumers in nations with public healthcare systems.
Although medical tourism can provide several benefits, it also presents certain risks and safety concerns, including:
Some countries have a risk of complications including HIV, hepatitis B, hepatitis C, blood infections, wound infections, and infections from donor tissue or blood.
If patients travel to a facility using a language that they don’t speak fluently, doctor-patient communication can be difficult. Given that doctors provide crucial pre-op and post-op information, as well as procedure specifics, this may lead to confusion and errors.
Certain areas may not have comparable requirements for medical licensing and accreditation. This creates the risk of low quality of care.
Doctors typically advise against air travel immediately after surgery. This is because flying raises the risk of developing a blood clot. Depending on the type of surgical procedure, patients should wait between seven and 10 days before flying.
To avoid these risks, medical tourism consumers should ensure that:
As we’ve already mentioned, a significant benefit of medical tourism is that you can gain access to treatments that have not yet or have only recently been, approved for use in your country. Procedures that have been proven effective and are widely used in certain areas of the world can often benefit international patients.
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 but not yet in the United States. TOPS is an alternative to spinal fusion back surgery.
Spinal fusion is widely used with spinal decompression procedures for conditions like spinal stenosis, spondylolisthesis, bone spurs, and more. Unfortunately, fusion can severely limit patients’ range of motion in the back. Additionally, the complete recovery process for spinal fusion may last for six months to a year.
The TOPS System preserves the full range of motion between the individual vertebral segments, unlike spinal fusion. It involves a minimally-invasive surgical procedure, which greatly shortens the spinal surgery recovery period. In fact, patients may start moving around the day after TOPS surgery with few, if any, restrictions.
For certain patients with specific medical conditions, medical tourism could be the ticket to high-quality, low-cost healthcare. If you think you may benefit from medical tourism, make sure to conduct thorough research, find an accredited facility, and evaluate all of the risks before scheduling your appointment abroad.
Back pain is a prevalent health concern in the United States and around the world. In fact, almost 65 million Americans have had a recent episode of back pain.
Thankfully, most back pain episodes can be successfully resolved with at-home care. But, if this approach doesn’t relieve your back pain after a few weeks, you should consult with a back pain specialist.
A specialist may recommend medication for back pain to improve your symptoms. There are several different types of medications that can alleviate back pain, all of which we’ll discuss below.
Before we dive into the topic of medication for back pain relief, let’s answer some of the most commonly asked questions about back pain.
Back pain can be either acute or chronic. Acute back pain typically develops suddenly and resolves within four weeks. However, many cases of acute back pain go away within just a couple of days.
Chronic back pain lasts for 12 weeks or longer. Patients with chronic back pain may experience temporary pain relief, followed by a flare-up.
Back pain cases lasting between four and 12 weeks are considered subacute. This means that while the pain lasts longer than acute pain, it’s not defined as chronic.
Back pain may be a sign of a more serious condition if:
Generally, if you’re experiencing back pain that hasn’t improved at all after two weeks of at-home care, we’d recommend scheduling a medical evaluation.
Back pain can stem from a wide range of factors. Muscle strains and spasms are common causes of acute back pain and often resolve without medical intervention. Muscular back pain may feel like:
Spinal problems, on the other hand, tend to require expert medical treatment. Conditions such as a slipped disc, spinal stenosis, spondylosis, and spondylolisthesis can trigger persistent back pain.
Unlike muscular pain, spinal problems can cause neurological symptoms, including numbness, tingling, and weakness in the extremities. Additionally, back pain stemming from the spine generally won’t improve with rest, although changing positions may provide some relief.
Cases of back pain caused by a spinal condition may require surgical spinal solutions if conservation treatment methods fail after several months.
If your back pain is continuing to get worse despite self-care and at-home treatment, you may have a more serious condition, rather than an acute injury. Spinal arthritis, herniated disc, and spinal stenosis are among the most common causes of chronic back pain.
A slipped disc occurs when one of the intervertebral discs that cushion the vertebrae is injured. Specifically, the jelly-like disc interior presses out through a crack in the disc’s tough outer shell. If the damaged disc presses on nearby nerves, you may experience a range of symptoms, including:
Most back pain improves with a few weeks of self-care and at-home remedies. This may include over-the-counter pain relievers, ice, heat, and rest. While you should avoid lifting heavy objects and vigorous exercise, gentle, low-impact exercise and moving throughout the day can also help relieve back pain.
While it may seem like sitting and lying down will help relieve your pain, it can actually make it worse by increasing tension in the back muscles. Additionally, movement improves circulation, which helps deliver healing nutrients and oxygen to the back.
Along with these at-home remedies, the following non-invasive and alternative treatments can help decrease back pain:
The most common first step in using medication to alleviate back pain is taking over-the-counter medicine. Typically, this involves acetaminophen, such as Tylenol, or NSAIDs (non-steroidal anti-inflammatory drugs). Aspirin, ibuprofen (such as Advil and Motrin), and naproxen (such as Aleve) are widely used for back pain management.
These medications are often effective at relieving back pain and can work within a very short period. However, make sure to always consult the medication label and/or ask your doctor about the best dose of these lower back pain medications for your needs.
Taking too high a dose of over-the-counter pain medications, or taking them for an extended period, can trigger side effects including:
Additionally, you may not be a candidate for over-the-counter pain relievers if you have a history of heart disease, high blood pressure, peptic ulcer disease, gastrointestinal problems, kidney disease, or liver cirrhosis.
If over-the-counter medications don’t relieve your back pain issues, your doctor may also prescribe a muscle relaxant. This type of prescription medication for back pain has proven to be effective for many patients and can help manage secondary pain, such as sore hips.
While muscle relaxants will often lessen back pain, they can cause side effects like sleepiness and dizziness. So, you should take them only when you’re done driving for the day. Ideally, you should only take muscle relaxants when you’re at home and can fully relax.
Don’t take muscle relaxants when you’re at work, have to make important decisions, cook, or complete any other tasks that require focus. Additionally, only take them when you can be sure that someone is available to care for your kids and pets.
Some patients are more sensitive than others to the effects of muscle relaxants and can’t function safely while on this particular type of back pain medication. Your physician will help determine if muscle relaxants are the right choice for you.
Your doctor may also prescribe you a narcotic, such as codeine or hydrocodone, as a chronic back pain medication. These medications aren’t prescribed to everyone because they present several risks, including the risk of addiction. Your physician will likely try several other courses of treatment before resorting to narcotics for back pain.
With this in mind, narcotics should be used only for a short period and with close doctor supervision. Take these lower back pain relief medications only as prescribed and be mindful of side effects including:
Interestingly, some back pain patients experience chronic back pain relief from low doses of certain types of antidepressants. Tricyclic antidepressants such as amitriptyline, in particular, have been beneficial for some back pain patients.
While you may not feel depressed or show other signs of depression, antidepressants are among the arsenal of low back pain medication that your physician may recommend.
Side effects of antidepressants can include:
Cortisone injections are another treatment option for severe back pain. These anti-inflammatory and pain-relieving injections are delivered directly to the space around your spinal cord.
Your doctor might inject cortisone into the facet joints of your vertebrae. This can decrease inflammation in the areas causing your back pain, allowing for a fuller range of motion and greater stability. Additionally, a cortisone injection can decrease inflammation around the nerve roots, potentially providing back pain relief for up to a few months after the injection.
Unfortunately, cortisone injections don’t support the body’s healing process or accelerate recovery. In fact, if a patient receives too many of these injections, they can cause tissue damage. For this reason, physicians recommend no more than three to four cortisone injections per year.
Ultimately, the best medication for back pain relief will vary from patient to patient. So, talk to your doctor about which medications may be ideal to relieve your back pain.
Additionally, don’t hesitate to request information on possible side effects and how long you should take each type of suggested medication. It’s crucial to closely follow your physician’s instructions to relieve your back pain with over-the-counter or prescription medications.
All patients undergoing back surgery should actively ensure that the healing process goes as smoothly as possible. In doing so, you can attain the best possible results from the procedure while avoiding complications that could compromise your health.
Proper incision care is a key step in the process of adopting healthy habits and positive lifestyle choices to promote healing. As an aspect of your spinal surgery recovery, incision care will benefit your overall health.
Here, we’ll discuss how to care for a spinal incision to ensure a successful surgical recovery and back pain relief. Additionally, we’ll explore innovations in the field of spine surgery that allow for smaller incisions and, as a result, a lower risk of complications.
After spinal surgery, the incision may be closed with Steri-Strips, staples, or sutures, including dissolvable sutures. Most often, spinal surgeons use a combination of these closure methods.
Since spinal surgery is performed beneath the layers of skin and muscle in the back, the incision must be closed at various layers. Your surgeon will suture the muscle layer together before closing the skin.
In preparing for back surgery, patients should begin on a path of improving their diet and physical activity. These practices will improve your overall health to ensure that the spinal surgery goes off without a hitch.
With that said, implementing healthy habits is not only essential for the surgery itself but also for the recovery process following the operation. While continuing the positive lifestyle changes that you applied before the procedure, make sure to rigorously follow your doctor’s orders, including those about what medications to avoid. Certain medications can interfere with the healing process, namely including NSAIDs. NSAIDs, like aspirin, ibuprofen, and naproxen, are blood thinners and can impair the body’s repair processes.
Proper care for the surgical incision is one of the most important aspects of post-operative home recuperation following back surgery.
You won’t be permitted to apply any ointments or lotions to the incision while it’s healing. You also shouldn’t bathe in a tub, swim, or use a hot tub until your incision is healed. Immersing the incision in water before your surgeon clears you to do so may increase your risk of infection and inhibit the healing process.
Additionally, you’ll need to keep the incision clean after spinal surgery. You can clean the incision site with soap and water, then gently dry it with a clean cloth. This helps prevent infection as the incision heals.
In most cases, non-dissolvable sutures and staples are removed 14 days following the spinal surgery. At this point, the incision is usually fully healed.
Many spinal surgery patients are eager to reduce scarring by applying scar treatments and vitamin creams to the incision. However, you must wait to get the go-ahead from your surgeon before doing so. Typically, surgeons allow patients to start applying scar creams six weeks after the procedure.
It generally takes about two weeks for a spinal incision, including a spinal stenosis incision, to completely heal. At this point, your surgeon will remove sutures and staples, as well as clear you to take baths and swim. However, this timeline can vary from patient to patient.
Spinal incision infections typically appear two to four weeks after the procedure. Your surgeon will advise you to be aware of infection symptoms, which include fever, worsening redness at the incision, and changes in the infection drainage. If any of these symptoms occur, make sure to reach out to your surgeon immediately.
Additionally, if the surgeon places any hardware or devices during the procedure and an infection develops, they may need to be removed. This also applies to patients with an implantation spinal cord stimulator incision or spinal fusion incision.
Immediately after the spinal nerves are decompressed in surgery, the healing process can begin. But, nerve tissue heals far slower than other types of tissue in the body, namely muscle tissue. So, while some patients will experience an immediate improvement in nerve pain after spinal surgery, other patients may need more time to notice a difference.
In the weeks and months after spinal surgery, patients should notice a gradual improvement in neurological symptoms such as numbness, tingling, and weakness. By adopting healthy lifestyle habits, such as engaging in low-impact exercise, eating healthily, and refraining from smoking, you can ensure that the spinal nerves heal as quickly as possible.
Surgeons always aim to create as small an incision as possible while successfully carrying out the procedure. This is because a smaller incision leads to less blood loss, less scarring, and a lower risk of infection.
Fortunately, the last several years have seen a revolution in back surgery procedures and outcomes. Now, more minimally-invasive procedures are available to patients that require spinal surgery. These procedures allow for much smaller incisions, among other advantages over traditional open back surgery.
One procedure that can now be replaced with minimally-invasive alternatives is spinal fusion back surgery. This procedure was traditionally performed in conjunction with spinal decompression surgery for spinal stenosis, spondylolisthesis, and related conditions.
Spinal fusion involves positioning an implant containing bone graft material in between the affected vertebrae. Over the course of several weeks after the procedure, the bone graft will trigger the fusing of the vertebrae, turning them into a single bone. As a result, the patient can avoid spinal instability after decompression surgery.
Unfortunately, spinal fusion requires a long recovery period and eliminates the natural movement of the individual vertebrae. It also creates the risk of adjacent segment disorder, or ASD, which occurs when the vertebrae surrounding the fused segment degenerate more rapidly than they otherwise would.
Thankfully, a spinal fusion alternative has emerged to improve outcomes and preserve patients’ range of motion: the TOPS (Total Posterior Solution) System. The TOPS System is an implant that facilitates a minimally-invasive spinal surgery. It’s been shown in clinical trials around the globe to provide superior outcomes for patients who undergo treatments such as lumbar laminectomy or other spinal decompression procedures for various causes of lower back pain.
As the example of the TOPS System indicates, these advances in minimally-invasive back surgery allow for not only fewer complications in surgical incision healing, but also improved outcomes overall.
Don’t hesitate to discuss concerns surrounding post-op incision care with your surgeon, and make sure to explore all of your spine surgery options.
Chronic lower back pain is an extremely common medical issue across the world. In a study conducted to determine the global prevalence of this health concern, approximately 19.6% of individuals aged 20 to 59 were found to experience chronic low back pain.
Given the high prevalence of persistent low back pain among the adult population, various treatments have gained recognition in recent years. So, anyone who’s had chronic lower back pain has likely heard the term “lumbar fusion”. But, what exactly is lumbar fusion?
Here, we’ll answer that question, along with common queries about recovery from lumbar fusion and fusion alternatives.
Lumbar fusion is a surgical procedure performed on the lower, or lumbar, a portion of the spine. Its goal is to stabilize the back after spinal decompression surgery to relieve pain, restore mobility, and/or alleviate other symptoms of pinched nerves in the lower back.
The procedure is also called lumbar spinal fusion, or simply spinal fusion. It takes its name from the fact that two (or occasionally more) adjacent vertebrae are fused as a result of the procedure.
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.
In lumbar fusion, the surgeon accesses the vertebrae to be fused and secures bone graft material in between them. During the recovery period, the bone graft material will stimulate the fusion of the vertebrae, causing them to combine into a single bone.
Conditions including spinal stenosis, spondylolisthesis, and degenerative disc disease can develop as a result of traumatic injuries or natural age-related degeneration. These spinal conditions can cause symptoms including tingling, numbness, pain, restricted mobility, and even paralysis.
The lower back is more susceptible to injury and degeneration because it’s subjected to bending, twisting, and other physical stresses throughout a lifetime. Poor posture can exacerbate the issue by misaligning the spine, which puts an additional impact on the lower back.
Physical therapy, medication, and/or steroid injections can relieve many of the symptoms of these spinal disorders. However, when these therapies aren’t effective, a spinal decompression procedure to relieve pressure on these nerves may be recommended.
In short, lumbar fusion may be performed for common spinal problems in patients who don’t respond to six months or more of conservative treatment.
There are several methods of fusion surgery, the most common of which are PLIF, ALIF, TLIF, and XLIF.
PLIF stands for posterior lumbar interbody fusion. With this method, the surgeon accesses the spine through an incision in the back. This is considered the traditional method of spinal fusion. Unfortunately, it requires the surgeon to pull the muscles away from the spine to access the spinal bones, which can trigger significant pain during the recovery process.
ALIF is an acronym for anterior lumbar interbody fusion. This method involves accessing the spine from the patient’s front, which is known as an anterior approach. The incision is made in the abdomen, then the surgeon moves aside intestines and large blood vessels to reach the spine.
The benefit of ALIF is that it doesn’t agitate the large back muscles, which leads to a lower risk of injury and complications than PLIF.
TLIF is short for transforaminal lumbar interbody fusion. This method of spinal fusion involves a posterior incision, meaning that it’s made in the back. But, unlike PLIF, the incision used in TLIF is made by way of the intervertebral foramen.
With TLIF, the surgeon can complete a fusion on the front and back of the spine in one procedure. This is beneficial for patients because it’s less invasive, involves a lower risk of injury, and leads to less scarring.
XLIF stands for extreme lateral interbody fusion. This method of spinal fusion is considered minimally invasive, making it a highly attractive option for modern patients.
In XLIF, the surgeon first takes x-rays to find the exact position of the affected spinal disc. Then, the surgeon makes an incision in the patient’s side, completely avoiding the large back muscles and blood vessels that obstruct the spine in PLIF and ALIF surgery.
XLIF leads to less blood loss, pain, and lumbar fusion surgery recovery time, as well as a shorter hospital stay.
Medical professionals often disagree about how to determine the success rate of lumbar spinal fusion. As a result, there are no standard criteria to calculate the success rate of a fusion procedure. Many physicians argue that while fusion successfully prevents spinal instability after decompression surgery, it does so at the expense of the patient’s mobility.
So, while spinal fusion can help improve patients’ back pain by around 60% to 70%, it’s crucial to consider the lost motion at the fused vertebrae with this percentage.
Spinal fusion typically requires a hospital stay of two to four days. This gives the affected vertebrae time to solidify.
During their time in the hospital, patients generally work with physical and occupational therapists to learn how to best carry out daily tasks (like standing, walking, and getting dressed) without disrupting the lumbar fusion recovery process. Additionally, your therapist will talk to you about the exercises to avoid after lumbar fusion.
Before discharging a spinal fusion patient, the hospital staff will make sure that their pain is effectively managed with medication; that there’s no indication of infection; that they can get out of bed and move without assistance; and that they can empty their bladder.
The main drawback of lumbar fusion is that it eliminates the natural independent movement of the vertebrae. This inhibits patients from bending, flexing, and twisting the spine as they could before the procedure. Your doctor will advise you of this, as well as other lumbar fusion precautions before you undergo the surgery.
The degree of spinal mobility lost will depend on the location of the fused vertebrae, as well as the number of vertebrae that are fused. However, for many patients, fusion takes away their ability to partake in certain physical activities, such as sports and other athletics.
After spinal fusion, some patients are no longer able to bend down and pick up items off of the floor. In this case, the patient will require special tools to retrieve objects.
Additionally, it’s worth noting that patients may need as long as a year to fully recover from lumbar spine fusion. This lengthy recovery period can significantly impact patients’ quality of life.
In some patients, lumbar spinal fusion leads to a complication known as adjacent segment disease or ASD. With this condition, the vertebrae that are adjacent to the fused vertebrae degenerate at a faster rate. This is because the adjacent segments undergo added stress as a result of the fusion.
Unfortunately, ASD can cause back pain, stiffness, and neurological symptoms like weakness, numbness, and tingling.
Non-fusion spinal implants are alternatives to lumbar fusion. Today the TOPS™ (Total Posterior Solution) System is one such implant that provides a clinically superior alternative to spinal fusion. It allows the individual vertebrae to maintain their full range of independent motion.
This is just one reason why lumbar spinal decompression candidates must know exactly what lumbar fusion is, as well as the full range of treatment options available. If you suffer from chronic back pain, ask a spine specialist about the comprehensive selection of therapies at your disposal.
The human body contains an extensive system of nerves that facilitate communication between the cells. Nerves send and receive messages throughout the body. Without them, we wouldn’t have basic human functions, like movement, balance, and sleep, or sensations, like touch.
Unfortunately, just like the rest of the human body, nerves are susceptible to damage. Radiculopathy is one type of nerve damage that can severely impact one’s mobility and quality of life.
In this article, we’re going to discuss a specific form of this nerve condition: lumbar radiculopathy.
The vertebrae are the bones of the spine. An intervertebral disc is located in between each vertebra and acts as a cushion by absorbing impact.
If the vertebrae or the discs between them impinge on a nerve root in the spinal column, chronic nerve injuries may result. Radiculopathy is the general term for these injuries.
Radiculopathy most commonly occurs in the lower, or lumbar, region of the spine. This condition has been termed lumbar radiculopathy. Though less common, radiculopathy may also occur in the neck, or cervical region of the spine, which is known as cervical radiculopathy.
Common symptoms of radiculopathy include radiating pain, numbness, tingling, and weakness. In some cases, a loss of motor function can result from lumbar radiculopathy. These symptoms may be felt all the way to the tips of the fingers or toes, even though the nerve injury is at the base of the spine.
Radiculopathy symptoms felt in the arms and hands are usually caused by cervical radiculopathy, while those in the back of the leg and the foot usually result from lumbar radiculopathy. The location of the nerve compression determines where radiculopathy symptoms are felt.
The severity of lumbar radiculopathy symptoms can vary from patient to patient. Some patients with radiculopathy experience severe, debilitating symptoms that significantly impact their day-to-day activities.
There are several possible causes for lumbar radiculopathy, including:
Degenerative disc disease is a normal part of the aging process. It occurs when the intervertebral discs weaken and dry out over time. As the discs become damaged, the nerves of the spine may become irritated, leading to radiculopathy symptoms.
Repetitive and high-impact motions can contribute to lumbar radiculopathy. This is more common among people with occupations that require repetitive motions or heavy lifting.
Being overweight or in poor physical health can also contribute to radiculopathy. This is because added body weight puts extra stress on the nerves, which can lead to nerve damage.
Diabetes is associated with heightened blood glucose levels. This can cause the development of deposits within the blood vessels that decrease circulation throughout the body. As a result, high blood sugar can lead to nerve damage.
A genetic predisposition can also increase one’s risk of developing spinal radiculopathy.
Various spinal conditions can cause nerve impingement and lead to radiculopathy. Examples of these conditions include herniated disc, spinal stenosis, osteoarthritis, spondylolisthesis, and scoliosis.
Sciatica is a form of radiculopathy. In fact, it’s the most prevalent type of radiculopathy. It refers to pain that radiates throughout the sciatic nerve, meaning that it starts in the lower back and moves through the buttocks, down the legs, and to the feet.
The terms lumbar radiculopathy and sciatica are commonly used interchangeably. This is because nerve impingement in the lumbar spine typically involves the sciatic nerve. After all, the sciatic nerve is the largest nerve in the body.
Lumbar radiculopathy has the potential to get worse. In some patients, the pain may come and go. But, in others, radiculopathy symptoms are persistent and gradually become worse over time.
If lumbar radiculopathy isn’t promptly addressed, various factors can exacerbate the condition by causing additional nerve damage. These factors include:
Poor posture increases the amount of stress placed on the spinal nerves. In patients who lead a sedentary lifestyle, sitting at a desk with poor posture for hours on end may significantly worsen radiculopathy symptoms.
Repeatedly twisting, bending, and straining the spine can further irritate the affected nerves, leading to worsened radiculopathy symptoms.
Weight-bearing physical activities can cause additional damage to the spinal nerves. Examples of these activities include football, wrestling, weightlifting, soccer, and hockey.
Lumbar radiculopathy treatment methods may be non-surgical or surgical. Doctors begin with non-surgical treatment, and if the patient’s symptoms don’t improve after several months, consider surgery.
Physical therapy, medication, steroid injections, and relaxation are often prescribed successfully to treat lumbar radiculopathy.
Physical therapy is often recommended for lumbar radiculopathy. It involves exercises and therapies designed to improve spinal stability and alignment. This can help create more space for the spinal nerve roots.
Non-steroidal anti-inflammatory drugs, or NSAIDs, can help relieve inflammation and pain caused by lumbar radiculopathy. This can help make radiculopathy symptoms more manageable. However, these medications generally aren’t recommended for long-term use.
Epidural steroid injections reduce the body’s inflammatory response at the injection site. For lumbar radiculopathy, this can help alleviate inflammation in the spinal nerves.
Doctors generally advise patients to receive no more than three to four epidural steroid injections per year. Since steroid injections hamper the immune system response, they can cause tissue damage when used in excess.
Rest and relaxation are recommended for patients with lumbar radiculopathy to give the spinal nerves time to heal.
When non-surgical treatments fail to provide relief for radiculopathy of the lumbar region, surgical methods may be recommended. Generally, physicians don’t recommend surgery for lumbar radiculopathy unless the patient has undergone at least six months of conservative treatment.
Spinal decompression surgery is the main surgical lumbar radiculopathy treatment. This type of spine surgery involves removing spinal tissues to alleviate pressure on the affected nerves. Laminectomy, laminotomy, laminoplasty, foraminotomy, and discectomy are all common methods of spinal decompression.
Since spinal decompression surgery involves removing tissues from the spine, it can lead to spinal instability. To prevent this, spinal decompression surgery is often combined with spinal fusion back surgery. This combination of procedures has been a common treatment modality for lumbar radiculopathy patients who don’t respond to conservative treatments.
Spinal fusion permanently joins the affected vertebrae using bone graft material. This prevents all motion in the fused spinal segment. Unfortunately, while this counters instability, it also significantly decreases the patient’s range of motion.
Additionally, fusing two spinal vertebrae forces the adjacent vertebrae to bear additional impact with day-to-day motions. The added impact can cause the adjacent spinal segments to deteriorate at a quicker rate, potentially leading to back pain, stiffness, and neurological symptoms. This complication of spinal fusion is known as adjacent segment disease or ASD.
The TOPS™ (Total Posterior Spine) System is a new advancement in spinal surgery that can be used as an alternative to spinal fusion. Unlike fusion, the TOPS™ System preserves the full natural range of motion of the individual vertebrae, which is lost when the bones are fused.
This spinal implant has also been shown to provide superior outcomes in clinical studies conducted across the globe. With TOPS™, lumbar radiculopathy patients can attain lasting relief for nerve pain without having to worry about complications from spinal fusion.
Advances like TOPS™ give individuals with back problems more options for effective treatments. So, if you’re suffering from persistent radiculopathy pain, speak with a spine specialist about the complete range of treatment solutions available today.
Lower back pain has long been a prevalent health concern around the world. In 2017, the prevalence of lower back pain was estimated to be approximately 7.5% of the world’s population. This totals about 577 million people.
There are numerous causes of lower back pain, as well as countless treatments that can help relieve it. Lumbar spinal decompression is one treatment strategy for alleviating lower back pain caused by a pinched nerve.
This article will discuss lumbar spinal decompression, when it’s implemented, and what patients can expect from the procedure.
Imagine if the branches of a tree were as large at the top as they are at the bottom. Now, imagine that a heavy load is placed on the ends of the very highest branches. This would put an enormous amount of stress on the lower portion of the tree trunk.
This is comparable to what we experience as humans with our spinal columns. The human spinal column is like the trunk of a tree, but we’re as large on the top of the trunk as we are at the bottom. This puts a high amount of stress on the lower back, which is also called the lumbar region of the spine.
The strain of lifting objects and twisting the spine over the course of a lifetime is exacerbated by degenerative spinal changes that occur with age. So, it’s not surprising that most of the back problems that bring patients to spinal specialists are centered in the lower, or lumbar, region of the spine.
The stresses discussed above, along with disease and/or injury, can result in a host of spinal disorders. Bulging or herniated discs, spinal stenosis, and spondylolisthesis are among the most common.
A bulging disc is a spinal disorder that occurs when the exterior of an intervertebral disc weakens, typically from the natural aging process. This can cause the disc to bulge out into one side of the spinal canal.
A herniated disc is essentially one step further than a bulging disc. It occurs when the soft interior of the disc protrudes out through a crack in the weakened disc exterior.
Spinal stenosis can result from a bulging or herniated disc, as well as a range of other factors. It’s a spinal condition characterized by an abnormal narrowing of the spinal canal.
Reduced space in the spinal canal can place stress on the spinal nerves or the spinal cord. But, decompression for lumbar spinal stenosis can effectively alleviate this stress.
Spondylolisthesis is a condition that develops when one of the vertebrae is unstable and slips out of its regular position. The displaced vertebra settles on the vertebra beneath it.
These disorders can place unnatural pressure on the nerves that emanate from the spinal column. This may cause pain, restricted mobility, and other symptoms of a pinched nerve.
Spinal decompression is a method of easing pressure on impinged spinal nerves. It can be performed either non-surgically or surgically. Lumbar spine decompression simply refers to decompression procedures performed on the lower portion of the spine.
The surgical solution for a lumbar pinched nerve involves removing a small amount of tissue from vertebrae in the lumbar region. The surgeon will remove the tissue that’s impinging, or putting pressure, on a nerve. This process is referred to as lumbar spinal decompression surgery.
There are various types of lumbar decompression surgery that may be implemented for different spinal disorders. The most common forms of surgical lumbar decompression include:
Laminectomy and laminotomy are two surgical methods of lumbar decompression that involve the lamina. The lamina acts like the roof of the spinal canal and protects the spinal cord.
Laminoplasty is a procedure that involves making two cuts in the lamina so that it swings outward, like a door. After creating a hinge with the lamina of the affected vertebra, the spinal surgeon will position small bone wedges to keep the “door” from closing. Commonly referred to as open-door laminoplasty, this procedure can effectively alleviate pressure on the spinal nerves without removing the lamina.
In foraminotomy, the surgeon creates more space around the area where nerve roots exit the spinal canal. This area is known as the intervertebral foramen. It acts as a passageway, linking the spinal canal to the periphery.
By opening up the intervertebral foramen in foraminotomy, the spinal surgeon can alleviate pressure on the spinal nerves.
Discectomy is a spinal decompression procedure that involves removing damaged intervertebral disc tissue. The spinal surgeon may remove some or all of the damaged disc, depending on the patient’s needs.
Removing tissue in lumbar decompression surgery can lead to spinal instability. So, historically, spinal fusion back surgery has been performed in conjunction with lumbar decompression surgery to stabilize the spine.
In spinal fusion, the surgeon places bone graft material in between the affected vertebrae. As weeks and months pass after the procedure, the vertebrae will fuse, forming a singular bone. By completely preventing motion in this segment, fusion effectively prevents instability following spinal decompression surgery.
Unfortunately, lumbar decompression and fusion can have certain negative effects on the body, including:
The key downside of spinal fusion is that it prevents all motion in the fused segment. This eliminates the patient’s ability to flex, twist, and bend the spine normally. As a result, patients may no longer be able to partake in their favorite sports and activities after spinal fusion surgery.
The spinal segments that are adjacent to the fused vertebrae must undergo additional stress to compensate for the fusion. This can lead to a complication known as adjacent segment disease (ASD), with which the adjacent vertebrae deteriorate at a more rapid rate. ASD can lead to lower back pain, radiating pain, difficulty walking or standing, and neurological symptoms.
Today, the TOPS™ (Total Posterior Spine) System provides an alternative to spinal fusion that preserves the spine’s natural full range of motion. This advanced spinal implant has been shown to provide better outcomes than fusion in clinical studies performed around the world.
The TOPS™ System provides an important additional treatment option for individuals with moderate to severe pinched nerve symptoms. It can provide a major improvement in lower back pain for patients who don’t respond to non-surgical lumbar spinal decompression therapy.
The recovery period for lumbar decompression surgery can vary depending on the exact procedure and whether or not spinal fusion is performed. However, patients can generally expect to wait four to six weeks before reaching their expected degree of mobility and returning to work.
Spinal fusion prolongs the recovery process for lumbar decompression surgery. It can take up to a year to fully recover from fusion. With this in mind, the TOPS™ System can significantly reduce the lumbar decompression surgery recovery time, allowing patients to return to physical activity much sooner.
Lumbar decompression surgery is an invasive procedure. So, as with any surgical procedure, it comes with certain risks.
With that said, lumbar decompression is widely performed and considered safe. Advancements in medical technology have even made minimally-invasive lumbar decompression surgery possible. This allows for greater safety and a lower risk of complications.
If you have symptoms of a pinched nerve, don’t hesitate to talk to your doctor about the complete scope of treatment options available to you.
Spinal stenosis is a prevalent spinal disorder in the U.S. and across the globe. In fact, the condition affects an estimated 250,000 to 500,000 U.S. residents.
This spinal disorder can occur in the lower, or lumbar, region of the spine, which is known as lumbar spinal stenosis. Or, it may occur in the neck, or cervical, region of the spine, which is known as cervical spinal stenosis. Lumbar spinal stenosis is the most common form of this condition, and it’s the topic of our article.
Spinal stenosis is a common condition, especially among patients who are aged 50 and over. It occurs when the spinal canal abnormally becomes narrower. The word “stenosis” can be traced back to ancient Greek and refers to narrowing, or constriction.
As the spinal canal progressively narrows over time, it strains the nerves that extend outward from the spine and travel into the extremities. This can cause a range of symptoms.
The symptoms of lumbar spinal stenosis can differ from patient to patient. However, pain, tingling, and numbness in the extremities are among the most common signs of this spinal disorder.
Other symptoms of lumbar spinal stenosis may include:
There might be other non-specific symptoms of spinal stenosis. So, please consult with your doctor for a precise diagnosis.
Most cases of spinal stenosis occur for unknown reasons. However, the causes of lumbar spinal stenosis are rooted in specific parts of the spine’s anatomy, such as:
An intervertebral disc is located between each of the bones in the spine. It provides cushioning for the bone and prevents damage by absorbing impact. These discs break down with age and may even become herniated, meaning that the disc interior protrudes from a crack in the disc interior.
A damaged intervertebral disc can take up extra space in the spinal canal, potentially leading to spinal stenosis.
The facet joints connect the vertebrae of the spine to one another. These joints support a large amount of weight and undergo a significant amount of stress. As a result, they’re vulnerable to wear and tear, as well as various injuries. Damage to the facet joints (and the cartilage within these joints) can trigger spinal stenosis.
When the spinal cord and/or the nerve roots become compressed, it may trigger pain and neurological symptoms. When the spinal cord and nerve roots are involved in spinal stenosis, the patient is rarely asymptomatic.
The narrowing, or tightening, of the spinal canal, may result from abnormal bone and/or tissue growth. or due to a hereditary disorder. This is referred to as inherited spinal stenosis.
Some people are born with a spinal canal that’s narrower than average. This can cause the patient to experience spinal stenosis symptoms much earlier in life than the average patient. Additionally, patients who are born with scoliosis may experience spinal stenosis.
Scoliosis is an atypical, sideways curve of the spine. It’s commonly recognized and diagnosed in children and adolescents. In patients with scoliosis, the curved spine may place stress on the spinal cord, potentially leading to spinal stenosis.
Degenerative spinal stenosis refers to cases of this condition that are caused by wear and tear on the spine. This is the most common type of spinal stenosis.
Spinal degeneration is a normal effect of aging. It occurs as the intervertebral discs and facet joints weaken from repeated strain over time. Factors including a sedentary lifestyle, poor posture, obesity, injuries, smoking, and other spinal disorders (such as scoliosis) can speed up the process of spinal degeneration.
Effects of aging that can contribute to the development of degenerative spinal stenosis include:
Leading a healthy lifestyle by exercising, eating a nutritious diet, and maintaining an optimal weight can help prevent spinal stenosis.
Options for spinal stenosis treatment include:
Various exercises can help with spinal stenosis by improving strength and mobility in the affected areas. You can perform these exercises at home to support your lumbar spinal stenosis recovery.
Examples of spinal stenosis exercises include:
This exercise engages the glute muscles, which support the pelvis and can help reduce the strain on the lumbar spine.
This simple exercise engages the transverse abdominis, which is a deep abdominal muscle that promotes proper spinal alignment and helps protect the lower spine.
This exercise stretches and helps relieve tension in the lower back muscles. It also flexes the spine, which relieves pain from spinal stenosis by temporarily creating more space in the spinal canal.
Physical therapy may improve symptoms of lumbar spinal stenosis by relieving pressure on the spinal cord. For lumbar spinal stenosis, physical therapy typically involves stretches for the lower back, legs, and hips, as well as strengthening exercises for the abdominal muscles, which support the lower spine. Your physical therapist may work with you on mobility exercises to improve your range of motion in the lower back.
Additionally, physical therapy may involve treatments that can help with pain, tension, and inflammation. These treatments include heat/cold therapy, electrostimulation, massage, etc.
Both over-the-counter and prescription medications may be used to reduce pain and inflammation from lumbar spinal stenosis. Talk to your doctor before starting a new medication for spinal stenosis symptoms in the lumbar spine.
In extreme cases, surgery for lumbar spinal stenosis may be recommended. Typically, doctors don’t recommend lumbar spinal stenosis surgery unless the patient has first undergone at least 6 months of conservative treatment.
For lumbar spinal stenosis, spinal decompression surgery is often performed. This type of surgical procedure involves removing portions of the vertebrae that are impinging on the roots of nerves emanating from the spine. By relieving this pressure, the procedure gives patients symptom relief and provides the spinal nerves with enough space to heal.
Laminectomy is the most common form of spinal decompression surgery for spinal stenosis of the lumbar region. In this procedure, the surgeon removes all or part of the lamina, which forms the ceiling of the spinal canal. Other types of spinal decompression surgery include foraminotomy and discectomy.
Following the spinal decompression procedure, spinal fusion back surgery has traditionally been performed to stabilize the spine. Spinal fusion involves placing bone graft material in between the affected vertebrae. Over time, the bone graft will cause the vertebrae to permanently fuse.
Unfortunately, this stabilization procedure eliminates the independent motion of the fused vertebrae and can contribute to the deterioration of adjacent vertebrae. Patients can lose a significant amount of motion in the lower back after spinal fusion.
Spinal fusion alternatives, such as non-fusion implants, can offer stability without limiting the patient’s mobility after spinal stenosis surgery. The TOPS™ System, for example, provides an alternative to spinal fusion that maintains the spine’s full range of motion. It’s been proven in clinical studies conducted worldwide to provide superior outcomes than spinal fusion following spinal decompression surgery.
Patients seeking surgical relief for an abnormal narrowing of the spine now have access to a wider range of treatment options than ever. Talk to your doctor about the best course of treatment for your needs.