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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.
* 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.
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.
Epidural injections of steroids have often been the treatment of choice for patients with a pinched nerve in the back whose symptoms did not respond to simple exercise, physical therapy, or other more conservative approaches. Steroid injections have also been offered to patients with spinal stenosis whose back pain was unrelieved by less invasive therapy. But the results of a new research study hint that injections of steroids for back pain may be less beneficial than believed. The study is small, but it still bears consideration, as the findings are statistically valid and underscore why healing is as much an art as a science.
The study of the efficacy of steroid injections for back pain examined more than 270 patients, aged 53 to 75 years old, culled from the ranks of a larger study of individuals with spinal health problems. The research subjects were followed for four years. Sixty-nine of these patients had epidural injections and 207 did not, but otherwise the patients’ symptoms were primarily the same in terms of severity, as measured by well-established scales used to measure pain in the leg and lower back. Using these scales, researchers found less improvement among those who had epidural injections than among patients who did not have injections.
Several caveats must be offered when considering the results of this research. First, as the authors readily acknowledge, factors that the researchers didn’t account for and couldn’t control may have affected or skewed the results. Nonetheless, we are seeing fresh thinking and new techniques improving outcomes for many spinal patients. For example, patients who elected to have spinal decompression surgery to relieve symptoms of pinched nerves typically opted for a spinal fusion back surgery in tandem, in order to stabilize the spine. Today, a growing number are opting for TOPSTM – the Total Posterior Solution – System, instead of spinal fusion. The TOPS system, unlike spinal fusion, preserves complete independent motion of the individual vertebrae. This is one more way that fresh thinking, and new technologies and procedures are transforming the care and treatment of back problems.
Lumbar spinal stenosis, a common medical problem, denotes an unnatural narrowing of the spinal canal, the center of the spinal column housing the spinal nerves that relay sensorial information to the brain and control the movements of our muscles. The term stenosis comes from Latin, and means a narrowing. When a portion of the spinal canal narrows unnaturally, it can put pressure on the spinal nerves, and these pinched nerves in turn can cause pain and limit mobility.
The good news is that a variety of treatment options are available that have been proven effective in helping individuals recover from or ameliorate the symptoms of spinal stenosis. Conservative, non-invasive therapies include simple lifestyle changes, medications, physical therapy, and injections of anti-inflammatory agents. For patients with spinal stenosis, there’s no way of knowing which of these approaches will be most successful, so physicians may simply prescribe one of these treatments as a first step, and monitor the results to see how the patient responds. If the first method selected doesn’t achieve the results of helping the patient recover from spinal stenosis, the next option may be tried, and so on.
For patients with moderate to severe spinal stenosis who do not respond to conservative treatments, surgery may be recommended. In this form of spinal decompression surgery, the surgeon trims away excess bone in the narrowed center of the affected vertebra, relieving pressure on the compressed nerve or nerves. Historically, a spinal fusion back surgery operation has been performed in conjunction with surgery to relieve spinal stenosis, in order to stabilize the region of the spine where the operation was performed. Today there’s an important, and better alternative to spinal fusion. The TOPS (Total Posterior Spine) System procedure provides better clinical outcomes than spinal fusion surgery. The TOPS solution has the added benefit of preserving the spine’s full range of motion, unlike spinal fusion, which permanently fuses adjacent vertebrae. TOPS also offers a much quicker recovery from surgical treatment for spinal stenosis than spinal fusion. If you’re a candidate for spinal stenosis surgery, make sure you understand all the advanced surgical solutions available today, and what impact each will have on your recovery from this condition.
Imagine if the branches of a tree were just as big at the top as they are at the bottom, and that sometimes, heavy loads were placed on the ends of the very highest branches. Think of the stress that would put on the lower portion of the tree trunk. Well, that’s analogous to the situation we humans experience with our spinal columns. Our spinal column is like the trunk of a tree, but we’re just as big at the top of our trunks as at the bottom. The stress this puts on our lower backs – also called the lumbar region of the spine – is exacerbated by the cumulative affect of a lifetime of lifting and twisting in combination with degenerative changes of the spine that occur as a result of aging. So it’s not surprising that the majority of back problems that bring patients to spinal specialists are centered in the lower, or lumbar region of the spine.
These stresses, along with our genetic makeup, disease or injury, can result in a host of spinal disorders such as bulging or herniated discs, slipped disc and spinal stenosis. These disorders, in turn, can result in unnatural pressure being put on nerves that emanate from the spinal column, potentially causing pain, restricted mobility, and other symptoms of pinched nerves. We talked about the problem of pinched spinal nerve and spinal decompression in general in a previous blog. As we noted, spinal decompression is a means of easing pressure on impinged spinal nerves, and can be performed either non-surgically or surgically. Lumbar spinal decompression simply refers to decompression procedures performed on the lower portion of the spine.
The surgical solution for a lumbar pinched nerve involves removing tissue from vertebrae in the lumbar region that impinge, or put pressure on a nerve. This is called lumbar spinal decompression surgery. Historically, spinal fusion back surgery has been performed in conjunction with lumbar decompression surgery to stabilize the spine. Today, the TOPS™ (Total Posterior Spine) System provides an alternative to spinal fusion that 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. This provides an important more treatment option for individuals with moderate to severe symptoms of pinched nerves who do not respond to non-surgical lumbar decompression procedures.
It may sound like something only a deep sea diver needs to be concerned about, but spinal decompression is an important topic for many people suffering from debilitating back pain. Spinal decompression refers to the process of relieving pressure on one or more pinched, or impinged nerves in the spinal column. The pressure on such nerves can cause pain, restrict mobility, and result in a host of other physical problems that can manifest in almost any part of the body. A host of spinal conditions, including spinal stenosis, disc degeneration, bulging, herniated or slipped discs, and facet syndrome can put pressure on nerves emanating from the spinal column.
Spinal decompression can be performed both surgically and non surgically. Non-surgical spinal decompression utilizes mechanical, computer controlled traction devices to reduce the pressure placed on nerves in specific portions of the spine. Inversion therapy, in which patients hang upside down, is another from of non-surgical spinal decompression.
For patients who do not respond to non-invasive methods, spinal decompression surgery can achieve dramatic improvements. In this surgical procedure, portions of the bone or tissue of the spine that impinge of a nerve are cut away, relieving the pressure. Historically, a spinal fusion procedure was performed in conjunction with spinal decompression surgery, in order to stabilize the spine at the point where the decompression procedure was performed. But spinal fusion, in which two vertebrae are fused to enhance spinal stability, eliminates the independent motion of the fused vertebrae, and may accelerate degeneration of adjacent vertebrae. Today, 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.
If you’re a patient whose pinched spinal nerve is not responding to non-invasive decompression methods, make sure you discuss all your surgical options with your physicians.
Spinal stenosis – one of the most common spinal conditions – is an abnormal narrowing of the spinal canal. (“Stenosis” refers to a narrowing, or constriction.) As the spinal canal progressively narrows over time, it puts pressure on the nerves branching out from the spine, causing pain, tingling, and numbness in the extremities. The condition can occur in the lower, or lumbar region of the spine – lumbar spinal stenosis, which is the most common form – or in the neck, or cervical region of the spine – cervical spinal stenosis.
The majority of cases of spinal stenosis develop for unknown reasons, but the causes of spinal stenosis can be traced to several components of spinal anatomy, including the intervertebral discs, the facet joints that connect the vertebrae to each other, and the spinal cord. The narrowing of the spinal canal may result from abnormal bone growth and/or tissue growth, or due to a hereditary disorder. Maintaining a healthy lifestyle including exercise, good nutrition and maintaining proper weight can help prevent spinal stenosis.
Options for treatment of spinal stenosis include spinal stenosis exercises, physical therapy that can relieve pressure on the spinal cord, and medication to reduce pain and inflammation. In extreme cases, surgery for spinal stenosis may be recommended. The surgery removes potions of the vertebrae that are impinging on the roots of nerves emanating from the spine. Following this spinal decompression procedure, spinal fusion back surgery has traditionally been performed to stabilize the spine. Unfortunately, this stabilization procedure eliminates the independent motion of the fused vertebrae, and can contribute to the deterioration of adjacent vertebrae. Today, the TOPS™ (Total Posterior Spine) System provides an alternative to spinal fusion that maintains the spine’s full range of motion, and that has been proven in clinical studies conducted worldwide to provide superior outcomes than spinal fusion following spinal decompression surgery. So patients seeking surgical relief for an abnormal narrowing of the spine now have access to a wider range of treatment options than ever.
A slipped disc is a common term for a herniated disc, which occurs when the central core of a spinal disc ruptures. Fluid from within the disc then leaks into the spinal canal, where it can interfere with the functioning of nerves. A slipped disc in the spine is the last stage in a degenerative disc disease process that begins with a bulging disc and progresses to a protruding disc, before it finally ruptures. The “slipped disc” has not actually shifted position. Symptoms of slipped disc vary depending on the location of the slipped disc in the spine, and the extent of the rupturing. A slipped disc may be entirely unnoticeable if it doesn’t result in pressure on a nerve. A slipped disc in the neck (a slipped cervical disc), may cause pain or numbness in the shoulders, arms or chest. A slipped disc in the lower back (a slipped lumbar disc) may cause sciatica, creating pain anywhere from the buttocks to the feet.
The main causes of slipped disc are spinal degeneration from the natural aging process, or from injury such as improper lifting of heavy objects or poor body mechanics that put unnatural stress on the spinal column. Smoking and excess body weight also increases the risk of developing a slipped disc. Sudden trauma such as an automobile accident rarely causes slipped disc. Treatments for slipped disc include slipped disc exercises and physical therapy, medication to relieve pain and pressure on spinal nerves, and in some cases surgery for slipped disc. Spinal fusion back surgery is often performed in conjunction with surgery for a slipped disc. The fusion stabilizes the spine, but eliminates the natural independent motion of the now-fused vertebrae. Today many patients are choosing the TOPS™ (Total Posterior Spine) System as an alternative to spinal fusion surgery. The TOPS solution provides better clinical outcomes and preserves the independent motion of the vertebrae. This is just one of the advances bringing new and better therapies to back patients worldwide.
If the vertebrae (the bones of the spine), or the cushioning discs between them impinge on the root of a nerve in the spinal column, chronic injuries to the nerve may result. Radiculopathy is the general term for these injuries. The condition most commonly occurs in the lower, or lumbar region of the spine, termed lumbar radiculopathy. Radiculopathy may also occur in the neck, or cervical region of the spine, which is termed cervical radiculopathy. Common symptoms include radiating pain, numbness, tingling, weakness, and loss of motor function. 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 nerve at 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.
Degenerative disc disease, a normal part of the aging process, can cause this condition, as can repetitive or stressful physical activities. Occupations that require repetitive motions or heavy lifting are common cause of lumbar radiculopathy. Being overweight or in poor physical health can also contribute to radiculopathy. Improper blood flow and progressive disease can also lead to the condition. A genetic predisposition and the presence of other spine disorders also increase one’s risk of developing spinal radiculopathy.
Physical therapy, medication, and relaxation are often prescribed successfully to treat lumbar radiculopathy. Spinal decompression surgery combined with spinal fusion back surgery has been a common treatment modality for patients who do not respond to conservative treatments. Today the TOPS™ (Total Posterior Spine) System, a new advance, can be performed 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. The TOPS System has also been shown to provide superior outcomes in clinical studies around the world. Advances like these give individuals with back problems ever more, and more effective, treatment options.
Radiculopathy is a term that refers to chronic injuries that result from the bones of the spinal column (vertebrae), or the cushioning discs between them, impinging on the root of a nerve in the spinal column. The symptoms of radiculopathy may be felt all the way to the tips of fingers or toes, even though the nerve compression occurs at the base of the nerve in the spine. Common symptoms include numbness, tingling, weakness, loss of motor function, and radiating pain.
Radiculopathy can result from lack of proper blood flow and progressive disease, or from repetitive or stressful physical activities, such as in jobs that involve heavy lifting or repetitive motions. A genetic predisposition and the presence of other spine disorders also increase one’s risk of developing spinal radiculopathy. Degenerative disc disease associated with the normal aging process can also cause this condition. Treatment options for radiculopathy include physical therapy, medication, and relaxation. For patients whose radiculopathy is not relieved by conservative treatment, spinal decompression therapy may be recommended. During this procedure, the portion of a vertebra impinging on the nerve root is trimmed away. This can provide dramatic relief from radiculopathy symptoms. Traditionally, spinal fusion back surgery has been performed in conjunction with spinal decompression to stabilize the spine at the point of the operation. Unfortunately, spinal fusion eliminates the natural independent motion of the fused vertebrae, and may contribute to deterioration of adjacent vertebrae. Today there is an alternative: the TOPS™ (Total Posterior Spine) System implant preserves the natural motion of the spine and has been shown in clinical studies around the world to provide better clinical outcomes than spinal fusion. With major medical advances occurring at a rapid pace today, it’s important to be aware of all the latest treatment options for any condition for which you are seeking medical treatment.