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What is Lumbar Radiculopathy?

Lumbar Radiculopathy Education

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.

What is Lumbar Spinal Decompression?

Spinal Stenosis

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.

Back Treatment Options

Spinal fusion

In our previous blog we discussed the tremendous stresses borne by the lumbar, or lower portion of the spine comprising the five lowest vertebrae. In fact, lumbar back pain is a significant health issue, affecting about 70 to 85 percent of Americans at some point in their lives, according the National Institutes of Health (NIH). Among the most common causes of lumbar spinal problems is the degeneration of bones and tissue in the spine that occur as a normal part of aging. But one doesn’t have to be older to have lumbar spinal problems. Back pain is the most frequent cause of activity limitation in people under the age of 45, according to the NIH. Trauma or injury, poor posture and biomechanics, genetics, obesity and poor muscle tone can all result in lumbar spinal problems that cause pain, limit mobility, and have other serious health consequences. These conditions include spinal stenosis, bulging disc, herniated disc, slipped disc, radiculopathy and spondylolisthesis.

A variety of treatment options are available for individuals affected by conditions causing lumbar back pain. Individuals with moderate to severe cases of these conditions who do not respond to conservative treatment options such as medication, physical therapy and lifestyle changes, may opt for a surgical solution. Frequently this involves cutting away portions of a lumbar vertebra that is impinging, or putting pressure on a nerve emanating from the spinal column. Such spinal decompression surgery can have a dramatic impact on relieving pain and restoring mobility. However, removing bony elements also weakens and destabilizes the spine, so historically a procedure known as lumbar fusion, or lumbar spinal fusion has been performed in conjunction with spinal decompression back surgery of the lower spine. In this procedure the vertebra from which tissue was removed is fused to an adjacent vertebra. This stabilizes and strengthens the spine, but lumbar fusion eliminates the natural flexion and independent motion of the fused vertebrae. Today lumbar decompression surgery patients have an alternative to lumbar fusion: the TOPS™ (Total Posterior Spine) System. 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 are considering surgery for a lumbar spinal problem, ask your physician about all your surgical options.

Recovering from Lumbar Spinal Stenosis

Lumbar Spinal Stenosis

 

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.

 

What is a Lumbar Laminectomy?

Lumbar Laminectomy

Medical terminology doesn’t go out of its way to be complicated or hard to understand. It’s simply that the language has to be very precise, and that much of it comes from Latin. Hence, it can be difficult to decipher some med-speak without a little help. Take the term “lumbar laminectomy,” a fairly common surgical procedure that can help alleviate the pain, mobility limitations and other symptoms that often accompany medical conditions of the lower spine. Indeed, the word “lumbar” refers to the lower spine. The lumber portion of the spine comprises the lowest five vertebrae of the spinal column, which bear the designation L1 through L5 – “L” standing for lumbar.

 

Every vertebra in the spinal column is covered in a bony sheath called the lamina, which helps protect

the nerves that run through the spinal column. But sometimes, due to injury, disease, degenerative changes, or other causes, the lamina can put pressure on nerves emanating from the spinal column, a condition referred to as a pinched nerve. Problems within the vertebrae, such as an unnatural narrowing of the spinal canal, a condition called spinal stenosis, can also result in pinched nerves.

When surgery is performed to relieve pressure on a pinched spinal nerve, a procedure called spinal decompression, it requires cutting away the portion of the lamina that is impinging on a nerve, or to gain access to the interior of the vertebrae t

o address a condition such as spinal stenosis. In medicine, the suffix “ectomy” refers to excision or removal. Thus, cutting away a portion of the lamina is a procedure called a laminectomy. So a lumbar laminectomy is an operation in which a portion of the lamina on one of the first five vertebrae is trimmed away. A lumbar laminectomy can achieve dramatic results in alleviating the symptoms of pinched nerves. Traditionally, spinal fusion back surgery was performed in concert with a laminectomy to stabilize the spine at the point of the operation. Now lumbar laminectomy patients have an alternative that provides better outcomes than spinal fusion surgery, while preserving the full range of the spine’s motion: The TOPS (Total Posterior Spine) System procedure. If you’re a candidate for a lumbar laminectomy or other spinal decompression procedure, make sure you understand all your treatment options.

 

Back Pain and Steroid Injections

Back Pain and Steroid Injections

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.

What Is Back Strain?

What Is Back Strain

Hearing “It’s just a back strain” may not be very comforting when you’re experiencing severe back pain. While back strain may sound like a minimal back injury, it can cause you a great deal of discomfort, perhaps sleepless nights, back spasms that can cause severe lower back pain and in some cases, immobility. Many people with back strains go to the emergency room for relief.

Most lower back pain episodes are caused by damage to the muscles and/or ligaments in the lower part of the back. When you have back strain, you may have one or both of the following:

  • muscle strain, caused when a muscle is over-stretched or torn, resulting in damage caused to the muscle fibers (also called a pulled muscle).
  • lumbar sprain, caused when ligaments – the tough fibrous tissues connecting the muscles to the bones and joints — are stretched too far or torn.

Strain and sprain are often used interchangeably, since the treatment and prognosis for both of these are the same. So one is not worse than the other, although the amount of pain you’re experiencing may make you think that what you have is indeed the worse of the two. Especially since you cannot see inside your back, your imagination may conclude that you have something much worse than a back strain or sprain. Patients experiencing pain can often jump to dramatic conclusions and envision difficult treatments ahead.

It can calm your worries to understand what a back strain is. When the muscles or ligaments in the lower back are strained or torn, the area around the muscles will likely become inflamed. That back inflammation leads to back spasms that can cause your severe back pain and immobility.

“How did this happen to me?” is likely the next question on your mind. Back strains are often the result of a movement or movements that put undue stress on the lower back. Motions like lifting a heavy object, lifting multiple heavy objects (such as with landscaping using large rocks or bricks,) lifting and twisting, a sudden and single twisting motion (like your last golf tee-off of the day,) or a fall are just some of the movements that can cause back strain.

Symptoms of back strain may range from a mild ache to sudden, debilitating pain often localized in the lower back. The pain of a back strain is likely to be located in the low back, and not radiate down your leg (as with sciatica.) Your back may be sore to the touch, pain comes on suddenly and strongly, you may have those muscle spasms in your lower back, and you might find standing or walking to be more uncomfortable than resting.

With a doctor’s care and pain-reducing medications, you may find your back strain’s worst pain subsiding quickly, but with back strain, you may experience a lower level of pain, or flare-ups of pain, for a few weeks to a few months, depending on how severe your back strain is. And how well you rest after being diagnosed. Self-care is essential with back strain, so that those stretched or torn muscles of ligaments can heal well. Most back strains and sprains are much better after 3 to 4 weeks, since the large muscles in your back have a good blood supply, which delivers healing nutrients and proteins to your injury site for healing to take place. You might not be able to see that happening, but as you heal from your back strain, that’s what’s happening beneath the surface.

Who Can Get Back Pain?

back pain

Back pain is not just a symptom of aging. Anyone, of any age, in any physical condition, can and will likely experience back pain at some point in their life. So if you are experiencing back pain, don’t think that you’re alone. There are plenty of seventeen year-old athletes who experience back pain and thus seek the same medical care that you do for your own back issues.

While getting older can be a cause of back pain, as your body’s discs, joints, muscles and ligaments carry you through your life for a longer amount of time, and while many people experience their first back pain episodes while in their 30s and 40s, there are other top causes of back pain:

  • Being overweight. When you’re carrying extra weight above your ideal body weight, that can put extra pressure on your spine, muscles and joints, leading to back pain.
  • Not being physically fit. People who do not exercise on a regular basis, and thus lack good muscle tone and bone strength, often experience more back pain.
  • Heredity. Some causes of back pain, such as ankylosing spondylitis, a form of arthritis that affects the spine, can have a genetic component.
  • Your job. If your job requires you to lift heavy boxes, or push or pull heavy loads, you might experience greater back pain.
  • Lifting heavy items. Or people. Like grandchildren who may be growing and getting heavier, yet you still want to lift them. And if you’re a caretaker of an ill relative, lifting them can aggravate your back as well.
  • Sitting too much. If you sit at a desk or worktable for too many hours in a row, with poor posture and without getting up to stretch and walk around a bit, you might experience back pain.
  • Smoking. If you’re a smoker, you may experience back pain, because your body might not be able to get enough nutrients to the discs in your back. You might also have a smoker’s cough that puts pressure on your body and affects your back. And smokers are also slow to heal, so your back pain might be longer-lasting.
  • Other diseases. Some types of arthritis and cancer can cause back pain.

In short, anyone can get back pain. And perhaps you see yourself in several of the above causes, so take steps now to help prevent back pain or help lessen your back pain symptoms.

Common Questions About Back Pain: What are the Different Types of Back Surgery

Back Surgery Can Potentially Cure Your Pain

There are several different types of back surgery proving successful at resolving patients’ back pain issues, each involving the highest level of surgical technology available today, as well as the skill of a board-certified spinal surgeon. If your spinal specialist advises back surgery, you’ll embark upon a learning process about the different available back surgery procedures – guided by your physician. You always want to get your information directly from your spinal surgeon, since back surgery information online can be outdated or incorrect, and Googling back surgery topics can sometimes cause unnecessary anxiety.   The best course of action for researching back surgery procedures is to prepare a list of questions for your surgeon, and request all of the back surgery literature possible that your doctor can provide you with so that you can fully understand what will be done during your surgical procedure.

Overall, back surgery can accomplish several different pain-relieving goals, including removing portions of the bone to widen the narrowed area in your vertebrae, which can cause back pain. Your spinal surgeon may remove the gel-like middle section of a ruptured disc to relieve pressure on pinched nerves in the back. And sometimes, the damage to a disc is so severe, your doctor has to remove the entire disc and then fuse together the remaining discs.

Below is a list of some of the different types of back surgery that may be the customized choice for your back damage or condition:

  • Discectomy. In this type of back surgery, your spinal surgeon will remove the herniated portion of a disc to relieve irritation and inflammation of a nerve.
  • Laminectomy. This back surgery procedure involves removing the bone overlying the spinal canal, which then enlarges the spinal canal to relieve nerve pressure caused by spinal stenosis.
  • Fusion. Spinal fusion permanently connects two or more bones in your spine. When the vertebrae are fused, you get added stability to your spinal movements, or relief of pain from a spinal fracture. Occasionally, spinal surgeons will opt for spinal fusion to eliminate painful motion between vertebrae that can result from a degenerated disc or injured disc.
  • Vertebroplasty. During this type of back surgery, your surgeon will inject bone cement into compressed vertebrae to stabilize fractures or compressed vertebrae, which can relieve pain. A balloon-like method may be used to expand the vertebrae area, allowing your surgeon to inject the bone cement into the treatment area for optimal results.
  • Artificial discs. Your spinal surgeon may find that your discs are in an advanced stage of degeneration, and that implanted artificial discs are necessary for the creation of a spine that functions better and without compression to the nerves. Artificial disc technology is advancing every day through rigorous studies and testing, and your surgeon can introduce you to the materials and information about having new discs implanted for your spinal pain relief.
  • TOPS (Total Posterior Spine) System.  A mechanical implant device that stabilizes the spine without eliminating the independent motion of the individual vertebrae, as spinal fusion does.

 

Since back surgery is a complex procedure, work with your spinal surgeon to explore all your options.  Every situation is different and you need to feel secure that you have fully researched which type of back surgery would be best for you, and if back surgery is necessary at all. And of course, your doctor will guide you through all the information you need regarding recovering from back surgery and what you can expect for your post-surgery lifestyle.

reference: www.mayoclinic.com