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A range of spinal conditions can lead to chronic lower back pain. When this pain doesn’t respond to non-surgical treatment options, your doctor may recommend lumbar arthroplasty.
Lumbar arthroplasty is a surgical procedure that can resolve symptoms of spinal conditions including spinal stenosis, spondylolisthesis, and facet joint arthrosis.
Below, you’ll find a detailed overview of spinal arthroplasty surgery to help you feel confident and informed heading into the procedure.
Lumbar arthroplasty is a surgical procedure that involves removing and replacing a damaged spinal disc in the lumbar spine. It’s commonly considered a substitute for spinal fusion, which involves fusing two vertebrae into a single bone.
In lumbar arthroplasty, the damaged spinal disc is replaced with a spinal implant, prosthetic, or artificial disc. There are many different implant options for this procedure, each of which can impact the success of the surgery and your spinal motion.
Later in this article, we’ll discuss spinal implants for lumbar arthroplasty, such as the TOPS spinal implant, in greater depth.
Both spinal fusion and lumbar arthroplasty can be used to resolve pain from spinal disc damage. However, arthroplasty can preserve motion in the spine, while spinal fusion limits it.
In spinal fusion, the surgeon removes the damaged spinal disc tissue, much like in lumbar arthroplasty. However, instead of using a spinal implant, the surgeon places bone graft material in between the affected vertebrae.
In the months following spinal fusion, the vertebrae will fuse and form one bone. This prevents lower back pain, but it also keeps the patient from bending and twisting the fused portion of the spine.
By using an implant instead of fusion, spinal arthroplasty allows the patient to retain spinal flexibility with lower back pain relief. Plus, the recovery process for lumbar arthroplasty with an implant is much shorter than that of spinal fusion.
One of the main applications of lumbar arthroplasty is lumbar degenerative disc disease. With almost 400 million people in the world each year diagnosed with degenerative disc disease, this spinal condition is a prevalent issue among older adults.
Degenerative disc disease occurs as a result of wear and tear on the spinal discs, typically due to aging. Spinal discs protect the vertebrae against damage by absorbing shock and reducing pressure on the spine. Unfortunately, the aging process can weaken and dry out these discs, often leading to pain and other symptoms.
The spinal discs consist of fibrous tissue, cartilage, and water. The fibrous tissue makes up each disc’s tough outer layer, called the annulus fibrosus. The interior of each spinal disc is a soft, viscous core called the nucleus.
When spinal discs are undermined by the natural aging process, it can increase your risk of developing spinal conditions, such as osteoarthritis, spinal stenosis, and spondylolisthesis.
If a degenerated disc in the lumbar spine causes severe and/or chronic back pain, lumbar arthroplasty may be performed to remove the diseased disc. However, lumbar arthroplasty is typically only performed if non-invasive treatments have failed.
Physicians usually recommend non-invasive treatments to relieve symptoms of lumbar disc disease before considering spinal arthroplasty. Examples of non-surgical solutions for disc disease include:
At-home heat and cold therapy can help relieve pain, muscle tension, and inflammation from lumbar disc disease.
Placing an ice pack over the lower back for 10 to 20 minutes can ease inflammation, swelling, and pain. Using a heating pad or taking a warm bath can release tension in the lower back and prevent spasms for pain relief.
Physical therapy is one of the most effective non-surgical treatments for disc disease. It often involves strengthening the muscles that support the spine, improving the body’s range of motion, and promoting physical activity to relieve pain.
Over-the-counter pain medications can offer relief from spinal disc disease pain. Generally, OTC pain medications are effective for mild pain and inflammation.
Severe pain typically needs to be treated with prescription pain medications. Additionally, prescription pain medications can generally only be used for a limited period of time, so they’re not a sustainable solution for spinal disc pain.
Epidural steroid injections can be used to relieve pain and inflammation from a damaged spinal disc. Specifically, steroid injections lower the immune activity in the damaged area of the spine, which reduces inflammatory cell production.
Usually, epidural steroid injections are the most effective when they’re used in combination with other therapies, such as physical therapy. However, physicians usually only recommend that patients get two to three steroid injections per year. Excessive injections can diminish the condition of the vertebrae and adjacent muscles.
Before undergoing lumbar arthroplasty to relieve lower back pain, it’s important to understand the surgery preparation, procedure steps, and recovery process.
To prepare for lumbar arthroplasty, your doctor may ask that you:
Smoking reduces blood flow and adversely affects the function of the heart and lungs. This can lead to breathing issues during surgery and inhibit your healing process.
Before undergoing lumbar arthroplasty, talk to your doctor about the medications and supplements that you’re currently taking. You may need to stop taking some or all of them before the surgery.
To ensure that the anesthesia is more predictable, patients are generally asked to stop eating and drinking around 8 hours before the procedure.
Spinal arthroplasty generally involves the following steps:
The exact steps of lumbar surgery can depend on a range of factors, including which spinal implant is used. The TOPS System is an innovative spinal implant that has proven to yield positive patient outcomes after lumbar arthroplasty surgery.
Lumbar arthroplasty doesn’t involve bone healing. So, it has a shorter and less painful recovery period than other spinal procedures, such as spinal fusion.
With that said, you may still be given pain medications and will need to avoid intense physical activities for several weeks. Your doctor will likely recommend physical therapy to improve spinal flexibility and stability after lumbar arthroplasty.
TOPS is a spinal arthroplasty system that can preserve patients’ range of motion and reduce the recovery period after lumbar arthroplasty surgery. Patients can often return to their favorite activities, including sports, within 4 to 6 weeks of spinal arthroplasty with the TOPS implant.
To learn more about the TOPS spinal arthroplasty system, reach out to Premia Spine today.
The lumbar facet joints are crucial structures within the lower spine. Thanks to these small joints, the spine can move comfortably and securely.
Unfortunately, the strain of age and injuries can trigger lumbar facet joint pain. Often referred to as lumbar facet joint syndrome, this type of spinal pain can limit your range of motion and daily activities.
In this article, we’ll discuss the treatment options for lumbar facet joint pain, including facet joint replacement.
Each of the vertebrae in the spine has two facet joints. One facet joint is located on either side of the vertebra. These joints link the vertebrae together to make the spine a cohesive structure.
There are a few key functions of the facet joints, including:
The facet joints help stabilize the spine, especially while it’s in motion.
By linking the vertebrae together, facet joints allow the spine to move. Thanks (in part) to the facet joints, the spine can securely twist and bend in different directions.
Facet joints protect the structures within the spine, including the spinal cord and discs.
The lumbar spine is the most common area of the spine for facet joint pain. In fact, lumbar facet joint pain is estimated to make up 15% of all back pain cases.
After the lumbar spine, the most prevalent area of the spine for facet joint pain is the cervical spine, followed by the thoracic spine.
Lumbar facet joint pain can lead to chronic lower back pain and reduced range of motion. This may limit your ability to carry out day-to-day activities.
Lumbar facet joint pain is most often caused by spinal degeneration. As we age, the structures of the spine gradually deteriorate. This age-related wear and tear can impact the facet joints in several ways.
For one, the facet joints themselves can wear down from the repeated impact. However, the degeneration of other spinal structures, like the spinal discs, can also affect the facet joints.
With age, the spinal discs lose strength and hydration. This can make the discs flatten out. As a result, the facet joints may become misaligned, leading to back pain.
Although it’s more common in the cervical and thoracic spine, lumbar facet joint pain can be triggered by trauma. The trauma of a sudden impact, (from a car accident, sports injury, etc.) can affect the lumbar facet joints and cause lower back pain.
Multiple treatment options can help relieve lower back pain and stiffness from lumbar facet joint disorders. Generally, doctors recommend a non-surgical treatment plan to start.
Non-surgical treatment options for lumbar facet joint pain include:
Heat and cold therapy are at-home treatments that can offer relief from symptoms of lumbar facet joint pain.
Avoiding activities that exacerbate facet joint pain is recommended for recovery. These activities may include long periods of sitting and repeatedly bending the spine.
While certain types of physical activity can worsen facet joint pain, it’s important to stay active (in moderation). Remaining sedentary can diminish the tissues in the lower back, leading to worsened pain.
Short walks, water aerobics, and using an elliptical machine are examples of low-impact exercises that can support your facet joint pain recovery.
Your doctor may recommend over-the-counter and/or prescription pain medications to treat lumbar facet joint pain. NSAIDs, acetaminophen, antidepressants, and muscle relaxants are all examples of medications that can provide lower back pain relief.
A physical therapist can help you overcome lumbar facet joint pain with stretching, strengthening exercises, and manual therapy. These methods can help relieve muscle tension, support spinal stability, and improve the alignment of the spine.
Epidural steroid injections may be used to decrease inflammation in a diseased facet joint. While this is often an effective method for pain relief, doctors typically limit the number of injections that you can get per year. Excessive steroid injections can lead to tissue damage.
If lumbar facet joint pain doesn’t respond to several months of non-invasive treatments, surgery may be recommended.
Surgery for lumbar facet joint pain typically involves replacing the damaged facet joint with a spinal implant. This process, commonly known as lumbar facet joint replacement surgery, can relieve pain and stiffness in the lower back.
Lumbar facet joint replacement has proven to be a long-term solution for spinal conditions, including lumbar spinal stenosis and degenerative spondylolisthesis.
In lumbar facet joint replacement surgery, the surgeon will first access the spine. Then, the damaged facet joint is removed.
Next, a spinal implant, such as the TOPS System, is implanted at the site of the diseased joint. This is usually at L4-L5, L3-L4, or L2-L3. The implant stabilizes the spine while allowing the patient to retain full spinal flexibility.
After lumbar facet joint replacement surgery with the TOPS spinal implant, patients can usually return to their regular activities within just 4 to 6 weeks.
Facet joint replacement surgery is an alternative to facet fusion surgery. Fusion involves fusing the vertebrae in the painful region of the spine together, forming a single bone.
While spinal fusion relieves facet joint pain, it does so by preventing motion in the spine. So, patients can’t bend, twist, and move as they used to after fusion.
Facet joint replacement stabilizes the spine and relieves facet joint pain without preventing spinal motion. This allows patients to quickly return to their favorite activities soon after the procedure.
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.
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:
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.
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:
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.