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:
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.
Recently, we addressed the topic of claudication. Claudication refers to pain typically felt in the legs as a result of vascular (blood vessel) problems or back problems (such as spinal stenosis) that can cause pinched nerves in the lower back.
Neurogenic claudication is a common symptom of lumbar spinal stenosis, which is the abnormal narrowing of the spinal canal in the lumbar (lower) spine. Neurogenic refers to the condition’s genesis in the nerves, while claudication (Latin for limp) refers to painful weakness or cramping in the legs.
Also called pseudoclaudication, neurogenic claudication occurs as a result of compression of the nerves in the lumbar spine. Neurogenic claudication is widely considered a syndrome, meaning that it involves a group of symptoms that usually develop collectively.
As aforementioned, most cases of neurogenic claudication are triggered by spinal stenosis, which occurs when the space around the spinal cord diminishes.
Spinal stenosis is estimated to affect 8% to 11% of adults in the United States, according to the American Academy of Orthopedic Surgeons. It’s the most prevalent in adults over the age of 50.
Common causes of spinal stenosis include bone spurs, bulging discs, and the thickening of ligaments in the spine.
These spinal conditions can trigger the impingement of spinal nerves, which leads to the symptoms associated with neurogenic claudication.
This syndrome may be bilateral (in both legs) or unilateral (in one leg). However, most cases of neural claudication are bilateral.
Symptoms of neural claudication typically include pain, cramping, weakness, and tingling. These symptoms most often appear in one or both legs, the lumbar spine, and the buttocks.
Pain from neural claudication may be triggered by walking or prolonged standing and is generally alleviated by changing position or bending the waist. Unlike vascular claudication, neural claudication can’t be alleviated simply by resting.
In severe cases, pain from this syndrome may be persistent. Without treatment, spinal stenosis and neural claudication can become a source of chronic pain.
First, your physician will need to run tests to provide a diagnosis. An x-ray, MRI, and CT scan are all often used to diagnose neural claudication and can identify stenosis, bone spurs, and slipped discs.
These tests can evaluate the general condition of the spinal bones and soft tissues to determine if neural claudication is present. This, along with a physical exam and patient interview, will help your physician diagnose your spinal symptoms.
Conservative treatments may be sufficient to relieve neurogenic claudication. Physicians generally start patients out with a conservative treatment plan before considering surgery.
Some of the most common non-surgical treatments for neurogenic claudication include:
Physical therapy for neural claudication usually involves exercises for spinal flexion, abdominal exercises to improve stability, and lifestyle recommendations. Massage and heat/ice therapy may also be implemented for pain relief.
Anti-inflammatory medications can help relieve pain and inflammation caused by neurogenic claudication. These medications may be found over-the-counter or prescribed, depending on the severity of the case.
Epidural steroid injections can be used to relieve pain from irritated nerves in the spine. When injected into the affected area, the steroid medication works to reduce pain signals from the injured nerves, leading to less pain and discomfort.
Keep in mind that epidural steroid injections should generally only be applied three to six times annually. If you get too many injections, there’s a risk of decreasing the strength of the vertebrae and adjacent muscle tissue.
In moderate to severe cases of neurogenic claudication that don’t respond to conservative protocols, surgery may be recommended. Spinal decompression surgery can improve your comfort and quality of life if neurogenic claudication is interfering with your daily activities.
Spinal decompression surgery is typically performed to remove portions of the vertebrae that are impinging on a nerve. This pinched nerve is the source of pain, weakness, and cramping in cases of neurogenic claudication.
Any procedure that relieves pressure on spinal nerves to resolve symptoms of spinal compression, including neurogenic claudication, is referred to as spinal decompression surgery. There are a few different approaches to spinal decompression, including discectomy, laminotomy, laminectomy, foraminotomy, foraminectomy, corpectomy, and osteophyte removal.
Your surgeon will determine the best method of spinal decompression to suit your circumstances.
Following the spinal decompression treatment, a secondary operation is performed to stabilize the spine in the area where vertebral material was removed. In the past, spinal fusion back surgery was the sole available surgical stabilization procedure performed with spinal decompression.
Spinal fusion involves connecting neighboring two vertebrae so that they eventually form one bone. To do this, the surgeon will position bone graft material in between the vertebrae.
To keep the vertebrae in position during the bone graft’s healing process, your surgeon may also perform posterior fixation. This involves using screws and rods to reinforce the alignment of the spine.
Although spinal fusion can prevent further damage from spinal instability, it has several downsides. For one, patients commonly need to stay in the hospital for up to four days after spinal fusion. After the patient returns home, it can take many months for the vertebrae to fuse together and for the spine to heal.
Spine fusion surgery eliminates the natural independent motion of the fused vertebrae. It can contribute to the deterioration of adjacent vertebrae, potentially leading to further complications.
Additionally, spinal fusion compromises the mobility of the spine. Patients may require special tools to pick up items off of the floor because they can no longer bend over after spinal fusion.
The TOPS (Total Posterior Solution) System provides an alternative to spinal fusion that preserves the full range of natural motion of each vertebra. It’s a mechanical device that supplants the tissues removed during spinal decompression.
With the TOPS spinal implant, it’s possible to reinforce the stability of the spine after spinal decompression surgery without compromising the patient’s range of movement. This device moves with the spine so that the patient can resume their normal activities soon after surgery.
The TOPS device also provides a faster, more comfortable recovery process after spinal decompression. This spinal implant reduces the trauma on the spinal tissues after decompression.
If you experience pain that interferes with your quality of life, seek qualified medical help and get the facts about all of your treatment options. Today’s advanced procedures provide excellent outcomes for spinal conditions including neural claudications.
We’ve addressed preparations for back surgery in recent blogs and specifically the surgery for spinal stenosis and fusion operations. Yet, the recovery process is just as necessary as the back surgery itself to your long-term health, so prepare well for postoperative routines and realities before the surgery is performed.
Among the first questions patients often ask about the spinal fusion back surgery recovery process is how soon they will get out of bed following the operation. Patients typically get out of bed the day after their surgery – with the help of attendants, who will assist you in sitting up, getting your legs over the side of the bed, standing up, and walking. You’ll be glad that you spent time getting in shape before your operation. The preparation pays off at times like this, as being in good health will help throughout your healing and recovery, as the body responds to the trauma of surgery and works to repair itself.
Movement is indeed critical to proper healing, and since you’ll spend a good deal of time in bed in the first days after the spinal fusion operation, it’s essential to learn how to move correctly in bed. We’ll show you the best way to turn over, sit up, and move in ways that will promote proper healing, strengthen muscles and minimize pain.
All surgeries involve certain risks in one way or another, such as infection, bleeding, or nerve damage. E.g., if you suffer from osteochondrosis, problems with other discs may occur. In most cases, such complications are associated with the rigid spinal fusion structure, where the load on the vertebrae is unevenly distributed. Therefore, people may feel unable to do some movements. Joints perform a dual function that leads to degenerative changes.
On the other hand, a spinal stenosis surgery implant is a more effective treatment for certain spine diseases. But the healing process can take several months, especially if the patient is overweight or has poor muscle tone. At the stage of preparation for surgery, you’d change your lifestyle and take the following steps:
Getting out of bed after back surgery will go smoothly, and you’ll be able to get up and walk unaided in a few days and soon even go home to recover. Some elderly or debilitated patients may consider visiting a rehabilitation center for about a week. That will help strengthen a back and learn how to move safely.
The hospital regimen in the first days after the operation provides instructions on how to get around, as flexibility will be limited. Patients often receive pain relievers and wear a brace to maintain the correct spine position. By the way, prescription opioids shouldn’t be consumed with alcohol. You can also replace them with more traditional methods – e.g., cold or heat wraps for 15-20 minutes with a break of 2 hours between procedures. A separate topic is the resumption of a diet consisting of solid food. Also, general anesthesia requires fasting for at least 8 hours before the intervention. On the day of surgery, only a sip of water is allowed to take medicine.
When you’re in better physical condition before surgery, healing time can be shortened, e.g., doing all kinds of exercises recommended by doctors, physical therapy, undergoing a course of massages, etc. This is how you can strengthen your back muscles. Subsequently, they’ll better support the spine, and you won’t wonder how to get in and out of bed after back surgery. In any case, a sedentary lifestyle puts a greater risk of wear and tear on the vertebrae located above and below the immobilized part.
Anything that was inconvenient or seemed impossible before the operation became available. Postoperative care is directly related to the initial preparation phase, namely the layout of your home. Oddly enough, but it’s essential to have a spacious bathroom with a shower and a rug so as not to slip, a firm mattress so that the process of getting in and out of bed after back surgery is as painless and gentle as possible for the operated area. Consider placing a portable small refrigerator and cooler in the room, as well as blankets and other supplies so that you can easily access them. You can also utilize a grabber to lift items off the ground and shelves (find them in pharmacies or specialized stores). For elderly patients who have difficulty walking, sticks or walkers are recommended. A soft lounge chair, unlike a regular chair, can reduce the load on the lumbar region. In general, you need to take care of preventing falls: remove objects through which there is a possibility of tripping, install handrails as required (e.g., in the shower, on the stairs). This way, you can recover in a safe environment. Household chores after discharge are also best left to family members, a home care aide, or a caregiver.
Here are some tips on how to get out of bed after back surgery faster.
For recovery to take place as quickly as possible and for the load on the spine to be optimal, it’s necessary to take short walks every 30 minutes. For example, if you sit for most of the day, you’d learn the most ergonomic position. Use supports with a low back or unique chairs that allow you to maintain correct posture.
Please note that after surgery, you’d avoid long car trips.
Sitting with knees higher than hips has a negative effect on the spine. Therefore, try to get up slowly: move to the edge of the seat and utilize the armrests to push upward. Focus on your feet.
Bending, lifting, twisting, and driving – all these activities are prohibited in the early stages of recovery. For example, flexion at the knees and hips is perfectly acceptable, but not the spine. Remember: don’t lift anything that weighs more than a gallon of milk (about 8 pounds)! It’d also be borne in mind that due to drowsiness, impaired judgment, and poor coordination – side effects of prescription opioid pain relievers, driving is prohibited during the recovery period.
Sleep is critical to the body’s recovery – the immune system is involved in reducing inflammation. Of course, it can be difficult to fall asleep at times, especially since now you have to consider the new rules of rest.
So, utilize the log technique – keep your knees together and keep your back straight. Remember how geisha slept in ancient Japan? They rested their necks on wooden supports while the load was transferred to the upper spine and shoulders. You have to do something similar in everyday life: sleep with your head in the pillow, with a rolled-up blanket under your knees. So your legs will be slightly bent, so there will be no intense pressure on the operated area.
It would be best if you did manipulations to cleanse the wound daily. In addition, it’s worth checking it for infection. If you notice signs of suppuration, redness, swelling, or palpation of the wound that causes too painful sensations, you’d urgently consult your doctor. Occasionally, an infection may cause fever and chills. Don’t take a bath; take a shower instead and use a soft sponge only.
Today, many candidates for spinal fusion surgery can opt for the TOPS (Total Posterior Solution) System instead. The TOPS™ implant has been shown to have better clinical outcomes and fewer post-surgical complications than spinal fusion. And unlike spine fusion procedures, the TOPS™ device preserves the full range of each vertebra’s motion. Patients concerned about how soon they can get out of bed following spine fusion back surgery should make sure they’re familiar with all their surgical options, as the choices they make can also affect their recovery.
Your caregivers will have plenty of valuable tips for helping ensure a smooth, steady recovery from spinal fusion. For example, such simple tips will help you rehabilitate more quickly and with less discomfort:
But it’s essential to take care of your physical condition even before the operation since the timing of your recovery depends on it.
Near the top of the list of questions from almost every spinal surgery, the patients indicate how long they will have to wait for the following surgery before resuming their everyday activities. When it includes athletics – golf and tennis, bowling and the like, pastimes that put tremendous strain on the back – the answer becomes more complex. The factors influencing the time before patients can get back in the game include their physical condition and health. Just because one engages in strenuous physical activity doesn’t mean they are in good physical condition or health. Recovery times are faster for surgery patients in good physical shape because their bodies heal more quickly. Of course, the operation itself will play a significant role in deciding when you’ll be back on the tennis courts, golf course, taking a job, or engaging in a simple walk. The postoperative physical therapy program also plays a significant role. But the type of back surgery is the primary factor affecting the time required to get back into sports activities.
How to recover from surgery if you are an athlete or cannot live without daily activity – read further in this article.
While many people consider back surgery as the end of a promising sports career, Olympic, amateur, or professional athletes have returned to their competition after many common types of operations. General physical condition, professionalism during surgery, and spine rehabilitation affect how quickly you return to the game. Here are some tips for athletes planning to return to sport after a minimally invasive intervention.
In most cases, surgeons consult about postoperative care. They depend not only on the patient’s health and medical history but also on the desire to return to sports. We previously discussed lower back surgery recovery: diet, exercise, physical therapy, massages, proper wound care, and medication support are vital aspects of recovery. Of course, you shouldn’t neglect motivation and grit to achieve success. And if your competition is right around the corner, and you’re still in the hospital ward, this is not a reason to be upset. Your orthopedic surgeon will take this into account when planning your postoperative period. Of course, everyone wants to leave and start an everyday life immediately. Still, following the recommendations, you’ll be able to return to sports faster than causing implicit harm to your body during self-rehabilitation. Returning too early cancels not only the healing but the operation’s effectiveness.
So, a doctor’s advice may include:
You’d also talk to your coach about your career prospects or options (if you’re an amateur athlete) when getting approval from your PCP to return to athletics. It’s essential to be careful and aware of the limitations.
The postoperative stage depends on the patient, understanding the symptoms of complications, and a quick reaction if something goes wrong. E.g., accurately characterizing the level of pain and discomfort, reporting aches, numbness of the limbs, dizziness, suppuration in the wound area doesn’t mean a step back in the rehabilitation progress, but on the contrary, the ability to accelerate after a slight slowdown. Try to protect the spine, especially in the early stages of recovery. Respect your body and its healing times.
Infections at the site of the surgical incision most often occur 2–4 weeks after the intervention. Most often, the following symptoms appear:
It’s essential to treat any of these and some other signs as they arise. If ignored, unavoidable consequences may occur.
For patients with deep infection, a course of intravenous antibiotics is often given for about two months. Chronic contamination leads to the removal of the implant.
Keep the wound clean: it must be washed with water and soap at least once a day. Remember to keep the wound dry for healing and crusting. It’s undesirable to utilize ointments, lotions, body creams on the operated areas. After two weeks, when the staples or stitches are removed, you may return to bathing or swimming.
For opioid pain relievers, discontinuation usually occurs within the first few weeks, at most a month. There are other pain management options, such as using acetaminophen or non-steroidal anti-inflammatory drugs. But, as in the first case, they have their pros and cons and depend on the medical history. By combining medicines with physical therapy, you can achieve impressive results.
It’s no secret that athletes’ dedication to the postoperative rehabilitation program greatly influences their subsequent success. Depending on overall progress in physical therapy, you may get consent to exercise, but return to activity must be gradual and gentle to avoid unnecessary risks.
Patients, who have undergone minimally invasive TOPS™ procedures, can usually regain a full and painless range of motion. They have the greatest likelihood of returning to sport at pre-injury levels. Conversely, most exercises after spinal fusion aren’t available to athletes, and the possibility of injury increases – they’re less likely to return to athletics. Any collisions and falls will negatively affect health.
In any case, physiotherapy is a panacea for healing – movement combined with other aspects of rehabilitation can give you a chance for a better life. Let’s consider the leading practices that are useful for patients in the postoperative period.
It’s worth moving daily to improve blood circulation and speed up the healing of muscles and spine tissues. E.g., an essential therapy is walking, which can support the normal functioning of the heart and lungs. An upright position of the body is the best activity for the spine after surgery – this way, you can protect the discs from unnecessary stress. So, start with simple walks, and then work with your coach to develop your exercise program.
That’s one of the simplest and effective therapies utilized in various types of operations. For instance, laminectomy recovery exercises are invaluable as they help protect discs and strengthen your back muscles.
This exercise is valuable because the discs hold the lower back during flexion and extension of the lumbar spine. So, to perform the training, you need to do the following steps:
To strengthen the muscles of the lower back, it’s worth doing the SLR exercise. To do this, while lying on your stomach, slowly and alternately lift each leg up. In doing so, try to tighten your abdominal muscles. Do an exercise with a delay of two seconds at the highest point of the limb position. As before, do ten reps per set. Such a physiotherapy approach is appropriate for laminectomy, fusion, microdiscectomy, decompression, and of course, implantation.
As you improve your range of motion in your spine, it’s time to start doing more challenging activities that will help you get back to working condition. To do this, discuss a possible change in activity with a PCP and trainer and adjust the training schedule. After implantation, you don’t have to worry that you can’t perform some exercises. The TOPS™ System is an alternative to spinal fusion and allows you to perform any range of movements required for warm-up, training, and cool-down.
The spine is one of the most important elements of the human body. When it stops working properly, it can cause tremendous pain. Moreover, it can also affect other parts of the human body, especially the legs. This is why it’s so crucial to address and diagnose all spinal problems in time.
If you feel pain and stiffness in your leg that eases when you sit down, you might suffer from neurogenic claudication.
What Is Neurogenic Claudication?
Neurogenic means that the problem appears in the nervous system. Claudication is a word to describe leg pain or heaviness, especially while walking. This problem can appear when there is a compression of the spinal nerves in the lower part of your spine.
This type of claudication is different from vascular claudication. The second one is caused by reduced blood flow to the leg.
What Are the Symptoms of Neurogenic Claudication?
Some of the most common neurogenic claudication symptoms appear mostly in the back or one or both legs and include:
Those symptoms can be also noticed in the hips or buttocks. People who suffer from neurogenic claudication can also feel that their legs are weak or heavy. Affected people often notice that those symptoms ease while leaning forward or sitting down. This can increase while standing upright and walking.
What Connects Neurogenic Claudication and Lumbar Stenosis
Neurogenic claudication is considered one of the main symptoms of lumbar stenosis. The first former is rather an effect of the problem, rather than its core. Lumbar stenosis is a health condition in which the canals that protect the nerve or the spinal cord narrow in the lower back area. When space is narrower, the nerve cannot travel freely down the spine to other parts of the body, for example, the legs.
There are some factors that can cause this disorder at a young age. However, most people who suffer from lumbar stenosis are 60 years old or higher. Simply put, this disorder affects people as they grow older.
With age, bones and joints thicken. The discs that connect vertebrae can lose their water. Because of that, they no longer play their crucial role which is absorbing shocks between the vertebrae.
When you sit down or lean, you can feel pain relief. It happens because while sitting you can stretch the spine. By doing so, you force the spaces of your spine to open up and take off the pressure from the nerves.
Causes and Risk Factors
The main cause of neurogenic claudication is spinal stenosis, or put more simply, narrowing of the spinal canal in the lower back (lumbar area). Some of the most common causes of spinal stenosis are arthritic changes and wear and tear in the lower spine.
Those changes can lead to bulging discs, overgrowth of bone spurs, and thickening of ligaments. Stenosis may press on the nerve roots that are responsible for feeling and movement of the lower body. This compressing can cause prolonged pain, tingling, and cramping.
The pain intensifies while standing because in this position the spinal canals are naturally narrower. That causes extra pressure on the nerve roots. You can temporarily ease the pain by flexing forward or sitting. Remember that it’s only a temporary solution and is not going to solve your problem. You need professional medical attention.
Neurogenic Claudication Test and Diagnosis
The best way to know if you suffer from neurogenic claudication is by consulting a specialist. You need to have thorough physical exams, connected with detailed interviews. This way a physician can determine where your pain comes from, and what type of pain it is.
Some of the symptoms allow a medical expert to recognize if you suffer from vascular claudication or a neurogenic one. One of the main differences between those two is that in the case of vascular claudication, the pain often eases after resting, while in neurogenic claudication, discomfort is relieved for a while when in a particular position.
To confirm a diagnosis of neurogenic claudication, you might need to participate in a few tests. They can determine the cause of your pain and better prepare you for treatment.
Some of the most common tests that are run when spinal stenosis is suspected are:
Based on your symptoms and effects of testing, a doctor can identify your problem and decide which method of treatment would be the best for you.
Can Neurogenic Claudication Lead to Disability?
As your spine is a very important part of the body, you have to act fast. Otherwise, you risk severe health problems or even disability. According to statistics, neurogenic claudication caused by lumbar spinal stenosis can lead to disability. It is the problem that causes most spinal surgeries among older people, and it is also considered one of the most common causes of disability among this group.
The most effective way to get rid of neurogenic claudication is by surgery. During the treatment, the nerve roots in the lumbar spine are decompressed. It might happen that if the compression that was affecting the spine caused a herniated disc, a microdiscectomy procedure might be necessary. In other cases, a process of laminectomy is very often necessary, when the part of a bone is removed.
Spinal implants can make the surgery less traumatic. A spinal implant is a very useful device that can reduce back pain. When you suffer from any disorder in your spinal column, you might benefit from it. The device can be surgically placed in between your vertebrae and you can manage it remotely once you feel the pain. You are going to send low-level electrical impulses to the spinal cord.
Thanks to this, you can stimulate your spine and reduce pain. This solution is ideal for anyone for whom the nonsurgical method of reducing pain doesn’t work. Spinal implants can be a great solution for people who suffer from neurogenic claudication and are looking for a long-lasting solution for their problem and pain.
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.
In our last blog we began addressing the topic of preparing for spinal fusion back surgery. We touched upon tests that may be performed, and the need to prepare physically through a conditioning regimen so your body is ready for the rigors of surgery. Here are additional points anyone considering spinal fusion should remember:
One potential complication of spinal fusion surgery is excessive bleeding. Several commonly used medications can increase bleeding, including aspirin, ibuprofen and other NSAIDs, as can anticoagulants such as warfarin. You will need to discontinue use of any such medications. Should your physician or surgeon be concerned about the risk of excessive blood loss during your spinal fusion operation, you may bank your own blood, called an autologous blood donation, before the surgery.
Be sure to discuss all the medications you are taking with your physicians, and they will advise you when (and if) you should stop taking them. Some medications could cause adverse affects in combination with the anesthetics or other medications used during the operation, and anti-inflammatory medication such as cortisone and chemotherapy can compromise the body’s ability to heal.
Failure of the bone graft to heal, called pseudarthrosis, is one of spinal fusion’s most problematic post-surgical complications. Smoking is associated with this complication, and nicotine has been shown to compromise the ability of bone cells to grow. It is imperative that smokers stop smoking prior to the surgery, and not smoke before their recovery is complete.
Before resigning yourself to spinal fusion surgery, remember that spinal problems often respond to more conservative treatments, such as physical therapy and healthy lifestyle changes. Alternative surgical procedures may also be available. For example, many candidates for spinal fusion can choose the TOPSTM(Total Posterior Solution) System instead. The TOPS System not only preserves all the natural flexion of individual vertebrae, unlike spinal fusion, but it has also been shown to have better outcomes in clinical trials around the world. Indeed, investigating alternative options is another productive way to prepare for a spinal fusion operation.
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.
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.