spinal surgery

Can Spinal Stenosis Surgery Be Minimally-Invasive?

Especially in people over the age of 50, spinal stenosis is a prominent cause of chronic back pain and neurological symptoms. When this condition isn’t improved with several months of non-invasive treatment, your doctor may recommend spine surgery. 

Patients who are concerned about the complications associated with traditional spine procedures may be interested in minimally-invasive spinal surgery. Also called MIS, minimally-invasive surgery can reduce your risk of complications, shorten your recovery, and cause less pain after the procedure. 

With the benefits of MIS in mind, can spinal stenosis surgery be minimally-invasive? Here, we’ll discuss this question and discover spinal fusion alternatives for spinal stenosis patients. 

What is Spinal Stenosis?

Spinal stenosis is a common condition that develops when the spaces in the spinal canal become narrower. With less space in the spinal canal, the nerve roots and spinal cord may become compressed. This can result in a variety of symptoms, including:

• Back pain and stiffness
• Sciatica, which is nerve pain that extends from the lower back to the buttocks and down the legs
• Cramping and/or numbness in the legs
• Lost sensation and/or a sensation of weakness in the feet
• In severe cases, lost bladder or bowel control

What Causes Spinal Stenosis?

Most often, spinal stenosis is triggered by osteoarthritis-related spinal degeneration. Osteoarthritis is a condition that occurs when the cartilage that cushions the joints (including the joints in the spine) breaks down over time. This results in pain, stiffness, and inflammation. 

Other spinal conditions including herniated discs, spinal fractures, and bone spurs can also lead to spinal stenosis. Less commonly, patients are born with a narrow spinal canal or scoliosis (an irregular curve of the spine), leading to congenital spinal stenosis

Surgery For Spinal Stenosis

Surgery for spinal stenosis typically entails spinal decompression. The goal of spinal decompression surgery is to alleviate pressure on the spinal cord and/or spinal nerves to relieve back pain, stiffness, and neurological symptoms. 

There are multiple possible approaches to decompressive spinal stenosis surgery. These include:

• Laminectomy

Laminectomy is the most frequently performed procedure for spinal stenosis. It involves removing some or all of the lamina, which covers the back of the vertebra. By getting rid of some or all of the bony arch at the back of the affected vertebra, your surgeon creates more room in the spinal canal. 

• Laminotomy

Laminotomy is similar to laminectomy. However, while laminectomy involves the total removal of the lamina, laminotomy involves only partial removal of the lamina. Laminectomy and laminotomy are both performed to alleviate nerve compression. 

To determine which procedure you need, your surgeon will consider the specifics of your case. However, both types of spine surgery are conventionally performed with a posterior method. 

• Foraminotomy 

Foraminotomy is another type of spine procedure. It’s done to expand the path where the spinal nerve roots leave the spinal canal. The name of this procedure is taken from the word “foramen”, which is defined as a passage in medical terminology. The end of the word, “otomy”, is a term meaning “to open”. 

While performing a foraminotomy, your surgeon will cut out any bone and soft tissue that’s blocking the passageway. By removing these tissues, your surgeon will effectively relieve pressure on the spinal nerve roots. 

• Facetectomy

The facet joints are small joints that connect the vertebrae from the back of the spine. Each vertebra has two facet joints. 

In facetectomy, the surgeon fully or partially removes the facet joints of the affected vertebrae. The goal of this procedure is to assuage nerve compression on the nerve roots that run near the facet joints of the lower spine. 

• Discectomy

Patients who experience spinal stenosis caused by a herniated (bulging) disc may need a discectomy. In this spinal procedure, the surgeon removes damaged disc tissue to eliminate strain on the spinal nerves. 

In a discectomy, your surgeon will aim to leave as much of the intervertebral disc untouched as possible. 

The Benefits of Minimally-Invasive Spinal Treatment

Minimally invasive spinal stenosis surgery presents several benefits over conventional spinal surgery. These include:

Less Postoperative Pain

During surgery, the body goes through a degree of trauma. But, minimally-invasive spine surgery limits or entirely avoids cutting through the muscles.

By reducing the trauma to your muscles and soft tissues, MIS leads to less pain after spinal procedures. This can also lessen the need for pain medication after surgery. 

Less Time in The Hospital

After undergoing spinal surgery, patients are eager to return home as fast as possible. After all, you’re bound to feel more comfortable in your own home than in a hospital bed. So, one of the most attractive benefits of minimally-invasive surgery is that it can reduce the length of your hospital stay. 

Faster Recovery

After struggling with chronic back pain, a lengthy recovery period from spine surgery can be daunting. Additionally, a lengthy recovery period can require patients to take time away from work and their favorite activities.  

Local Anesthesia

Many minimally-invasive procedures can be done with local anesthesia, rather than general anesthesia. This makes MIS safer, as the risk of severe complications is much lower with local anesthesia when compared to general anesthesia. 

Less Scarring

Though arguably a less crucial benefit than reduced pain and a faster recovery, less scarring is a perk of minimally-invasive surgery. Due to a smaller incision, MIS limits scarring after surgery. 

Lower Risk of Complications

Medical complications are a major concern among surgery patients. Minimally-invasive surgery can limit the risk of medical complications, including the risk of infection and an adverse reaction to general anesthesia. Additionally, MIS avoids excess blood loss and the problems that it can cause. 

Minimally-Invasive Spinal Stenosis Surgery

Minimally invasive surgery (MIS) is available for spinal stenosis. Methods that can be used to achieve minimally invasive spine surgery include:

• Using small incisions to limit bleeding and scarring
• Using specialized instruments and/or a microscopic camera to guide the surgeon
• Moving the muscles away from the spine with a tubular retractor
• Accessing the spine from the patient’s side, rather than the back, to avoid the large back muscles
• Using a percutaneous placement of rods, screws, and other spinal implants for implant placement without disturbing the spinal muscle
  • A percutaneous placement involves using x-ray imaging to position guidewires into the vertebrae on the same path as the screws will take. The screws can then take the route of the guidewires and help guide the rod placement. The rods can be connected to the screws and the screws can be secured into place using screw extenders that reach outside of the skin.  

Spinal Fusion and Minimally-Invasive Spinal Stenosis Surgery 

Spinal fusion is commonly performed for spinal stenosis surgery. By fusing two or more of the injured vertebrae together, fusion provides stability and pain relief. However, spinal fusion isn’t conventionally a minimally-invasive procedure. 

The Downsides of Spinal Fusion Surgery

Along with the risks of a non-MIS procedure, traditional fusion also presents risks of its own. For one, fusion significantly lengthens the amount of time that the patient must remain in the hospital after spine surgery. Additionally, the complete recovery period after spinal fusion can last as long as a year. 

One of the most prominent downsides of spinal fusion is the fact that it can limit patients’ mobility. In the area of the fused vertebrae, patients often lose the ability to bend, rotate, and flex the back. This can prevent patients from taking part in their favorite activities after fusion surgery.

Thankfully, minimally-invasive spinal fusion surgery is possible with the help of innovative spinal implant systems. 

Spinal Implants For Minimally-Invasive Spinal Stenosis Surgery

Some implant systems can facilitate minimally-invasive spinal stenosis surgery and serve as spinal fusion alternatives. By stabilizing the spine without preventing motion, an implant can help resolve spinal stenosis without the need for fusion. 

The TOPS spinal implant is one of the available alternatives to spinal fusion that can allow for a minimally-invasive procedure. It’s a mechanical device that replaces the tissues removed in spinal decompression surgery. The implant works by instituting a controlled range of motion in the spine.  

Minimally-Invasive Spinal Fusion Surgery Recovery Time

The minimally-invasive spinal stenosis surgery recovery time is much shorter than that of conventional spine surgery. With the TOPS System, patients can regain a complete range of motion immediately after the procedure. Additionally, in comparison to fusion, TOPS patients are subject to far fewer restrictions during the recovery period. 

Non-Surgical Alternatives to Spinal Stenosis Surgery

Patients looking to entirely avoid spinal surgery may achieve symptom improvement from ongoing non-surgical treatment. Treatment options include:

• Physical therapy
• Chiropractic care
• Massage therapy
• Acupuncture
• Anti-inflammatory medication
• Epidural steroid injections
• Lifestyle and activity modifications

Your doctor can advise you on the best approach for surgical or non-surgical treatment to resolve symptoms of spinal stenosis, including proven and less invasive solutions like the TOPS spinal implant. 

Degenerative Joint Disorders That May Require a Surgery

Degenerative joint disease is also referred to as osteoarthritis or OA. Osteoarthritis is the most widespread form of arthritis, and it’s mainly caused by age-related joint degeneration. 

Many different disorders fall under the umbrella of degenerative joint disease. If these disorders don’t respond to conservative treatments, surgery may be required for symptom relief. 

Let’s discuss the degenerative joint disorders that may require surgery, as well as available treatment options. 

Which Degenerative Joint Disorders May Require Surgery?

Degenerative joint disorders can gradually progress, become severe, and fail to respond to non-surgical treatment options.

Examples of degenerative joint disorders with the potential to require surgery include: 

Osteoarthritis

Osteoarthritis can severely diminish various joints in the body, including the knees, hips, and fingers, as well as the facet joints in the spine. If the condition becomes severe, it can cause chronic, debilitating pain and a loss of function of the affected joint. 

If non-surgical treatment options don’t resolve joint pain from osteoarthritis, the joint may need to be surgically removed and replaced with an artificial joint. 

Spondylosis

Spondylosis is a term that refers to spinal degeneration. It occurs when the spinal bones, called vertebrae, wear down and change with age. Oftentimes, spondylosis is called osteoarthritis of the spine or degenerative disc disease. 

Oftentimes, spondylosis can be effectively treated without surgery. Physical therapy, pain medications, chiropractic care, rest, and spinal injections have a high rate of success in spondylosis patients. 

However, if this degenerative condition doesn’t respond to non-surgical treatments and causes severe symptoms such as spinal instability and weakness, tingling, or numbness in the extremities, surgery may be required. 

Surgery For Spondylosis

Examples of surgical procedures that may be done for spondylosis include:

• Laminectomy, which involves removing some of all of the lamina, the bony layer of the vertebra that encloses the spinal canal
• Facetectomy, which involves removing one of the spine’s facet joints. Facet joints connect the vertebrae to allow for spinal motion and stability. 
• Laminotomy, which involves creating a larger opening in the spinal canal by removing some of the lamina
• Foraminotomy, which also involves creating a larger opening in the spinal canal, but by enlarging the space around the intervertebral foramen

These procedures are all forms of spinal decompression surgery, which we’ll discuss in greater detail below. 

Spinal Stenosis

Spinal stenosis is a condition that occurs when the space inside of the spinal canal narrows. It most often occurs as a result of spinal degeneration from the aging process. 

As the spinal canal becomes narrower with spinal stenosis, it can irritate and compress the spinal nerves. This may lead to back pain, along with numbness, tingling, and weakness in the extremities.  

Spondylolisthesis

Spondylolisthesis is a condition that occurs as a result of spinal instability. With this condition, one of the vertebrae slips out of place and settles on the vertebra beneath it. Spinal disc degeneration is a common cause of spondylolisthesis in older adults. 

When one of the vertebrae are out of alignment with spondylolisthesis, it can lead to back pain, stiffness, trouble walking and/or standing, and muscle spasms, along with numbness, tingling, and weakness in the foot. 

Spine Surgery For Degenerative Joint Disorders

Spine surgery for degenerative joint disorders may involve the following procedures:

Facet Joint Replacement

Facet joint replacement is a type of spine surgery that involves replacing a degenerated facet joint with a spinal implant, like the Premia Spine TOPS System. In this procedure, the surgeon will remove the affected facet joint and secure the implant in its place to stabilize the spine while relieving pain from spinal degeneration.  

Spinal Decompression

Spine surgery for spinal degeneration usually involves spinal decompression and fusion. Decompression surgery involves removing the spinal tissue that’s causing the patient’s symptoms, typically because it’s pressing on nearby spinal nerves.  

What’s Involved in Spinal Decompression?

During spinal decompression, the patient is first put under general anesthesia. Next, the surgeon creates an incision (often in the abdomen). The organs and other tissues then must be moved aside to create access to the spine. 

Once the surgeon has achieved access to the spine, he or she will remove the spinal tissues that are causing nerve compression. The type and amount of tissue that’s removed during spinal decompression can vary from patient to patient. 

With the spinal tissue removed, the surgeon typically then performs spinal fusion (or, as an alternative, places a spinal implant) to stabilize the spine. 

Spinal Fusion

After decompression is complete, spinal fusion is often performed to stabilize the spine. This procedure involves positioning bone graft material in between the affected vertebrae. The bone graft stimulates the fusion of the vertebrae in the months after the procedure. 

Downsides of Spinal Fusion

• Reduced spinal mobility

Spinal fusion prevents spinal instability. However, it also inhibits the motion of the spine. Patients largely lose the ability to twist, bend, and flex the spine after spinal fusion. 

Reduced spinal mobility can limit the patient’s activities and everyday movements after the spinal fusion. For example, some patients may no longer be able to bend over after fusion and may require tools to pick up items off of the ground. 

• Prolonged recovery process

Since fusion involves operating directly on spinal bone tissue, it also prolongs the recovery process for degenerative joint disease surgery. Patients require more downtime after spinal fusion, and the recovery process tends to be more painful than non-fusion procedures. 

• Risk of adjacent segment degeneration

Adjacent segment degeneration (ASD) can occur in patients who undergo spinal fusion. It’s a condition that occurs when the spinal bones around the fused vertebrae are placed under added stress. As a result, these portions of the spine degenerate more rapidly. 

Fusion Alternatives For Degenerative Joint Disease Treatment

Spinal implants like the TOPS System are alternatives to spinal fusion in surgery for degenerative joint disorders. In facet joint replacement and spinal decompression, an implant can stabilize the spine without compromising the patient’s mobility. 

The TOPS spinal implant moves with the spine, allowing the patient to twist and bend quickly after the procedure. As a result, patients experience relief from symptoms of spinal degeneration without compromising the normal motion of the spine. 

For more information about the TOPS System in degenerative joint disease treatment, contact Premia Spine today.  

What is Spinal Stenosis?

Table of Contents

Understanding Spinal Stenosis

What Causes Spinal Stenosis?

Spinal Stenosis Symptoms

Severe Spinal Stenosis Symptoms

Spinal Stenosis and Walking Problems

What is Considered Severe Spinal Stenosis?

Can Spinal Stenosis Be Treated At Home?

What Is The Best Treatment For Spinal Stenosis?

What Is The Latest Treatment For Spinal Stenosis?

“What is spinal stenosis?” is one of the most frequently asked questions in any spinal specialist’s office. Given that up to 95% of people develop degenerative spinal changes by age 50, it’s no surprise that spinal stenosis is a prevalent medical concern today. 

Although spinal stenosis is a common back problem, many affected patients have never heard of it at the time of their diagnosis. With this in mind, we’ll provide a detailed explanation of spinal stenosis below, including the causes, symptoms, and treatments available for this prevalent condition. 

Understanding Spinal Stenosis

“Stenosis” means “narrowing,” and spinal stenosis signifies an unnatural narrowing of the spinal canal. The spinal canal is the space at the center of the vertebrae that houses the spinal nerves. 

This restriction of the spinal canal places pressure on the spinal nerves. It can also impact nerves that emanate from the affected vertebrae to other parts of the body. The area that’s the most commonly affected by stenosis is the lower, or lumbar, region of the spine. 

What Causes Spinal Stenosis?

Spinal stenosis can be caused by a variety of factors, including:

• Chronic inflammatory, arthritic, and spinal conditions conditions

Osteoarthritis, rheumatoid arthritis, scoliosis, and herniated disc are among the medical conditions that may lead to spinal stenosis.  

• The normal aging process

The spine naturally changes with age. For one, the intervertebral discs dry out, become thinner, and may begin to bulge. An injured intervertebral disc takes up additional space in the spinal canal, potentially leading to spinal stenosis. 

Additionally, the aging process can cause the ligaments and/or bone in the spine to thicken or expand. When this occurs, the open space in the spinal canal becomes more limited.

Spinal stenosis is most often seen in adults above the age of 40 years, and women are affected by spinal stenosis more frequently than men.

• Heredity factors

Clinical studies have confirmed that lumbar spinal stenosis is highly genetic. This is despite the fact that spinal degeneration is widely considered to be the key contributing factor to the development of stenosis. In a 2014 study, lumbar spinal stenosis cases yielded heritability estimates of 66.9%. 

Spinal Stenosis Symptoms

Symptoms of spinal stenosis can include intense back and leg pain, as well as numbness or cramping in various regions of the body. In spinal stenosis patients, loss of sensation can be extreme. 

Severe Spinal Stenosis Symptoms

Lumbar spinal stenosis symptoms in severe cases may include difficulty controlling urine or bowel movements and difficulty balancing while walking. While these symptoms can sound alarming, especially if you were just diagnosed with spinal stenosis, they only occur in a small portion of spinal stenosis patients.

To illustrate this fact, let’s consider a survey conducted in 564 U.S. hospitals and general practice clinics. Out of 3,647 patients diagnosed with lumbar spinal stenosis in this survey, only 135 patients experienced bowel and bladder dysfunction. 

Bowel and bladder dysfunction mainly occur in spinal stenosis patients with cauda equina lesions. The cauda equina is the collection of nerve roots located in the lower spinal cord. It facilitates movement and sensation in the legs and bladder. 

Spinal stenosis can trigger cauda equina syndrome, which requires immediate diagnosis and treatment to prevent severe neurological complications. 

Spinal Stenosis and Walking Problems

As we mentioned above, severe spinal stenosis can lead to walking and balance problems. However, even in its earlier stages, spinal stenosis can cause difficulty walking for extended distances.

Walking problems with lumbar spinal stenosis may include:

• Cramping, tingling, and/or numbness in the legs while walking
• Pressure in the lower back while standing upright
• Muscle weakness in the legs
• Pain in the buttocks, legs, and/or back while walking
• A foot that slaps the ground when you take a step due to weakness

Leaning forward alleviates pressure on the spinal nerves. So, spinal stenosis patients experiencing walking problems often experience relief when they sit down, crouch, lean forward, or even push a grocery cart.

If you’ve been diagnosed with spinal stenosis and are experiencing severe pain and weakness while standing or walking, reach out to your doctor immediately. You may be experiencing cauda equina syndrome.   

What is Considered Severe Spinal Stenosis?

Patients may have what’s considered a severe case of lumbar spinal stenosis if they experience a loss of physical function or are disabled as a result of the stenosis. Additionally, physicians may classify a case of spinal stenosis as severe if the patient doesn’t respond to several months of non-surgical treatment. 

Severe spinal stenosis typically requires surgery for symptom relief. After spinal stenosis surgery, patients generally experience restored function and improved quality of life. 

Can Spinal Stenosis Be Treated At Home?

Patients experiencing symptoms of spinal stenosis need to receive a medical evaluation and diagnosis. This ensures that any troubling symptoms are promptly addressed before causing lasting complications.

With that said, after receiving a diagnosis, many patients with early spinal stenosis can manage their symptoms with at-home care. Paired with physical therapy and physician-recommended lifestyle changes, at-home treatment can significantly improve spinal stenosis symptoms. 

Along with heat/cold therapy, exercises for spinal stenosis are among the most widely-recommended at-home treatment for this condition. Spinal stenosis exercises can be done at home to strengthen the spine’s stabilizing muscles and improve range of motion. Your physical therapist may give you a specific exercise regimen to complete at home based on your personal needs. 

What Is The Best Treatment For Spinal Stenosis?

Many treatments for spinal stenosis are available, including medications, physical therapy, and, as we mentioned above, exercises for stretching the spine. 

Physical therapy is often highly successful in treating spinal stenosis. Your physical therapist may implement a combination of therapies including massage, stabilization methods, heat/cold therapy, exercises, and acupuncture to help you overcome your symptoms. 

Spinal Stenosis Surgery

For patients with moderate to severe spinal stenosis who don’t respond to conservative spinal stenosis therapy, spinal decompression surgery may be an option.

In spinal decompression surgery, the back surgeon reestablishes the proper diameter of the spinal canal at the affected area. To accomplish this, the surgeon will remove bony elements that have grown towards the spinal canal and are impinging on the nerves.

There are a few different spinal decompression procedures. The most common of these procedures for spinal stenosis is laminectomy, which involves removing some or all of the lamina. The lamina is the section of bone that covers the back of the spinal canal.

Am I a Candidate For Spinal Decompression?

You may not be a candidate for spinal decompression surgery as a treatment for spinal stenosis if:

• You’re currently pregnant
• You have already had spinal fusion
• You have vertebral fractures
• You’re experiencing pain from a previous failed spinal surgery
• You’ve already had an artificial disc or spinal implant placed
• You’ve already undergone more than one spinal surgery and haven’t recovered properly 

Spinal Fusion

Typically, spinal fusion back surgery is performed in conjunction with the decompression procedure. Spinal fusion involves turning two or more adjacent vertebrae into one bone. This is done by placing bone graft material in between the vertebrae, then securing them with screws and rigid rods.

Fusion restores stability but eliminates the natural mobility between the vertebrae. The fusion of the vertebrae is permanent and typically diminishes patients’ ability to move, stretch, and rotate the torso. 

The Risk of Reoperation After Spinal Fusion

Clinical research has shown that spinal fusion has a higher reoperation rate than spinal decompression alone. With this in mind, patients must carefully consider the risk of reoperation before undergoing decompression with fusion. 

One reason why spinal fusion may lead to reoperation is the risk of adjacent segment disease. This complication of spinal fusion occurs when the vertebrae above and below the fused segment undergo added pressure. This leads to a faster rate of degeneration in these vertebrae. 

Patients with adjacent segment disease may start to experience back pain, reduced range of motion, and neurological symptoms. These uncomfortable and potentially debilitating symptoms can create the need for corrective spinal surgery. 

What Is The Latest Treatment For Spinal Stenosis?

Many modern spinal stenosis patients are concerned over the risks of decompression surgery with spinal fusion. This has led to an increased interest in alternative treatments that alleviate spinal stenosis symptoms without the risks associated with fusion. 

Patients who haven’t responded to conservative treatments can now consider non-fusion spinal implants as a spinal stenosis treatment option. These implants are designed to alleviate nerve compression while stabilizing the spine. As a result, patients can experience relief from spinal stenosis without reduced mobility from fusion. 

The TOPS™ System For Spinal Stenosis

Today, a new implantable device allows the surgeon to decompress and stabilize the spine while preserving the spine’s range of motion: the TOPS™ System, developed here at Premia Spine.

How Does TOPS™ Work For Spinal Stenosis?

The TOPS™ System works for spinal stenosis by replacing the tissues removed during spinal decompression. The implant is designed to be placed at a single level between L2 and L5 in the lower spine. These segments are the most commonly affected by spinal stenosis. 

Once positioned, the TOPS™ System allows movement in all directions. It simultaneously blocks sheer forces on the lower spine, which helps prevent injury after spinal stenosis surgery. 

TOPS™ System Results

Clinical studies show the TOPS™ System provides better outcomes than spinal fusion. In a seven-year study for TOPS™ in the management of lumbar spinal stenosis, the device maintained clinical improvement and radiologic stability, preserved spinal motion, and prevented degeneration. 

Physician and patient testimonials demonstrate that the TOPS™ System provides excellent outcomes for spinal stenosis patients and allows patients to retain mobility at the operative segment. Additionally, patients experience symptom relief long after the TOPS™ System procedure. 

We encourage patients with persistent back pain to consult with a spinal specialist and learn more about all of the available treatment options.

“What is spinal stenosis?” is one of the most frequently asked questions in any spinal physician’s office. Spinal stenosis is a common back problem, but many affected patients have never heard of it before they are given the diagnosis. Symptoms of spinal stenosis can include intense pain inside the back of the legs and numbing or cramping in various regions of the body. The loss of sensation that spinal stenosis patients experience can be extreme.

Here at Premia Spine we focus on advanced surgical treatments for spinal stenosis and related spinal disorders, including bone spurs, or facet arthrosis, and slipped disc, or spondylolisthesis. We’re excited to share information about these conditions – conditions that affect up to 70 percent of all people at some point in their lives – through our blog. An explanation of spinal stenosis is a good place to start.

“Stenosis” means “narrowing,” and spinal stenosis signifies an unnatural narrowing of the spinal canal, the space at the center of the vertebrae that houses the spinal nerves. This narrowing puts pressure on the nerves, and on nerves that emanate from the affected vertebrae to other parts of the body. The most commonly affected area is the lower, or lumbar, region of the spine. The neck, or cervical region of the spine, can also exhibit a narrowing; these conditions are called lumbar spinal stenosis and cervical spinal stenosis respectively.

Spinal stenosis can be caused by a variety of factors, including heredity, chronic inflammatory and arthritic conditions, and the normal aging process. In fact, it is most often seen in adults above the ages of 45 years; women are affected by spinal stenosis more frequently than men. The severity is related to the extent of the narrowing and of any attendant spinal problems, such as bone spurs, slipped discs, pinched nerves, spondylolisthesis, or sciatica. A neurosurgeon, orthopedic surgeon or any physician specializing in spinal disorders can diagnose spinal stenosis based on radiographs and X-rays.

Many treatments for spinal stenosis are available, including medications and physical therapy, including exercises for stretching the spine. For patients with moderate to severe spinal stenosis who do not respond to conservative spinal stenosis therapy, spinal decompression surgery may be an option. In spinal decompression procedures, the back surgeon reestablishes the proper diameter of the spinal canal at the affected area by removing bony elements that have grown towards the spinal canal and are impinging on the nerves. Typically, spinal fusion back surgery is performed in conjunction with the decompression procedure. Spinal fusion involves connecting two or more adjacent vertebrae with screws and rigid rods. Fusion restores stability but eliminates the natural mobility between the vertebrae.

Today a new implantable device allows the surgeon to decompress and stabilize the spine while preserving the spine’s range of motion: the TOPS™ System, developed here at Premia Spine. Clinical studies show the TOPS System provides better outcomes than spinal fusion. We encourage patients to consult with a physician who specializes in spinal medicine and to educate themselves about treatment options.

What is the X-Stop procedure?

X-Stop is a minimally invasive spinal surgery procedure that may be performed to treat cases of lumbar spinal stenosis that don’t respond to more conservative treatments, such as physical therapy and medication. X-Stop is also the name of the titanium implant used in the procedure, a device in a category termed “Interspinous Process Decompression Systems.” This lumbar spinal surgery procedure was approved as safe and effective by the FDA in 2005.

Lumbar spinal stenosis is an unnatural narrowing of the spinal column in the lower, or lumbar portion of the spine. The constricted spinal canal that characterizes spinal stenosis puts pressure on the spinal cord and the nerves emanating from it at the affected vertebrae, which can cause pain and restrict mobility. In the X-Stop procedure, the titanium implant is inserted into the spine through a small incision made between two spinal “processes” of the vertebra affected by stenosis. Spinous processes are the protrusions of the individual vertebra visible along the back. The X-Stop device distracts two vertebral segments and relieves the pressure on the nerve roots caused by the stenosis, which in turn often relieves leg and back pain. The X-Stop, a recent advance in spinal stenosis surgery, is not an alternative to spinal fusion back surgery, a procedure that eliminates the natural flexion and rotation of the fused vertebrae. The X-Stop is ideal for patients with very mild spinal stenosis. For more advanced disease, the X-Stop is not applicable because the implant cannot be used when decompression surgery is necessary to remove the bony elements pressing on nerve roots. In such situations, where decompression surgery is performed in conjunction with spine stabilization, the TOPS System may be a more relevant solution for maintaining the spine’s native motion.

As developers of treatments for advanced spinal stenosis and associated conditions, we at Premia Spinerecommend that patients learn about all their treatment options. If you have a back condition that’s causing pain or is affecting your mobility, be certain to learn about all the choices available to you.

What is Interspinous Process Fusion?

As we noted in our last blog, X-Stop, an implant deployed in the surgical treatment of mild spinal stenosis, was approved by the FDA in 2005 as a safe and effective treatment for symptoms of lumbar spinal stenosis. This procedure illustrates the advances that make spinal medicine such an exciting field. Today, there are devices similar to the X-Stop in design but that do allow motion at the operative segment. These devices are used to create a spinal fusion between the adjacent vertebral segments. This procedure is more commonly referred to as an interspinous process fusion. As with the X-Stop, a device is inserted in a small incision made between adjacent spinous processes, which are the bony protrusions of the vertebrae that can be seen and felt along the back of the spine. Interspinous process fusion is another form of spinal fusion back surgery that eliminates the natural flexion and rotational ability of the individual vertebrae.

Interspinous process fusion is typically performed in about one hour, either under general anesthesia or using intravenous sedation with local anesthesia, and can be performed as an outpatient procedure. The procedure is relevant for patients who have mild spinal stenosis and require only a minimal removal of bone and soft tissue to achieve pain relief. This represents an advance in spinal care, but any spinal surgery has the risk of complications, and not every technique is right for every patient. Before considering surgical intervention including interspinous process fusion, patients should try more conservative treatments such as exercises, physical therapy, epidural injections, and pain medications. When surgery is recommended, interspinous process fusion is most appropriate for people over 50 years of age with mild spinal stenosis confined to one or two levels of the spine, and who experience relief from symptoms when bending forward at the waist or when sitting. With more advanced spinal stenosis disease, patients should consider the option of avoiding fusion surgery and opting for a solution, such as TOPS Posterior Arthroplasty, that preserves motion of the spine at the operative level while stabilizing the segment after decompression surgery. Here at Premia Spine, developers of advanced surgical treatments for spinal stenosis and related spinal problems, we think it’s important for anyone suffering from ongoing back pain or restricted mobility to know all their treatment options.

How Long Does it Take to Recover From Spinal Surgery?

Any surgery is a serious stress for the body. Therefore, even if the surgeon who performed the operation is a true genius of medicine and everything went well, postoperative rehabilitation is necessary to restore the body’s strength and functions fully.

In recent years, there has been a tendency to increase the incidence of spine disease, which is primarily due to lack of adequate exercise, poor nutrition, and a sedentary lifestyle in the era of total computerization. That consequently leads to a decrease in the tone of the torso muscles that hold the spine.

Thus, in the developed countries of the world, osteochondrosis of the spine is 90% of the total number of dystrophic diseases of the spine.

Recovering from back surgery happens in entirely different ways, as there are four main types, each of which has a different effect on the body.

Discectomy

That’s the removal of the disc that separates the vertebrae and helps support part of your spinal column. The intervention can be performed with different surgical techniques under general or spinal anesthesia.

Such an operation is prescribed for injuries or degeneration of the spinal cushion, with osteochondrosis or hernia. Disease symptoms are as follows: localized pain and numbness or extremities tingling.

Recovery from the procedure is often quick, but the patient continues to feel pain. There may also be numbness or weakness in the nerve pathway that has been exposed to high pressure.

Foraminotomy

Foraminal Therapy is applied to patients who have been diagnosed with spinal canal stenosis, a gradual narrowing of the vertebrae openings on any part of the back (cervical, thoracic, lumbar). That’s a manipulation of the spinal nerve roots that requires repositioning the tissues and cutting the bone to relieve pressure on the nerve. The procedure involves access to each vertebral level, so the incision length depends on the desired operable area.

The practice of recovery from lower back surgery shows slow and steady progress: patients can be exposed to light physical activity and also drive a car after eight weeks. Complete healing occurs within 18 months.

Laminectomy

That’s the removal of the plate, bone spurs, ligaments, as well as the back of the bones that make up the vertebrae to relieve pressure on the spinal nerves or spine. The procedure is performed under general anesthesia and mechanical ventilation.

Laminectomy is usually performed for lingering back or neck pain and nerve damage symptoms such as limb weakness and numbness. Patients can often lose control of bowel movements and urination. Complications such as bleeding, infections, blood clots, and nerve root damage can occur with this type of intervention.

After the surgery, a mandatory stay in the hospital for up to several days is required, and most likely, in the evening, you won’t be able to walk as with TOPS™ implantation. Of course, any mobility will be controlled with medication: you’ll have to overcome pain to do any exercise constantly. When caring for the sick, it’s necessary to follow clear rules for bathing, walking, and sleeping. It’ll take at least 3-4 months for your bones to heal well, and recovery will take place gradually over a year.

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If your diagnosis is spine arthrodesis, but you’re young and healthy, then the possibility of work will still be excluded for a period of up to 6 weeks. On the other hand, older people will have to fight for every movement: it’ll take 4-6 months for them to recover.

Spinal fusion

It’s the fusion of two bones in the back. Today, the procedure is considered outdated and incomplete among doctors: its peak came at the turn of the 20th century and required great care and planning from the patient and the surgeon. Previously, it was prescribed to patients with osteochondrosis or other diseases that didn’t respond to conservative treatment.

The fusion aims to prevent pain by immobilizing a specific spine area and is very dangerous in everyday life. Specialized titanium screws, rods, and plates are designed to maintain the rigidity and stability of two or more vertebral segments, which will be a monolithic bone structure after surgery. Such an operation is often delayed up to 8 hours. Recovery time to spinal fusion is also very long and takes from 6 months to a year. Its duration depends on your preoperative state: if you’re in good physical shape and have a healthy lifestyle, it promises the best predictions.

TOPS™ System

The Premia Spine TOPS™ implant maintains the mobility of the vertebral segment while the upper and lower vertebrae don’t suffer from increased stress as in previous procedures. Such a design doesn’t immobilize a person but gives the whole range of movements. The operation is considered minimally invasive, and its average duration is about 60-120 minutes. There is also an early clinically significant reduction in pain compared to the patient’s baseline.

Complications during implantation are much less common than in previous procedures. E.g., only one patient had an asymptomatic screw halo in the postoperative period six months later. However, the process involved changing the screw position, which could probably be the reason for the above conclusion. Also, after 36 months, one patient showed progressive degenerative changes.

Many specialists have inclined to therapy with no fusion spinal surgery in recent years based on safety and positive results of clinical trials.

Recovery from lower back surgery will depend on your preparedness in the preoperative period: the level of activity and physical fitness will affect the rapid progress. You will be able to walk and move on the next day after the intervention – the maximum stay in the hospital for patients is four days. Achievement of the expected level of mobility is reached already at 4-6 weeks and depends on the correct rehabilitation approaches and a course of physiotherapy. Using nutrients to improve recovery and healing is another aspect of quick recovery.

How does nutrition help you recover?

Research shows that using spinal surgery recovery vitamins and other supplements helps the body rehabilitate better. Immune nutrition minimizes the risk of complications such as infection. Oral supplements are commonly used in tablets, or the liquid is given intravenously. Arginine, glutamine, omega-3 fatty acids, nucleotides, and antioxidants are the primary nutrients for healing after injuries such as osteochondrosis, herniated discs, and surgery. Let’s take a look at each substance.

Arginine

It’s an amino acid that the human body produces in small quantities. The supplement is so valuable that it increases the ability to fight infections.

Foods containing arginine are nuts, seeds, legumes, and poultry (especially turkey).

Glutamine

The amino acid can be synthesized in sufficient quantities. It participates in biological processes that control cell growth and also reduces the risk of infections.

You can get glutamine naturally by eating beef, eggs, rice, corn, and soy cheese.

Omega-3

Reduces the body’s inflammatory response, which is a source of persistent back pain. Salmon, eggs, nuts, flax, spinach, and other leafy vegetables contain omega-3.

Nucleotides

DNA and RNA are made up of nucleotides, which are their formative and supportive components. The human body synthesizes and processes nucleotides, but they can additionally come from food. Sources of nucleotides are foods of plant and animal origin.

Antioxidants

Antioxidants are vitamins A and C, beta-carotene, and selenium. They reduce oxidative stress associated with chronic inflammation.

Examples of naturally occurring antioxidants include leafy greens, nuts, fruits, seeds, and whole grains.

To understand how long the recovery from back fusion surgery is, consider its risks. There can be a difficult struggle with the arising complications, where the correct diet and universal rehabilitation methods aren’t always appropriate. On the other hand, with the TOPS™ implant, healing will be much faster as the risks of infections and bleeding are minimized.

What difficulties do patients face after surgery? 

First of all, it is a pain and fear that will increase with movement. Therefore, the patients often limit themselves, thus delaying recovery.

It may seem that rehabilitation of the spine is not necessary, as if you can go home after surgery and get treated there. But this is really a very risky intention, and if you do so, you may stay bedridden forever.

Spinal surgery can provide dramatic relief for people with moderate to severe spinal problems that do not respond to conventional conservative therapy. For example, spinal decompression can remove pressure on nerves, relieve pain and restore mobility in many such patients.

Spine surgery recovery time varies depending on the procedure. The main purpose of rehabilitation is to restore the full range of motion, as well as the formation of a capable muscular corset.

Here are the methods used: the simplest exercises, supervision, and support of a doctor, physiotherapy procedures, classes on the simulators and in the pool, therapeutic baths, massage, reflexology, and psychological support.

First, the physiological therapist examines the postoperative card, and the features of surgery. Then, in collaboration with other specialists, create a method of treatment. The method of treatment includes two sides, physical and psychological. These two methods perfectly complement each other and give a great result together. 

The recovery time

If you’re a candidate for spinal surgery, it’s important to understand all aspects of the procedure and its aftermath. One of the most important questions these patients should have answers to is the length of time required to recover from spinal surgery.

Recovery time from back surgery depends on the form of surgery. There are two forms of back surgery: procedures where vertebrae are fused together versus procedures that do not immobilize the spine. Recovery from fusion surgery can take longer than the recovery time from back surgeries that only involve a decompression or a surgery that preserves motion. Your physician can tell you more about the recovery time required for a particular procedure. But it’s important for patients to consider outcomes as well as recovery time.

Effects achieved after physical rehabilitation:

•     improving blood circulation;
•     elimination of edema and pain;
•     healing of sutures and soft tissues;
•     increase muscle strength;
•     improving bone growth;
•     restoration of physiological movements of the spine;
•     activation of global muscles;
•     synchronization of work of all parts of a body;
•     prevention of secondary diseases. 

For example, spinal decompression surgery has traditionally been performed in conjunction with spinal fusion back surgery. As part of the recovery process, restrictions on motions and activities are placed on the patient to allow the previously independent vertebral bodies to biologically fuse together and become one long rigid segment devoid of motion. In contrast, with the TOPS™ System, an alternative to spinal fusion following a spinal decompression procedure, there are no restrictions placed on the patient. You maintain a full range of independent vertebral motion after surgery, and the patient dictates the speed of recovery from this back surgery. You can increase your activity level as quickly as you want.

When should you start spine surgery recovery?

The answer is simple — the sooner, the better. Rehabilitation treatment should begin immediately after surgery and continue until an acceptable result is achieved. The rehabilitation process is no less important than the success of the operation itself.

Timely physical and psychological rehabilitation helps to pass the adaptation period quickly and without consequences. The doctor, before the intervention, must explain its features, course, possible complications. After the operation, he must clearly indicate what restrictions the patient has and when they are removed. In the initial stage, you should use painkillers to reduce discomfort. But by the end of the first week, they should be canceled.

The importance of rehabilitation measures should not be underestimated. Rehabilitation mustn’t cause pain, as muscle spasms can cause a painful reaction. The clinical effect will give a gradual muscle relaxation and increased range of motion in the joints.

The patient should be guided in the stages of rehabilitation, know the rules of conduct and the necessary exercises in the postoperative period. It is the doctor who determines how much recovery time is required in each case.

Back surgery treatment doesn’t end when the surgeon completes the operative work. The recovery period is of critical importance in restoring spinal health. Whatever the recovery period requires, make sure you carefully follow your physician’s instructions. And be aware of all your options for spinal surgery, so you’ll have not only the possible shortest recovery time but also the best possible outcome to your back surgery.

The rules of spinal surgery emphasize the consumption of more vegetables and fruits, preference for white meat and fish, the addition of jelly to the diet. After all, these dishes help to restore cartilage.

The rehabilitation program is made individually. It depends on the type of operation, patient’s age and general condition, the recovery period. The activities are planned and carried out under the close supervision of a surgeon, a neurologist, and a physical therapist.

People with low back pain develop a fear of movement, which once again confirms the close connection between biological and psychosocial factors. Often patients avoid the movements that caused the pain, even after recovery. This not only negatively affects the mobility of the spine but can also provoke depression, which increases the risk of recurrence.

How long you will recover after surgery depends on many factors. First of all, it is a method of surgery. Minimally invasive recovery techniques are now increasingly used. After that, the patient returns home for 3-4 days. With traditional interventions, the hospital stay can be extended by 1-1.5 weeks.

Previously, patients were allowed to get out of bed only a day after surgery. Other methods are now being practiced. In a few hours, it is recommended to get to your feet. You may need the help of a nurse. You can walk on the first day for no more than 5-10 minutes, then the load increases.

If the surgery was complex, only passive rehabilitation (massage, passive gymnastics) is used in the first month. The effect begins on the muscles of the thighs, buttocks, pelvis, shoulder girdle, and chest. The operated site is not involved in this period.

Gradually active ones are connected to passive techniques. With a physical therapist, you will learn how to perform exercises for flexibility, strengthening the back muscles properly. You can use gymnastic sticks and rubber bands, expanders, dumbbells, fitness and medicine balls during classes. At a remote stage, join the exercises on a special simulator, a balancer.

One of the causes of lumbar spine surgery is overweight and poor nutrition. Therefore, we recommend that all clients who come for rehabilitation and have signs of obesity consult a nutritionist. The doctor will choose the type of diet that will help normalize body weight and speed recovery.

Spine and lumbar spine surgery is a procedure with a rather lengthy recovery.

Recovering from back surgery requires patience, so during the early stages of recovery from spinal fusion surgery, some basic activity restrictions must be followed:

• lay face up on the bed;
• no bending;
• no lifting;
• no twisting;
• no driving.

Young people are generally more capable of a faster recovery from back surgery than their older counterparts.

Conclusion

The purpose of treatment and rehabilitation measures is to remove swelling in the operated area and eliminate pain. Doctors prescribe patients a course of medication and procedures designed to prevent complications after surgery.

Walking is important after spinal surgery, but you must remember to start slowly and follow your doctor’s orders on how much to walk

Do not do strenuous activities, like jogging or golfing; do not do household duties that put a strain on the back, like gardening and vacuuming.

It should not be assumed that six months after the intervention, you can forget about rehabilitation. The degenerative changes in the spine that provoked the hernia do not go away. It is possible to slow down their development and prevent the recurrence of the problem only with the help of exercise, massage, and lifestyle changes. Therefore, most doctors recommend not to stop special classes for the rest of your life.

Take your time, be patient, allow your attendants to help you, and know that each day, with each step, you’re on your way to recovery.

How much physical therapy do I need after spinal surgery?

Whether a patient is having open back surgery for a spinal cord injury or a minimally invasive procedure for a condition such as a slipped disc or spinal stenosis, the operation itself is only the first part of a successful outcome. The post-surgical recovery period is critically important for long-term success, and the proper physical therapy program plays a large role in this process.

Patients for both open and minimally invasive back surgery will require physical therapy. Physical therapy strengthens the muscles in the back and helps heal the tissues in the area where the surgery was performed. In fact, back problems are often caused in part by muscle weakness. Even in otherwise well conditioned individuals, the back muscles around areas exhibiting spinal problems have been shown to be weaker than surrounding muscles, and weak muscles also contribute to poor spine and spinal joint functioning. Thus, one of the goals of post-operative therapy is to strengthen muscles that support the spine. Some of these muscles are in the back, but specific abdominal muscle groups also provide back support. Biofeedback devices can help patients learn how to activate, control and exercise these abdominal muscles, thereby strengthening them.

The amount of physical therapy required will vary based on the procedure performed, and this is one area where surgical options are important to consider. For example, patients undergoing spinal decompression surgery typically have a secondary procedure performed in conjunction in order to stabilize the vertebral segments where the spinal decompression was performed. This secondary operation following the spinal decompression procedure may be spinal fusion or the TOPS™ (Total Posterior Solution) implant. The TOPS Solution preserves the full range of motion of individual vertebra whereas spinal fusion surgery eliminates this independent movement. More important from a recovery perspective, The TOPS solution places no restrictions on patients.  You can do whatever you feel like pursuing.

The amount of physical therapy required after spinal surgery will vary from patient to patient, and from procedure to procedure. Make sure you’re aware of the physical therapy associated with the procedure you’re considering.

Are some spinal surgeries more successful than others?

Are some spinal surgeries more successful than others? The short answer is yes, but that doesn’t tell the entire story. Any spinal surgeon will tell you that every patient’s case is unique, and that post-operative recoveries and long-term outcomes also vary from patient to patient.  In addition, every operation is different, whether dealing with a traumatic spinal cord injury of a degenerative condition like spinal stenosis. For that reason alone some spinal surgeries are more successful than others. Some patients may work harder at their recovery, while others may benefit from an extremely skilled surgeon. Patients don’t always define success in the same terms, and thus rate clinically identical outcomes differently. But beyond these differences in individual cases is the undeniable fact that some surgeries carry more risk or have a lower rate of clinical success than other procedures, and that some are proven to provide superior outcomes than others for treating the same condition. Spinal decompression surgery, a relatively common procedure, is an excellent example of differences in the success rates of spinal surgeries.

Spinal decompression is performed to relieve pressure on a nerve within or emanating from the spinal column, the cause of common back problems such as sciatica. The spinal decompression procedure, which involves cutting away portions of a vertebra impinging on a nerve, can dramatically reduce pain and restore mobility in many cases. However, the procedure leaves the vertebral segment weakened and in need of stabilization. Traditionally, spinal fusion surgery was performed in conjunction with spinal decompression therapy to stabilize the spine at the segment where the decompression was performed. Today the TOPS™ (Total Posterior Solution) System is available as an alternative to spinal fusion back surgery. In clinical studies around the world, the TOPS Solution has been found to deliver superior clinical outcomes than spinal fusion surgery. And that’s a definition of success in just about every patient’s and doctor’s book.

What is Endoscopic Spine Surgery?

The last several years have seen great strides in developing advanced surgical solutions for spinal problems. Many of these advances involve minimally invasive procedures that leave surrounding tissue undisturbed, allowing faster recovery times and eliminating many of the complications associated with invasive back surgery operations.

Minimally invasive spine surgery is taken one step further by state-of-the-art miniaturized medical equipment, such as fiber optic cameras and microscopes. These procedures, often referred to asendoscopic spine surgery, lend themselves to treating a variety of spinal conditions and disorders including slipped disc and pinched nerves. These minimally invasive spine surgery procedures can remove tissue exerting pressure on nerve roots emanating from the spine, providing dramatic relief for back pain and restricted mobility. However, like any form of surgery, endoscopic spine surgery should be performed only if non-surgical treatment options have been exhausted and these restricted access techniques can adequately address the patients’ diseases. Conservative treatments include physical therapy, epidural injections, and medication to control pain and discomfort. If you and your physician conclude that endoscopic back surgery may be appropriate, the decision on which procedure is best should be made only after a thorough evaluation of all aspects of your case. In some situations where bone must be removed from a vertebra as part of the surgical procedure (as in a laminectomy or spinal decompression surgery procedure), the endoscopic procedure does not provide adequate access or visualization to perform a proper decompression. Suboptimal removal of pain generators, especially when followed by the fusion of adjacent vertebrae, can have adverse outcomes. Moreover, it is irreversible as spine fusion surgery eliminates the independent flexion and rotation of the fused vertebrae. But another advance of recent years, the TOPS™ System, has proven to provide a better clinical outcome than spinal fusion. An implant device, the TOPS, or Total Posterior Solution System, preserves the independent motion of the individual vertebrae.

If you suffer from back pain or other symptoms of spinal problems, don’t let outdated ideas about back surgery keep you from seeking treatment. Today a host of conservative treatments such as medication and physical therapy can often provide relief, and when surgery is called for, it can often be performed without complications.

Causes of Back Pain in Adolescents vs. Adults

Though the majority of spinal problems appear between the ages of 35 and 55, wrought by natural processes associated with aging, you don’t have to be an adult to have back problems. Back pain can also affect adolescents and even children.

As many as half of all young people will experience back pain by age 20. It may appear as a sharp, shooting pain, or as a burning or aching. It may be felt anywhere in the back. These are the same symptoms adults experience, but the causes of adolescent back pain are usually different than those that afflict their elders.

Table of Contents

Is Back Pain Normal for Adults?

What Are the Red Flags for Back Pain?

What Causes Back Pain in Adolescence?

Is Back Pain Normal During Puberty?

When Should I Be Worried About My Child’s Back Pain?

Will My Child’s Back Pain Go Away On Its Own?

How Do You Get Rid of Back Pain for Adults?

Spinal Fusion For Back Pain in Adolescents and Adults

Continue reading to learn more about the differences between the causes of back pain in adolescents and adults. 

Is Back Pain Normal for Adults?

Back pain is normal for adults because it’s an extremely common medical condition. An estimated 80% of adults experience lower back pain at some point in their lives. 

But, why exactly has back pain become normal for adults? There is no singular answer to this question, but medical experts believe that the growing prevalence of back pain is due to factors including:

• A lack of physical fitness
• Occupational risk factors, including sitting in an uncomfortable office chair, sitting for hours without breaks during the work day, and performing jobs that require heavy lifting
• High stress levels
• Poor sleep quality
• Anxiety, depression, and other mental health factors
• Genetic factors, such as a family history of lumbar disc disease

What Are the Red Flags for Back Pain?

The red flags for back pain that indicate the potential for serious complications include:

• Fever
• Weakness, numbness, or pain in the leg muscles
• Lost sensation in the inner thighs and buttocks (saddle anesthesia)
• Weight loss that can’t be attributed to other factors
• Recent surgery, illness, or a history of cancer
• Incontinence 

If you experience back pain with any of the symptoms listed above, seek out urgent medical care. Possible causes of these symptoms, such as cauda equina syndrome, require immediate treatment to prevent permanent complications. 

What Causes Back Pain in Adolescence?

Back pain in adolescence is most often caused by sprains, strains, scoliosis, herniated disc, and spondylolysis (vertebral stress fracture).

Benign musculoskeletal diseases and trauma are responsible for most cases of back pain in adolescents, just as they are for adults. Any strenuous or straining activity – sports or play, carrying a heavy backpack, or falling – can sprain muscles in the back and cause pain. Such strains and trauma account for many of the younger patients seen in hospital emergency rooms suffering from back pain.

Less commonly, back pain in adolescence can be caused by spinal infections, kidney infections, or spinal tumors. 

Is Back Pain Normal During Puberty?

Back pain is normal during puberty, to a degree. Growth spurts during puberty can cause muscular imbalances as the muscles and ligaments struggle to keep up with the growing bone. 

Clinical research published in BMC Musculoskeletal Disorders focused on puberty-related back pain in young girls. This research identified a “highly significant trend” for worsened back pain with increasing levels of puberty until teens reach maturity. Lower back pain, in particular, was linked to puberty, while mid-back and neck pain didn’t seem to correlate with the pubertal stage. 

When Should I Be Worried About My Child’s Back Pain?

You should worry about your child’s back pain if it lasts for longer than several weeks, occurs constantly, keeps them awake at night, or is accompanied by other symptoms, such as fever or neurological symptoms. If your child is exhibiting back pain with these symptoms, seek out prompt medical care for a diagnosis and treatment. 

Will My Child’s Back Pain Go Away On Its Own?

Fortunately, most cases of adolescent back pain resolve on their own. The exact cause of back pain is never identified in at least half the adolescents seeking treatment. However, adolescents can exhibit severe spinal conditions capable of causing long-term problems. 

These include stress fracture of the spine, known as spondylolysis, spondylolisthesis, which is forward slippage of one vertebra on another, and lumbar disc herniations. Infections, inflammatory diseases, and tumors can also cause back pain in children and adolescents, as can other congenital or acquired conditions. However, most cases of back pain in children are caused by muscle strains and generally resolve within a few weeks. 

If your child is experiencing significant, persistent back pain, don’t hesitate to seek out professional medical care. 

How Do You Get Rid of Back Pain for Adults?

To get rid of back pain for adults, start by improving your posture, focusing on your sleep quality, and managing inflammation with ice and heat therapy. Over-the-counter medications, like NSAIDs, can also help reduce back pain and swelling. 

When at-home methods fail to relieve back pain, it’s time to see a medical professional. Your doctor can work to pinpoint the cause of your pain and, if appropriate, refer you to a spinal specialist. 

Your physician and/or spinal specialist may recommend:

• Physical therapy

Physical therapy focuses on strengthening muscles that can lessen the impact on the spine. Physical therapists can also implement other treatments for back pain, including massage, electrical stimulation, and ultrasound.

• Lifestyle adjustments

Physical therapy is often the most effective for back pain when it’s paired with lifestyle adjustments. Your physician can recommend the changes that will be the most effective for your diagnosis, which may include:

• Quitting smoking
• Managing stress levels
• Reaching an optimal weight
• Avoiding high-impact activities, such as running and contact sports
• Engaging in regular, low-impact exercise to retain mobility and strength
• Eating a balanced, nutrient-rich diet
• Altering your sleeping position to reduce strain on the spine
• Practicing proper posture
• Investing in a high-quality desk chair with lumbar support

• Prescription medications 

Certain prescription medications can help with back pain, including muscle relaxants, antidepressants, and prescription-strength NSAIDs.  

• Steroid injections

Steroid medication can be injected directly into the site of your back pain to suppress inflammation and provide fast pain relief. However, physicians advise that patients undergo no more than three to four steroid injections per year to avoid tissue damage. 

• Surgery

When non-surgical methods don’t improve back pain after several months, physicians may recommend surgery. This is typically used as a last resort when back pain starts to disrupt the patient’s normal activities. 

Spinal decompression surgery can alleviate back pain, neurological symptoms, and restricted mobility from conditions like spinal stenosis, spondylolisthesis, and herniated disc. During this procedure, the surgeon removes the tissue that’s impinging on the spinal nerves, providing the space that it needs to heal and recover. 

Spinal Fusion For Back Pain in Adolescents and Adults

To eliminate the possibility of spinal instability after decompression surgery, many surgeons perform spinal fusion. It involves placing bone graft material between the affected vertebrae to spur bone fusion, eliminating all motion at the spinal segment. 

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The fusion process can lead to reduced mobility and adjacent segment degeneration in all patients, regardless of age. In fact, when spinal fusion is performed on younger patients, it’s more likely to lead to complications. This is simply because younger patients have more years to experience the effects of spinal degeneration.

Spinal Fusion Alternatives

Adolescents and adults can both benefit from the TOPS™ System as a spinal fusion alternative. A TOPS™ System implant can be used following decompression spine surgery, rather than the spinal fusion procedure that’s typically performed.

Whereas spine fusion surgery eliminates the independent movement of fused vertebrae, the TOPS™ System preserves each vertebra’s full range of flexion and rotational motion. That’s welcome news for spine decompression patients of all ages.

If you or your child is struggling to manage persistent back pain, schedule an appointment with a spine specialist in your area to learn more about your treatment options.