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

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Back Surgery Can Potentially Cure Your Pain

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You always want to get your information directly from your spinal surgeon, since back surgery information online can be outdated or incorrect, and Googling back surgery topics can sometimes cause unnecessary anxiety.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

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

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

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

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

reference: www.mayoclinic.com

Preparing for Spinal Fusion Surgery, Part II

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Doctors Completing Surgery

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.

How to Prepare for Spinal Fusion Back Surgery

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Doctors Performing Surgery

Spinal fusion back surgery is often performed in conjunction with spinal decompression treatment. The decompression procedure relieves pressure on pinched nerves emanating from the spine, reducing pain and restricted mobility in limbs caused by the compressed nerve. But the spinal decompression surgery involves removing portions of vertebrae, making the spine weaker at these points. Thus, spinal fusion surgery is performed to strengthen the spine after decompression, and involves fusing two adjacent vertebrae with the use of an implant.

Preparing for spinal fusion surgery – whether performed on the lumbar, thoracic or cervical spine – is similar to preparations for any spinal operation, but there are a few specifics to be aware of. First, be prepared to be thoroughly examined before the surgery is performed, so your physicians can plan all aspects of your operation. Radiograph assessments of spinal instability, EMG to test nerve function, and an MRI, CAT, or other scan is often performed to identify nerve compression.

Your overall physical condition will also be assessed to ensure you are in sufficient health to undergo the rigors of the surgery. You will need to discuss any and all pre-existing medical conditions with your physicians, and further evaluation of such conditions may be necessary before proceeding with spine fusion surgery. In fact, one of the most important ways to prepare for spinal fusion is to get into the best physical condition possible. Being in good physical condition translates into fewer complications during surgery and faster recoveries after, among other benefits.

Spinal surgery of any kind should be considered a last resort, undertaken only if more conservative treatments have proven ineffective. But many patients undergoing spinal decompression now have an alternative procedure to spinal fusion, shown in clinical tests around the world to have better outcomes than spinal fusion. The TOPSTM (Total Posterior Solution) System stabilizes the spine without eliminating the independent motion of the individual vertebrae, as spinal fusion does. So one of the best ways to prepare for spinal fusion is to find out if an alternative solution like TOPS makes more sense than spinal fusion surgery for you or a loved one.

What is a Lumbar Laminectomy?

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Lumbar Laminectomy

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

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

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

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

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

Recovering from Lumbar Spinal Stenosis

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Lumbar Spinal Stenosis

Lumbar spinal stenosis, a common medical problem, denotes an unnatural narrowing of the spinal canal, the center of the spinal column housing the spinal nerves that relay sensorial information to the brain and control the movements of our muscles. The term stenosis comes from Latin, and means a narrowing. When a portion of the spinal canal narrows unnaturally, it can put pressure on the spinal nerves, and these pinched nerves in turn can cause pain and limit mobility.

The good news is that a variety of treatment options are available that have been proven effective in helping individuals recover from or ameliorate the symptoms of spinal stenosis. Conservative, non-invasive therapies include simple lifestyle changes, medications, physical therapy, and injections of anti-inflammatory agents. For patients with spinal stenosis, there’s no way of knowing which of these approaches will be most successful, so physicians may simply prescribe one of these treatments as a first step, and monitor the results to see how the patient responds. If the first method selected doesn’t achieve the results of helping the patient recover from spinal stenosis, the next option may be tried, and so on.

For patients with moderate to severe spinal stenosis who do not respond to conservative treatments, surgery may be recommended. In this form of spinal decompression surgery, the surgeon trims away excess bone in the narrowed center of the affected vertebra, relieving pressure on the compressed nerve or nerves. Historically, a spinal fusion back surgery operation has been performed in conjunction with surgery to relieve spinal stenosis, in order to stabilize the region of the spine where the operation was performed. Today there’s an important, and better alternative to spinal fusion. The TOPS (Total Posterior Spine) System procedure provides better clinical outcomes than spinal fusion surgery. The TOPS solution has the added benefit of preserving the spine’s full range of motion, unlike spinal fusion, which permanently fuses adjacent vertebrae. TOPS also offers a much quicker recovery from surgical treatment for spinal stenosis than spinal fusion. If you’re a candidate for spinal stenosis surgery, make sure you understand all the advanced surgical solutions available today, and what impact each will have on your recovery from this condition.

Back Treatment Options

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Spinal fusion

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

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

What is Lumbar Spinal Decompression?

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Spinal Stenosis

Imagine if the branches of a tree were just as big at the top as they are at the bottom, and that sometimes, heavy loads were placed on the ends of the very highest branches. Think of the stress that would put on the lower portion of the tree trunk. Well, that’s analogous to the situation we humans experience with our spinal columns. Our spinal column is like the trunk of a tree, but we’re just as big at the top of our trunks as at the bottom. The stress this puts on our lower backs – also called the lumbar region of the spine – is exacerbated by the cumulative affect of a lifetime of lifting and twisting in combination with degenerative changes of the spine that occur as a result of aging. So it’s not surprising that the majority of back problems that bring patients to spinal specialists are centered in the lower, or lumbar region of the spine.

These stresses, along with our genetic makeup, disease or injury, can result in a host of spinal disorders such as bulging or herniated discs, slipped disc and spinal stenosis. These disorders, in turn, can result in unnatural pressure being put on nerves that emanate from the spinal column, potentially causing pain, restricted mobility, and other symptoms of pinched nerves. We talked about the problem of pinched spinal nerve and spinal decompression in general in a previous blog. As we noted, spinal decompression is a means of easing pressure on impinged spinal nerves, and can be performed either non-surgically or surgically. Lumbar spinal decompression simply refers to decompression procedures performed on the lower portion of the spine.

The surgical solution for a lumbar pinched nerve involves removing tissue from vertebrae in the lumbar region that impinge, or put pressure on a nerve. This is called lumbar spinal decompression surgery. Historically, spinal fusion back surgery has been performed in conjunction with lumbar decompression surgery to stabilize the spine. Today, the TOPS™ (Total Posterior Spine) System provides an alternative to spinal fusion that preserves the full range of the spine’s natural motion, and has been shown to provide better outcomes than fusion in clinical studies performed around the world. This provides an important more treatment option for individuals with moderate to severe symptoms of pinched nerves who do not respond to non-surgical lumbar decompression procedures.

What is Spinal Decompression?

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Spinal Decompression

It may sound like something only a deep sea diver needs to be concerned about, but spinal decompression is an important topic for many people suffering from debilitating back pain. Spinal decompression refers to the process of relieving pressure on one or more pinched, or impinged nerves in the spinal column. The pressure on such nerves can cause pain, restrict mobility, and result in a host of other physical problems that can manifest in almost any part of the body. A host of spinal conditions, including spinal stenosis, disc degeneration, bulging, herniated or slipped discs, and facet syndrome can put pressure on nerves emanating from the spinal column.

Spinal decompression can be performed both surgically and non surgically. Non-surgical spinal decompression utilizes mechanical, computer controlled traction devices to reduce the pressure placed on nerves in specific portions of the spine. Inversion therapy, in which patients hang upside down, is another from of non-surgical spinal decompression.

For patients who do not respond to non-invasive methods, spinal decompression surgery can achieve dramatic improvements. In this surgical procedure, portions of the bone or tissue of the spine that impinge of a nerve are cut away, relieving the pressure. Historically, a spinal fusion procedure was performed in conjunction with spinal decompression surgery, in order to stabilize the spine at the point where the decompression procedure was performed. But spinal fusion, in which two vertebrae are fused to enhance spinal stability, eliminates the independent motion of the fused vertebrae, and may accelerate degeneration of adjacent vertebrae. Today, the TOPS™ (Total Posterior Spine) System provides an alternative to spinal fusion for patients undergoing spinal decompression back surgery. Unlike spinal fusion, TOPS preserves the full range of the spine’s natural motion, and has been shown to provide better outcomes than fusion in clinical studies performed around the world.

If you’re a patient whose pinched spinal nerve is not responding to non-invasive decompression methods, make sure you discuss all your surgical options with your physicians.

Spinal Surgery for a Slipped Disc

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Spinal Surgery Scar

A slipped disc is a common term for a herniated disc, which occurs when the central core of a spinal disc ruptures. Fluid from within the disc then leaks into the spinal canal, where it can interfere with the functioning of nerves. A slipped disc in the spine is the last stage in a degenerative disc disease process that begins with a bulging disc and progresses to a protruding disc, before it finally ruptures. The “slipped disc” has not actually shifted position. Symptoms of slipped disc vary depending on the location of the slipped disc in the spine, and the extent of the rupturing. A slipped disc may be entirely unnoticeable if it doesn’t result in pressure on a nerve. A slipped disc in the neck (a slipped cervical disc), may cause pain or numbness in the shoulders, arms or chest. A slipped disc in the lower back (a slipped lumbar disc) may cause sciatica, creating pain anywhere from the buttocks to the feet.

The main causes of slipped disc are spinal degeneration from the natural aging process, or from injury such as improper lifting of heavy objects or poor body mechanics that put unnatural stress on the spinal column. Smoking and excess body weight also increases the risk of developing a slipped disc. Sudden trauma such as an automobile accident rarely causes slipped disc. Treatments for slipped disc include slipped disc exercises and physical therapy, medication to relieve pain and pressure on spinal nerves, and in some cases surgery for slipped discSpinal fusion back surgery is often performed in conjunction with surgery for a slipped disc. The fusion stabilizes the spine, but eliminates the natural independent motion of the now-fused vertebrae. Today many patients are choosing the TOPS™ (Total Posterior Spine) System as an alternative to spinal fusion surgery. The TOPS solution provides better clinical outcomes and preserves the independent motion of the vertebrae. This is just one of the advances bringing new and better therapies to back patients worldwide.

What is Lumbar Radiculopathy?

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Lumbar Radiculopathy Education

If the vertebrae (the bones of the spine), or the cushioning discs between them impinge on the root of a nerve in the spinal column, chronic injuries to the nerve may result. Radiculopathy is the general term for these injuries. The condition most commonly occurs in the lower, or lumbar region of the spine, termed lumbar radiculopathy. Radiculopathy may also occur in the neck, or cervical region of the spine, which is termed cervical radiculopathy. Common symptoms include radiating pain, numbness, tingling, weakness, and loss of motor function. These symptoms may be felt all the way to the tips of the fingers or toes, even though the nerve injury is at the base of the nerve at the spine. Radiculopathy symptoms felt in the arms and hands are usually caused by cervical radiculopathy while those in the back of the leg and the foot usually result from lumbar radiculopathy.

Degenerative disc disease, a normal part of the aging process, can cause this condition, as can repetitive or stressful physical activities. Occupations that require repetitive motions or heavy lifting are common cause of lumbar radiculopathy. Being overweight or in poor physical health can also contribute to radiculopathy. Improper blood flow and progressive disease can also lead to the condition. A genetic predisposition and the presence of other spine disorders also increase one’s risk of developing spinal radiculopathy.

Physical therapy, medication, and relaxation are often prescribed successfully to treat lumbar radiculopathy. Spinal decompression surgery combined with spinal fusion back surgery has been a common treatment modality for patients who do not respond to conservative treatments. Today the TOPS™ (Total Posterior Spine) System, a new advance, can be performed as an alternative to spinal fusion. Unlike fusion, the TOPS System preserves the full natural range of motion of the individual vertebrae, which is lost when the bones are fused. The TOPS System has also been shown to provide superior outcomes in clinical studies around the world. Advances like these give individuals with back problems ever more, and more effective, treatment options.