Although it’s not as common as spinal stenosis or a herniated disc, spondylolysis is near the top of the list of conditions that can cause lower back pain. This spinal condition is relatively common, affecting approximately one out of 20 people. You may also hear it referred to as a stress fracture or pars defect.
Learning about spondylolysis can help you better understand the factors that could be behind your back pain. In this article, we’ll provide a detailed overview of spondylolysis, including modern treatment options for this condition.
Spondylolysis is a stress fracture in a vertebra, which is a bone in the spinal column. The fracture occurs at the point where the vertebra connects to the vertebra above it, known as the pars interarticularis.
The pars interarticularis is a thin piece of bone that links the upper and lower segments of the facet joints. It connects the vertebrae and facilitates the movement of the spine.
The fracture in the pars interarticularis can allow a vertebra to move out of its usual position and press against, or compress, the spinal cord. This condition is called spondylolisthesis. Spondylolisthesis can cause several symptoms, with lower back pain being the most common.
Spondylolysis isn’t rare, affecting an estimated 3% to 7% of Americans. Many of the patients who are diagnosed with spondylolysis are younger than traditional spinal patients. In fact, in one orthopedic series, spondylolysis accounted for 47% of cases of acute lower back pain in teen athletes.
Spondylolysis is rooted in a weakness in the pars interarticularis. The exact cause of a weakness in the pars interarticularis isn’t known.
With that said, factors that can influence the weakness in the vertebrae that characterizes spondylolysis include:
Genetics are believed to play a role in some cases of spondylolysis. Some children are born with this spinal condition.
Repetitive spinal trauma may also lead to spinal trauma. This commonly occurs in young athletes who frequently stress the spine. In two prospective studies, the incidence of lower back pain in athletes with spondylolysis was 72.5 % in high school rugby players, 80.5% in college football players, and 79.8% in high school football players.
The good news is that many people with spondylolysis remain asymptomatic. Asymptomatic patients have no symptoms and are usually unaware they even have spondylolysis.
When the spondylolysis does cause lower back pain, it usually spreads across the lower back. Spondylolysis pain often feels like a muscle strain and is generally exacerbated by exercise or vigorous activities.
In adolescent patients, spondylolysis symptoms often appear during growth spurts. This makes the most common age of diagnosis for teenage patients with spondylolysis 15 to 16.
Spondylosis and spondylolysis are often confused, and it’s easy to see why. The names of these spinal conditions are very similar. But, each is a distinct ailment with different causes and symptoms.
The spondylosis diagnosis is used for degenerative osteoarthritis of the spine. With this condition, the cartilage that protects the ends of the vertebrae breaks down. As a result, the space between the vertebrae shrinks.
Spondylosis may also involve age-related degeneration of the spinal discs and bone spurs. This condition differs from spondylolysis, which specifically involves a stress fracture in the pars interarticularis.
We’ve already mentioned spondylolisthesis and how it can result from spinal instability caused by spondylolysis. Similar to spondylosis, spondylolisthesis is commonly confused with spondylolysis. Additionally, spondylolysis can often cause spondylolisthesis, which further adds to the confusion.
Ultimately, spondylolisthesis involves vertebral misalignment due to spinal instability, while spondylolysis is a stress fracture of the pars interarticularis.
Most cases of lumbar spondylolysis are resolved with non-surgical treatment methods. Non-surgical spondylolysis treatment often involves lifestyle modifications, medications, and physical therapy.
Spondylolysis is a common injury in young athletes, namely those who are involved in sports that involve spinal hyperextension. So, physicians generally recommend that spondylolysis patients take a break from sports to give the spine time to heal.
Simple over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) can often relieve mild spondylolysis symptoms.
Physical therapy is one of the most effective non-invasive treatment options for spondylolysis. Your physical therapist can help you regain a high quality of life and safely go back to your usual activities.
The goals of physical therapy for spondylolysis are to:
In general, patients with spondylolysis should try to avoid all high-impact activities, such as running, as well as activities that put added stress on the lower spine. Heavy lifting, football, diving, and competitive swimming can all strain the lower spine.
With spondylolysis exercises to avoid in mind, it’s important to stay active with spondylolysis. Physical activity improves blood flow to the damaged and irritated spinal tissues, which facilitates the healing process. Additionally, gentle exercise will help you maintain muscle strength and mobility throughout your recovery.
Many patients, especially young athletes, are eager to avoid spending time on the bench due to spondylolysis. While genetic factors that may make you more susceptible to spondylolysis can’t be altered, certain tactics may help you prevent this spinal condition.
First off, consider a sports injury prevention program, which may be available from your local physical therapist. This type of program focuses on safely building muscle strength and increasing flexibility. Together, strength and flexibility can help prevent excess strain on the spine.
Additionally, avoiding repetitive motions that strain the back can help prevent lumbar spondylolysis. Unfortunately, this may not be possible in specific sports, such as gymnastics and weightlifting. Athletes who are predisposed to spondylolysis should consider talking to their coaches about their unique needs.
As a general rule of thumb, practicing proper posture can help avert spondylolysis and a host of other spinal conditions. Try to be mindful of your posture while you sit, stand, and lift heavy objects. Keeping your spine straight with your shoulders back and head levels allows for proper spinal alignment.
In moderate to severe spondylolysis cases that don’t respond to conservative treatments, spondylolysis surgery may be required. There are a few different surgical approaches that your physician may recommend.
Surgery may be implemented to repair the spinal stress fracture. During this type of procedure, the surgeon will likely use a titanium screw to secure either side of the fracture together. For additional support, your surgeon may also place bone graft material in the affected area.
Patients with spondylolysis and nerve compression from spondylolisthesis may benefit from spinal decompression surgery. Spinal decompression involves removing a portion of the defective vertebra that’s compressing the spinal nerve.
Typically, spinal fusion surgery is performed following the decompression procedure to stabilize the spine. Spinal fusion involves placing bone graft material in between the affected vertebrae. This process, over several months, permanently fuses the targeted vertebrae.
Unfortunately, while spinal fusion can successfully prevent spinal instability after decompression surgery, it also eradicates the independent motion of the vertebrae. This leaves patients’ mobility seriously compromised and increases the risk of degeneration in the neighboring vertebrae.
With these downsides (among others) in mind, many modern spondylolysis patients look for spinal fusion alternatives. Recently, an advanced alternative to spinal fusion, the TOPS™ posterior arthroplasty procedure, has gained prevalent in the United States. Having been approved and successfully used for years in Europe and other countries, the TOPS™ System provides better clinical outcomes than fusion while preserving the patient’s full range of back motion.
Back pain is one of the world’s most common and debilitating medical conditions. As pioneers of advanced surgical treatments for spinal disorders, we at Premia Spine encourage anyone suffering from back pain, including spondylolysis pain, to learn about all the treatment options available today.
If you’re struggling with persistent back pain along with numbness, tingling, or weakness, you may have a spinal condition. Spondylolisthesis is one possible condition that can trigger these symptoms and ultimately compromise your quality of life.
In this article, we’ll dive into the topic of spondylolisthesis and explain what patients can expect from a spondylolisthesis diagnosis. While the prospect of managing this condition may seem intimidating, rest assured that there are numerous effective treatment options for spondylolisthesis.
With spondylolisthesis, one of the vertebrae in the spine becomes displaced due to instability. As a result, it moves downward in relation to its proper position, settling on the vertebra beneath it.
This malpositioning can put pressure on the spinal cord, as well as the nerves that emanate from the spinal column. This pressure can lead to pain in the lower back and leg.
Spondylolisthesis of the lumbar region (meaning that it occurs in the lower back) is the most common. Specifically, the L5-S1 level of the spine is most frequently affected by spondylolisthesis, followed by the L4-5 level.
You’ve probably heard the common medical term, “a slipped disc”. While this may seem to indicate the slippage involved in spondylolisthesis, it’s an entirely different condition.
Spondylolisthesis affects the spinal bones, which are known as vertebrae. A slipped disc is an injury involving an intervertebral disc, which is a cushion of shock-absorbing tissue. There’s an intervertebral disc located in between each of the vertebrae in the spine.
Given that spondylolisthesis and a slipped disc affect different parts of the spine and develop differently, it’s crucial to distinguish them. A spinal specialist can give you an accurate diagnosis of back pain.
As another spinal condition that’s commonly confused with spondylolisthesis, you may have heard of spondylolysis. This condition, unlike a slipped disc, is related to spondylolisthesis. However, they’re still different conditions.
Spondylolysis is a stress fracture that runs through the pars interarticularis, a small segment of bone that connects two vertebrae. When the pars interarticularis is fractured, patients may experience back pain that worsens with physical activity. However, not all spondylolysis patients have symptoms.
Approximately one out of 20 people have spondylolysis, making it a relatively common condition. Additionally, spondylolysis can lead to spondylolisthesis. This is because the pars interarticularis fracture can diminish the stability of the spine and potentially lead to slippage.
Spondylolisthesis has several possible causes, the most common of which include:
The most common cause of spondylolisthesis is degenerative changes in the vertebral joints and cartilage due to aging. When spondylolisthesis is caused by age-related spinal changes, it’s known as degenerative spondylolisthesis.
Younger individuals may experience spondylolisthesis caused by a birth defect in the facet of the vertebra. The defect, which is present at birth, can cause the vertebra to slip out of position. This is referred to as dysplastic spondylolisthesis.
Spondylolisthesis can also result from sudden trauma, such as a sports injury or car accident. This is known as traumatic spondylolisthesis and can occur in people of all ages.
In athletes that repetitively strain and overstretch the spine, spondylolisthesis is a relatively common injury. This is especially true in younger athletes, given that their spines haven’t fully developed.
The most frequent symptom of lumbar spondylolisthesis is lower back pain. The pain typically worsens after exercise and abates when you sit or bend forward.
Decreased range of motion and tightness of the hamstring muscles are common spondylolisthesis symptoms.
The nerve compression may also result in pain, numbness, tingling, or weakness in the legs, and in cases of severe compression, loss of bowel or bladder control.
Spinal stenosis isn’t exactly a symptom of spondylolisthesis. However, degenerative spondylolisthesis is a prevalent cause of spinal stenosis, which is an abnormal narrowing of the spinal canal.
A physician specializing in spinal disorders can diagnose spondylolisthesis using radiographs and x-ray imaging, as well as a comprehensive physical exam. You’ll likely stand sideways as the x-rays are taken so your physician can see the vertebra’s slippage clearly.
After your physician has examined the imaging test results, the severity of your spondylolisthesis case will be graded. The grading scale is based on the degree of slippage from the vertebra’s normal position.
Upon making a diagnosis, a physician can recommend appropriate treatments for spondylolisthesis.
As aforementioned, spinal specialists use a grading system to determine the severity of spondylolisthesis cases. Spondylolisthesis grades include:
Several factors can worsen spondylolisthesis, including:
If you’ve been diagnosed with spondylolisthesis, your physician likely recommended lifestyle adjustments to help you avoid the factors listed above.
Any exercises that involve heavy lifting and excessive twisting or bending should be avoided with spondylolisthesis. If you enjoy a specific sport, you should talk to your physician about whether it’s safe to participate in that sport while you’re struggling with spondylolisthesis symptoms.
Sports that tend to exacerbate spondylolisthesis symptoms include:
Treatments for spondylolisthesis include physical therapy, exercises for relieving pressure on the affected spinal nerves, medication, and epidural steroid injections. In many patients, these treatments are sufficient to alleviate the symptoms of spondylolisthesis.
Physical therapists can help patients manage spondylolisthesis in several ways.
For one, your PT can offer valuable insights and education about how your lifestyle is affecting your symptoms. From your exercise regimen to your footwear to your posture, your physical therapist can identify areas for improvement. In making the recommended adjustments, you can likely reduce the pressure on your spine, leading to an improvement in spondylolisthesis symptoms.
Additionally, your PT can implement various non-invasive methods of pain management. Targeted heat and cold therapy can help alleviate inflammation and pain. Electrical stimulation is another popular method among physical therapists to gently reduce the transmission of pain signals to the brain.
Physical therapists can also recommend stretching and strengthening exercises for spondylolisthesis. By stretching to reduce muscle tension, you can gain greater back flexibility. By strengthening various muscle groups, you can gain greater stability in the lumbar spine, hips, and pelvis.
Many spondylolisthesis patients find that chiropractic care is a helpful tool for alleviating their symptoms. Chiropractors specialize in spinal manipulation to treat issues involving the musculoskeletal system.
Key goals of chiropractic care for spondylolisthesis include improving spinal mechanics, restoring spinal function, and improving posture. In achieving these goals, your chiropractor may alleviate compression on the spinal nerves, which often leads to reduced symptoms.
One of the main benefits of chiropractic care for spondylolisthesis is that it’s non-invasive. Chiropractors focus on methods including manual and instrument-assisted manipulation to adjust the spine, making it a safe back pain treatment option.
Physicians often recommend over-the-counter medications to help spondylolisthesis patients manage pain and inflammation. In more advanced cases that don’t improve with over-the-counter options, physicians may instead suggest prescription medications.
There are a few different types of drugs that may help with spondylolisthesis. The main types include:
In simpler terms, analgesics are painkillers. These over-the-counter medications’ primary function is to relieve pain. The most common analgesic is acetaminophen, or Tylenol.
NSAIDs alleviate inflammation along with pain. There are numerous over-the-counter NSAIDs, such as aspirin, Aleve, and Advil (ibuprofen), as well as prescription NSAIDs.
This type of prescription medication can be helpful for patients suffering from spondylolisthesis nerve pain. Neuropathic agents target nerve pain directly and can help with spondylolisthesis symptoms including tingling, numbness, and weakness.
Gabapentin and pregabalin (Lyrica) are two of the most commonly prescribed neuropathic agents for spondylolisthesis.
Some spondylolisthesis patients experience chronic back pain caused by muscle spasms in the back. In these cases, physicians may prescribe a muscle relaxant to stop the spasms. Soma, Flexeril, Baclofen, Tizanidine, and Robaxin are among the most widely prescribed muscle relaxants.
For patients with moderate to severe spondylolisthesis who don’t respond to conservative therapies, physicians may recommend spinal decompression surgery. The idea of undergoing surgery can be daunting, but note that most patients’ symptoms improve with non-surgical treatment.
If you and your physician determine that surgery is the right route of treatment, you’ll likely discuss the spinal decompression procedure.
Spinal decompression involves removing portions of the vertebrae that impinge on the spinal cord and nerve roots. There are several different approaches to spinal decompression, including laminectomy, foraminotomy, discectomy, and corpectomy. For spondylolisthesis, surgeons often opt for laminectomy.
Laminectomy involves removing some or all of the lamina. This is the small section of bone that covers the back of the spinal canal. By removing it, your surgeon can create more space for the spinal nerves and alleviate nerve impingement.
Spinal decompression can have a dramatic effect, relieving pain and other spondylolisthesis symptoms. However, removing portions of the lamina reduces the stability of the spinal column. So, after decompression surgery, spinal stability remains a key concern for spondylolisthesis patients.
This is why surgeons traditionally perform spinal fusion after spinal decompression.
Spinal fusion involves placing bone graft material in between the affected vertebrae. Then, screws and rods are implanted to secure the graft in place and provide additional stability.
In the period following spinal fusion surgery, the bone graft material will spur the permanent joining of the affected vertebrae. This prevents all movement between the fused vertebrae, which can prevent instability in spondylolisthesis patients.
Unfortunately, in stabilizing the vertebrae, spinal fusion eliminates the natural independent motion that gives the spine flexibility. This diminishes patients’ ability to carry out certain movements, namely those that require the bending or twisting of the spine. Fusion has also been shown to promote the deterioration of adjacent vertebrae.
Now, there’s an alternative to spinal fusion for spondylolisthesis: the TOPS™ System, developed here at Premia Spine. The TOPS™ System restores stability while preserving the spine’s full range of motion after spinal decompression. It’s been clinically shown to provide better outcomes than spinal fusion surgery for degenerative lumbar spondylolisthesis.
In a seven-year study for patients with degenerative spondylolisthesis and lumbar spinal stenosis, the TOPS™ System maintained clinical improvement and stability. Additionally, in a five-year study of the TOPS™ System for 10 patients with degenerative spondylolisthesis and lumbar spinal stenosis, the clinical outcome scores “improved significantly across all scoring systems”. In this study, there were no failures at five years and no patients required revision surgery.
The TOPS™ device is approved for use in Europe and many other countries. In the United States, the FDA granted Premia Spine approval to begin an IDE investigation of the TOPS™ System.
Patient and surgeon testimonials are highly encouraging for the TOPS™ System as a spondylolisthesis treatment. Many patients note that they’re able to return to their favorite activities after the TOPS™ procedure, as it preserves spinal mobility.
We encourage anyone with persistent back problems to consult a physician who specializes in spinal disorders and learn about the latest available treatment options.
Can you really travel to a foreign destination for a vacation and receive high-quality medical care at the same time? That’s the question many people raise when the subject of medical tourism comes up.
Many people are skeptical of medical tourism, and understandably so. When you receive medical care in your home country, you’ll naturally feel more comfortable with the treatment process. However, there are many advantages that medical tourism can offer.
For some patients, traveling to a different country for medical care is a worthwhile task. Keep reading to learn more.
Medical tourism is a term used to describe the action of traveling internationally for medical care.
The following benefits are attributed to the popularity of medical tourism for USA patients:
This is the key benefit of medical tourism. Many people can attain high-quality medical care at a fraction of the cost by traveling overseas. This particularly applies to patients in the U.S., which lacks a public healthcare system.
The quality of care should always be the primary consideration in medical tourism. There are first-rate medical facilities and health care professionals in many areas across the globe. Some of these areas, which are widely considered to be the best countries for medical tourism, include Germany, the United Kingdom, Turkey, Israel, India, Thailand, Singapore, Latin America, Eastern Europe, and Cyprus.
Different areas of the world have different medical regulatory bodies. Here in the United States, the FDA (Food and Drug Administration) protects Americans’ health by regulating drugs, biological products, medical devices, food, cosmetics, and even certain electric products.
In many instances, medical innovations have been developed, proven to be successful, and used for many years in other areas of the world. But, with the FDA’s regulatory processes, it can take a long time for those proven medical solutions to become available in the United States. This can also apply to residents of other countries who don’t have access to many of the advanced medical treatments in the United States.
Medical tourism can give patients access to the latest medical technology and, as a result, a higher quality of care.
The United States has the most expensive healthcare in the world. So, while few people would consider medical tourism to the U.S., many Americans contemplate international travel to lower their medical expenses.
When considering traveling internationally for a procedure, it’s wise to consider medical tourism examples and statistics.
Consumers who are interested in medical tourism value a variety of factors. The most prominent of these factors include:
Finances are arguably the most important factor to medical tourism consumers. In fact, in a study from the Medical Tourism Association, 85% of surveyed patients who traveled overseas to a hospital reported that the cost of medical care was a very important deciding factor.
The healthcare system in the United States leaves an estimated 9.6% of residents without health insurance, as of 2021. Even among individuals who do have health insurance coverage, high co-pays and deductibles can make it difficult to afford medical care.
With these facts in mind, it’s unsurprising that cost is a crucial factor for medical tourism consumers. Above all, these consumers want to secure an affordable price for medical care by traveling overseas.
Quality of care is paramount for many medical tourism consumers. By traveling to other countries, patients can attain a higher quality of care (at a lower cost) when compared to the medical treatment available in their home countries.
However, without the assurances that Americans are accustomed to under the FDA, consumers must consider the laws and regulations surrounding medical care in the country that they’re traveling to, as well as the foreign practice’s certifications.
While discussing the benefits of medical tourism, we mentioned that it can grant patients access to advanced treatments that aren’t available in their home country. With this in mind, the treatments available in other countries are a key consideration for medical tourism consumers.
Waiting lists for health care services are another consideration among medical tourism consumers. As of 2022, in the United States, 28% of patients sometimes, rarely, or never receive a response from their primary physician on the same day. This is a high percentage when compared to many other areas of the globe. However, 27% of patients in the U.S. wait one month or more for a specialist appointment, which is a lower percentage than in many other countries, including Norway and Canada.
With that said, long wait lists are primarily a concern for medical tourism consumers in nations with public healthcare systems.
Although medical tourism can provide several benefits, it also presents certain risks and safety concerns, including:
Some countries have a risk of complications including HIV, hepatitis B, hepatitis C, blood infections, wound infections, and infections from donor tissue or blood.
If patients travel to a facility using a language that they don’t speak fluently, doctor-patient communication can be difficult. Given that doctors provide crucial pre-op and post-op information, as well as procedure specifics, this may lead to confusion and errors.
Certain areas may not have comparable requirements for medical licensing and accreditation. This creates the risk of low quality of care.
Doctors typically advise against air travel immediately after surgery. This is because flying raises the risk of developing a blood clot. Depending on the type of surgical procedure, patients should wait between seven and 10 days before flying.
To avoid these risks, medical tourism consumers should ensure that:
As we’ve already mentioned, a significant benefit of medical tourism is that you can gain access to treatments that have not yet or have only recently been, approved for use in your country. Procedures that have been proven effective and are widely used in certain areas of the world can often benefit international patients.
The TOPS™ (Total Posterior Solution) procedure, performed in association with spinal decompression surgery, is an example of a procedure that has been used extensively in Europe but not yet in the United States. TOPS is an alternative to spinal fusion back surgery.
Spinal fusion is widely used with spinal decompression procedures for conditions like spinal stenosis, spondylolisthesis, bone spurs, and more. Unfortunately, fusion can severely limit patients’ range of motion in the back. Additionally, the complete recovery process for spinal fusion may last for six months to a year.
The TOPS System preserves the full range of motion between the individual vertebral segments, unlike spinal fusion. It involves a minimally-invasive surgical procedure, which greatly shortens the spinal surgery recovery period. In fact, patients may start moving around the day after TOPS surgery with few, if any, restrictions.
For certain patients with specific medical conditions, medical tourism could be the ticket to high-quality, low-cost healthcare. If you think you may benefit from medical tourism, make sure to conduct thorough research, find an accredited facility, and evaluate all of the risks before scheduling your appointment abroad.
All patients undergoing back surgery should actively ensure that the healing process goes as smoothly as possible. In doing so, you can attain the best possible results from the procedure while avoiding complications that could compromise your health.
Proper incision care is a key step in the process of adopting healthy habits and positive lifestyle choices to promote healing. As an aspect of your spinal surgery recovery, incision care will benefit your overall health.
Here, we’ll discuss how to care for a spinal incision to ensure a successful surgical recovery and back pain relief. Additionally, we’ll explore innovations in the field of spine surgery that allow for smaller incisions and, as a result, a lower risk of complications.
After spinal surgery, the incision may be closed with Steri-Strips, staples, or sutures, including dissolvable sutures. Most often, spinal surgeons use a combination of these closure methods.
Since spinal surgery is performed beneath the layers of skin and muscle in the back, the incision must be closed at various layers. Your surgeon will suture the muscle layer together before closing the skin.
In preparing for back surgery, patients should begin on a path of improving their diet and physical activity. These practices will improve your overall health to ensure that the spinal surgery goes off without a hitch.
With that said, implementing healthy habits is not only essential for the surgery itself but also for the recovery process following the operation. While continuing the positive lifestyle changes that you applied before the procedure, make sure to rigorously follow your doctor’s orders, including those about what medications to avoid. Certain medications can interfere with the healing process, namely including NSAIDs. NSAIDs, like aspirin, ibuprofen, and naproxen, are blood thinners and can impair the body’s repair processes.
Proper care for the surgical incision is one of the most important aspects of post-operative home recuperation following back surgery.
You won’t be permitted to apply any ointments or lotions to the incision while it’s healing. You also shouldn’t bathe in a tub, swim, or use a hot tub until your incision is healed. Immersing the incision in water before your surgeon clears you to do so may increase your risk of infection and inhibit the healing process.
Additionally, you’ll need to keep the incision clean after spinal surgery. You can clean the incision site with soap and water, then gently dry it with a clean cloth. This helps prevent infection as the incision heals.
In most cases, non-dissolvable sutures and staples are removed 14 days following the spinal surgery. At this point, the incision is usually fully healed.
Many spinal surgery patients are eager to reduce scarring by applying scar treatments and vitamin creams to the incision. However, you must wait to get the go-ahead from your surgeon before doing so. Typically, surgeons allow patients to start applying scar creams six weeks after the procedure.
It generally takes about two weeks for a spinal incision, including a spinal stenosis incision, to completely heal. At this point, your surgeon will remove sutures and staples, as well as clear you to take baths and swim. However, this timeline can vary from patient to patient.
Spinal incision infections typically appear two to four weeks after the procedure. Your surgeon will advise you to be aware of infection symptoms, which include fever, worsening redness at the incision, and changes in the infection drainage. If any of these symptoms occur, make sure to reach out to your surgeon immediately.
Additionally, if the surgeon places any hardware or devices during the procedure and an infection develops, they may need to be removed. This also applies to patients with an implantation spinal cord stimulator incision or spinal fusion incision.
Immediately after the spinal nerves are decompressed in surgery, the healing process can begin. But, nerve tissue heals far slower than other types of tissue in the body, namely muscle tissue. So, while some patients will experience an immediate improvement in nerve pain after spinal surgery, other patients may need more time to notice a difference.
In the weeks and months after spinal surgery, patients should notice a gradual improvement in neurological symptoms such as numbness, tingling, and weakness. By adopting healthy lifestyle habits, such as engaging in low-impact exercise, eating healthily, and refraining from smoking, you can ensure that the spinal nerves heal as quickly as possible.
Surgeons always aim to create as small an incision as possible while successfully carrying out the procedure. This is because a smaller incision leads to less blood loss, less scarring, and a lower risk of infection.
Fortunately, the last several years have seen a revolution in back surgery procedures and outcomes. Now, more minimally-invasive procedures are available to patients that require spinal surgery. These procedures allow for much smaller incisions, among other advantages over traditional open back surgery.
One procedure that can now be replaced with minimally-invasive alternatives is spinal fusion back surgery. This procedure was traditionally performed in conjunction with spinal decompression surgery for spinal stenosis, spondylolisthesis, and related conditions.
Spinal fusion involves positioning an implant containing bone graft material in between the affected vertebrae. Over the course of several weeks after the procedure, the bone graft will trigger the fusing of the vertebrae, turning them into a single bone. As a result, the patient can avoid spinal instability after decompression surgery.
Unfortunately, spinal fusion requires a long recovery period and eliminates the natural movement of the individual vertebrae. It also creates the risk of adjacent segment disorder, or ASD, which occurs when the vertebrae surrounding the fused segment degenerate more rapidly than they otherwise would.
Thankfully, a spinal fusion alternative has emerged to improve outcomes and preserve patients’ range of motion: the TOPS (Total Posterior Solution) System. The TOPS System is an implant that facilitates a minimally-invasive spinal surgery. It’s been shown in clinical trials around the globe to provide superior outcomes for patients who undergo treatments such as lumbar laminectomy or other spinal decompression procedures for various causes of lower back pain.
As the example of the TOPS System indicates, these advances in minimally-invasive back surgery allow for not only fewer complications in surgical incision healing, but also improved outcomes overall.
Don’t hesitate to discuss concerns surrounding post-op incision care with your surgeon, and make sure to explore all of your spine surgery options.
The human body contains an extensive system of nerves that facilitate communication between the cells. Nerves send and receive messages throughout the body. Without them, we wouldn’t have basic human functions, like movement, balance, and sleep, or sensations, like touch.
Unfortunately, just like the rest of the human body, nerves are susceptible to damage. Radiculopathy is one type of nerve damage that can severely impact one’s mobility and quality of life.
In this article, we’re going to discuss a specific form of this nerve condition: lumbar radiculopathy.
The vertebrae are the bones of the spine. An intervertebral disc is located in between each vertebra and acts as a cushion by absorbing impact.
If the vertebrae or the discs between them impinge on a nerve root in the spinal column, chronic nerve injuries may result. Radiculopathy is the general term for these injuries.
Radiculopathy most commonly occurs in the lower, or lumbar, region of the spine. This condition has been termed lumbar radiculopathy. Though less common, radiculopathy may also occur in the neck, or cervical region of the spine, which is known as cervical radiculopathy.
Common symptoms of radiculopathy include radiating pain, numbness, tingling, and weakness. In some cases, a loss of motor function can result from lumbar radiculopathy. 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 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. The location of the nerve compression determines where radiculopathy symptoms are felt.
The severity of lumbar radiculopathy symptoms can vary from patient to patient. Some patients with radiculopathy experience severe, debilitating symptoms that significantly impact their day-to-day activities.
There are several possible causes for lumbar radiculopathy, including:
Degenerative disc disease is a normal part of the aging process. It occurs when the intervertebral discs weaken and dry out over time. As the discs become damaged, the nerves of the spine may become irritated, leading to radiculopathy symptoms.
Repetitive and high-impact motions can contribute to lumbar radiculopathy. This is more common among people with occupations that require repetitive motions or heavy lifting.
Being overweight or in poor physical health can also contribute to radiculopathy. This is because added body weight puts extra stress on the nerves, which can lead to nerve damage.
Diabetes is associated with heightened blood glucose levels. This can cause the development of deposits within the blood vessels that decrease circulation throughout the body. As a result, high blood sugar can lead to nerve damage.
A genetic predisposition can also increase one’s risk of developing spinal radiculopathy.
Various spinal conditions can cause nerve impingement and lead to radiculopathy. Examples of these conditions include herniated disc, spinal stenosis, osteoarthritis, spondylolisthesis, and scoliosis.
Sciatica is a form of radiculopathy. In fact, it’s the most prevalent type of radiculopathy. It refers to pain that radiates throughout the sciatic nerve, meaning that it starts in the lower back and moves through the buttocks, down the legs, and to the feet.
The terms lumbar radiculopathy and sciatica are commonly used interchangeably. This is because nerve impingement in the lumbar spine typically involves the sciatic nerve. After all, the sciatic nerve is the largest nerve in the body.
Lumbar radiculopathy has the potential to get worse. In some patients, the pain may come and go. But, in others, radiculopathy symptoms are persistent and gradually become worse over time.
If lumbar radiculopathy isn’t promptly addressed, various factors can exacerbate the condition by causing additional nerve damage. These factors include:
Poor posture increases the amount of stress placed on the spinal nerves. In patients who lead a sedentary lifestyle, sitting at a desk with poor posture for hours on end may significantly worsen radiculopathy symptoms.
Repeatedly twisting, bending, and straining the spine can further irritate the affected nerves, leading to worsened radiculopathy symptoms.
Weight-bearing physical activities can cause additional damage to the spinal nerves. Examples of these activities include football, wrestling, weightlifting, soccer, and hockey.
Lumbar radiculopathy treatment methods may be non-surgical or surgical. Doctors begin with non-surgical treatment, and if the patient’s symptoms don’t improve after several months, consider surgery.
Physical therapy, medication, steroid injections, and relaxation are often prescribed successfully to treat lumbar radiculopathy.
Physical therapy is often recommended for lumbar radiculopathy. It involves exercises and therapies designed to improve spinal stability and alignment. This can help create more space for the spinal nerve roots.
Non-steroidal anti-inflammatory drugs, or NSAIDs, can help relieve inflammation and pain caused by lumbar radiculopathy. This can help make radiculopathy symptoms more manageable. However, these medications generally aren’t recommended for long-term use.
Epidural steroid injections reduce the body’s inflammatory response at the injection site. For lumbar radiculopathy, this can help alleviate inflammation in the spinal nerves.
Doctors generally advise patients to receive no more than three to four epidural steroid injections per year. Since steroid injections hamper the immune system response, they can cause tissue damage when used in excess.
Rest and relaxation are recommended for patients with lumbar radiculopathy to give the spinal nerves time to heal.
When non-surgical treatments fail to provide relief for radiculopathy of the lumbar region, surgical methods may be recommended. Generally, physicians don’t recommend surgery for lumbar radiculopathy unless the patient has undergone at least six months of conservative treatment.
Spinal decompression surgery is the main surgical lumbar radiculopathy treatment. This type of spine surgery involves removing spinal tissues to alleviate pressure on the affected nerves. Laminectomy, laminotomy, laminoplasty, foraminotomy, and discectomy are all common methods of spinal decompression.
Since spinal decompression surgery involves removing tissues from the spine, it can lead to spinal instability. To prevent this, spinal decompression surgery is often combined with spinal fusion back surgery. This combination of procedures has been a common treatment modality for lumbar radiculopathy patients who don’t respond to conservative treatments.
Spinal fusion permanently joins the affected vertebrae using bone graft material. This prevents all motion in the fused spinal segment. Unfortunately, while this counters instability, it also significantly decreases the patient’s range of motion.
Additionally, fusing two spinal vertebrae forces the adjacent vertebrae to bear additional impact with day-to-day motions. The added impact can cause the adjacent spinal segments to deteriorate at a quicker rate, potentially leading to back pain, stiffness, and neurological symptoms. This complication of spinal fusion is known as adjacent segment disease or ASD.
The TOPS™ (Total Posterior Spine) System is a new advancement in spinal surgery that can be used 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.
This spinal implant has also been shown to provide superior outcomes in clinical studies conducted across the globe. With TOPS™, lumbar radiculopathy patients can attain lasting relief for nerve pain without having to worry about complications from spinal fusion.
Advances like TOPS™ give individuals with back problems more options for effective treatments. So, if you’re suffering from persistent radiculopathy pain, speak with a spine specialist about the complete range of treatment solutions available today.
Each year, for every 1,000 adults, there are approximately 5 to 20 cases of disc herniation. Also known as a slipped disc, a herniated disc is a prevalent spinal disorder that develops when the interior core of an intervertebral disc burst out through the damaged disc exterior.
Although a slipped disc can typically be managed with non-invasive methods, there are cases that require surgery. Here, we’ll discuss slipped disc surgery, when it’s needed, and what it entails.
The spinal discs act as cushions in the spine. Located in between each vertebra, the discs absorb impact and reduce the stress imparted on the spinal bones.
Unfortunately, age-related degeneration, repetitive movements, and sudden trauma to the spine can damage the spinal discs. A disc is considered herniated when the tough disc exterior becomes cracked and the soft disc interior extends outward.
When this injury occurs, fluid from within the disc can leak into the spinal canal. Here, it can disrupt the spinal nerve function.
A slipped disc in the spine is often the final stage in the process of disc degeneration. This process typically begins with a bulging disc, which occurs when the disc exterior weakens and the disc bulges out to one side. This may progress to a protruding disc before the disc finally ruptures. Although the name may be misleading, a “slipped disc” has not actually shifted position.
Symptoms of a slipped disc can vary depending on the location of the damaged disc and the severity of the rupture. If a slipped disc doesn’t impart pressure on a nerve, it may be entirely unnoticeable to the patient. However, if a slipped disc does press on adjacent nerves, it may cause pain, numbness, weakness, and tingling.
A slipped disc in the neck, which is known as a slipped cervical disc, may trigger symptoms in the shoulders, arms, or chest. A slipped disc in the lower back, which is known as a slipped lumbar disc, may cause sciatica. This refers to pain that radiates downward from the lower back, causing nerve pain in the buttocks, legs, and feet.
The most prevalent causes of slipped discs are:
As people age, the spinal discs naturally become drier and weaker. This, along with accumulated wear and tear on the spine over the course of many years, can lead to a slipped disc. Disc herniated most commonly occurs in patients between the ages of 35 and 50.
Improperly lifting heavy objects and exercising with improper bodily mechanics are examples of activities that may cause a slipped disc. Athletes in sports that place significant stress on the spine, including football and weightlifting, are often at a heightened risk of disc herniation.
Smoking, excess body weight and a sedentary lifestyle also increase the risk of developing a slipped disc. Sudden trauma to the spine, (which may occur during an automobile accident, for example) may cause a slipped disc, although it’s rare.
Treatments for slipped disc include:
Slipped disc treatment without surgery typically involves physical therapy. Targeted slipped disc exercises and PT can alleviate tension, improve your posture, and strengthen the muscles that support the spine.
Additionally, physical therapy can help reduce the pressure of the damaged disc on your spinal nerves. Your physical therapist may recommend alternative therapies such as massage, acupuncture, and electrostimulation to further enhance your recovery process.
Certain medications can be used to manage pain and inflammation from a slipped disc. Over-the-counter options are available, as well as prescription medications from your doctor. Always consult your doctor before starting a new medication.
In some cases, surgery for slipped discs is required for the patient to make a full recovery.
As we’ve already mentioned, slipped discs rarely require surgery and heal with non-invasive methods. However, a slipped disc may require surgery if:
Before undergoing an invasive procedure, patients must talk to their doctors and learn about the slipped disc surgery risks.
Decompression surgery is most commonly performed for a slipped disc. This surgical method involves alleviating pressure on the spinal nerves by removing spinal tissue. There are different types of spinal decompression surgery, including discectomy, laminectomy, corpectomy, and foraminotomy.
Spinal 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 newly-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 medical advancements bringing new, improved therapies to patients worldwide.
Spinal fusion surgery for a slipped disc involves an extensive recovery period. The procedure itself generally takes 4 to 6 hours to complete, and patients typically remain in the hospital for 2 to 4 days. The complete slipped disc surgery recovery time with spinal fusion may take anywhere from 6 months to a year.
With the TOPS™ system, the slipped disc surgery recovery period is much less involved than that of spinal fusion. The procedure is considered minimally invasive and typically only lasts for 60 to 120 minutes.
Patients can generally walk and move around just one day after TOPS™ surgery. After 4 to 6 weeks, patients reach their expected level of mobility. This recovery time for slipped disc surgery can be further aided by physical therapy and a nutrient-dense diet.
Surgery for slipped discs involving spinal fusion can improve back pain and symptoms at a rate of anywhere from 60% to 90%, depending on the study. For TLIF surgery with spinal fusion, studies have shown that the procedure improves patients’ pain by 60% to 70%, with an 80% satisfaction rate among patients.
With that said, it’s difficult to determine the success rate of slipped disc surgery with fusion without considering the risks. Patients may lose a significant degree of mobility in this procedure, which can diminish their quality of life.
Additionally, the risk of increased degeneration around the fused segment, which is known as adjacent segment disease, must be taken into account. The prevalence of adjacent segment disease in patients who undergo lumbar spinal fusion ranges from 2% to 14%.
To evaluate the success rate of the TOPS™ System for slipped disc surgery, we can consider the results of a 7-year follow-up study. The study evaluated 10 patients suffering from spinal stenosis with degenerative spondylolisthesis who underwent spinal decompression with TOPS™.
Although spinal surgery for a slipped disc is widely considered to be a last resort, it can help patients achieve pain relief, improved mobility, and a higher quality of life. If you’re experiencing symptoms of disc herniation, schedule an appointment with your doctor for an evaluation.
Lower back pain has long been a prevalent health concern around the world. In 2017, the prevalence of lower back pain was estimated to be approximately 7.5% of the world’s population. This totals about 577 million people.
There are numerous causes of lower back pain, as well as countless treatments that can help relieve it. Lumbar spinal decompression is one treatment strategy for alleviating lower back pain caused by a pinched nerve.
This article will discuss lumbar spinal decompression, when it’s implemented, and what patients can expect from the procedure.
Imagine if the branches of a tree were as large at the top as they are at the bottom. Now, imagine that a heavy load is placed on the ends of the very highest branches. This would put an enormous amount of stress on the lower portion of the tree trunk.
This is comparable to what we experience as humans with our spinal columns. The human spinal column is like the trunk of a tree, but we’re as large on the top of the trunk as we are at the bottom. This puts a high amount of stress on the lower back, which is also called the lumbar region of the spine.
The strain of lifting objects and twisting the spine over the course of a lifetime is exacerbated by degenerative spinal changes that occur with age. So, it’s not surprising that most of the back problems that bring patients to spinal specialists are centered in the lower, or lumbar, region of the spine.
The stresses discussed above, along with disease and/or injury, can result in a host of spinal disorders. Bulging or herniated discs, spinal stenosis, and spondylolisthesis are among the most common.
A bulging disc is a spinal disorder that occurs when the exterior of an intervertebral disc weakens, typically from the natural aging process. This can cause the disc to bulge out into one side of the spinal canal.
A herniated disc is essentially one step further than a bulging disc. It occurs when the soft interior of the disc protrudes out through a crack in the weakened disc exterior.
Spinal stenosis can result from a bulging or herniated disc, as well as a range of other factors. It’s a spinal condition characterized by an abnormal narrowing of the spinal canal.
Reduced space in the spinal canal can place stress on the spinal nerves or the spinal cord. But, decompression for lumbar spinal stenosis can effectively alleviate this stress.
Spondylolisthesis is a condition that develops when one of the vertebrae is unstable and slips out of its regular position. The displaced vertebra settles on the vertebra beneath it.
These disorders can place unnatural pressure on the nerves that emanate from the spinal column. This may cause pain, restricted mobility, and other symptoms of a pinched nerve.
Spinal decompression is a method of easing pressure on impinged spinal nerves. It can be performed either non-surgically or surgically. Lumbar spine decompression simply refers to decompression procedures performed on the lower portion of the spine.
The surgical solution for a lumbar pinched nerve involves removing a small amount of tissue from vertebrae in the lumbar region. The surgeon will remove the tissue that’s impinging, or putting pressure, on a nerve. This process is referred to as lumbar spinal decompression surgery.
There are various types of lumbar decompression surgery that may be implemented for different spinal disorders. The most common forms of surgical lumbar decompression include:
Laminoplasty is a procedure that involves making two cuts in the lamina so that it swings outward, like a door. After creating a hinge with the lamina of the affected vertebra, the spinal surgeon will position small bone wedges to keep the “door” from closing. Commonly referred to as open-door laminoplasty, this procedure can effectively alleviate pressure on the spinal nerves without removing the lamina.
In foraminotomy, the surgeon creates more space around the area where nerve roots exit the spinal canal. This area is known as the intervertebral foramen. It acts as a passageway, linking the spinal canal to the periphery.
By opening up the intervertebral foramen in foraminotomy, the spinal surgeon can alleviate pressure on the spinal nerves.
Discectomy is a spinal decompression procedure that involves removing damaged intervertebral disc tissue. The spinal surgeon may remove some or all of the damaged disc, depending on the patient’s needs.
Removing tissue in lumbar decompression surgery can lead to spinal instability. So, historically, spinal fusion back surgery has been performed in conjunction with lumbar decompression surgery to stabilize the spine.
In spinal fusion, the surgeon places bone graft material in between the affected vertebrae. As weeks and months pass after the procedure, the vertebrae will fuse, forming a singular bone. By completely preventing motion in this segment, fusion effectively prevents instability following spinal decompression surgery.
Unfortunately, lumbar decompression and fusion can have certain negative effects on the body, including:
The key downside of spinal fusion is that it prevents all motion in the fused segment. This eliminates the patient’s ability to flex, twist, and bend the spine normally. As a result, patients may no longer be able to partake in their favorite sports and activities after spinal fusion surgery.
The spinal segments that are adjacent to the fused vertebrae must undergo additional stress to compensate for the fusion. This can lead to a complication known as adjacent segment disease (ASD), with which the adjacent vertebrae deteriorate at a more rapid rate. ASD can lead to lower back pain, radiating pain, difficulty walking or standing, and neurological symptoms.
Today, the TOPS™ (Total Posterior Spine) System provides an alternative to spinal fusion that preserves the spine’s natural full range of motion. This advanced spinal implant has been shown to provide better outcomes than fusion in clinical studies performed around the world.
The TOPS™ System provides an important additional treatment option for individuals with moderate to severe pinched nerve symptoms. It can provide a major improvement in lower back pain for patients who don’t respond to non-surgical lumbar spinal decompression therapy.
The recovery period for lumbar decompression surgery can vary depending on the exact procedure and whether or not spinal fusion is performed. However, patients can generally expect to wait four to six weeks before reaching their expected degree of mobility and returning to work.
Spinal fusion prolongs the recovery process for lumbar decompression surgery. It can take up to a year to fully recover from fusion. With this in mind, the TOPS™ System can significantly reduce the lumbar decompression surgery recovery time, allowing patients to return to physical activity much sooner.
Lumbar decompression surgery is an invasive procedure. So, as with any surgical procedure, it comes with certain risks.
With that said, lumbar decompression is widely performed and considered safe. Advancements in medical technology have even made minimally-invasive lumbar decompression surgery possible. This allows for greater safety and a lower risk of complications.
If you have symptoms of a pinched nerve, don’t hesitate to talk to your doctor about the complete scope of treatment options available to you.
Back pain is a universal health concern, and it doesn’t discriminate. The factors that trigger back pain are often the same in women and men. However, certain causes of back pain, such as menstruation, pregnancy, and osteoporosis, are either unique to or more prevalent among women.
Here, we’ve listed what can cause lower back pain in a woman.
Menstruation is a key cause of back pain that exclusively affects women. During menstruation, the uterus produces substances known as prostaglandins. Prostaglandins manage muscle contraction, and during menstruation, they send messages to the uterus instructing it to contract.
These muscle contractions are the direct cause of cramps and back pain during menstruation. Additionally, the cramps associated with menstruation place added stress on the back muscles, potentially leading to back muscle pain.
Pregnancy often causes back pain, particularly in its later stages. The added weight of carrying the fetus puts significant stress on the spine, as well as the supporting muscles and ligaments.
Additionally, the ligaments stretch and soften during pregnancy. This is one of the body’s methods of childbirth preparation. Unfortunately, as the ligaments soften, the lower back and pelvis become less supported. This may trigger back pain.
Also, while being overweight for any reason can cause back pain, the rapid weight gain that occurs during pregnancy compounds the problem.
Mental stress is known to cause or contribute to back pain, in part because it contributes to the involuntary tightening of muscles in the back. Stress can also cause or exacerbate back pain in pregnancy which, as a major life change, is a time of great psychological stress.
Later in life, our bodies’ bone-building process gradually weakens. As a result, calcium is depleted from our bones, and our overall bone mass drops. The bones become more brittle, making them more prone to breakage. This phenomenon, which is referred to as osteoporosis, is more common among women than men.
If osteoporosis causes spinal fractures (known as compression fractures), it can lead to severe back pain. With a compression fracture from osteoporosis, patients typically struggle to sit, stand, and walk.
Common spinal conditions, such as degenerative disc disease, herniated disc, spondylolisthesis, and spinal stenosis, affect women, just as they do men. These conditions can lead to chronic back pain.
Certain internal organs can lead to lower right back pain in female patients. Specifically, organs located in the pelvis, abdomen, and mid-back area may be the root of lower back pain.
In women, the reproductive organs in the pelvis can trigger pain in the lower right area of the back. For instance, endometriosis, which typically affects the ovaries and fallopian tubes, can lead to pain that extends to the lower back.
The appendix is an organ that’s linked to the large intestine. People who develop appendicitis, which occurs when the appendix becomes inflamed, can develop lower right back pain.
Appendicitis requires immediate treatment to prevent rupture and complications. In addition to lower right back pain, symptoms may include sudden pain on the right side of the lower abdomen that worsens with abrupt motions, loss of appetite, nausea, and vomiting.
The kidneys are organs that remove waste from the blood. Kidney issues, such as kidney stones or a kidney infection, can lead to pain on one side of the lower back. Other symptoms of kidney problems often include pain while urinating, nausea, and vomiting.
Ulcerative colitis is a condition that’s characterized by inflammation in the colon. It causes repeated cramping in the abdomen that may trigger lower back pain, as well as symptoms including diarrhea, weight loss, and fatigue.
Extreme lower back pain can be cause for concern. But, since back pain is a common ailment, it can be difficult to know whether or not your pain requires medical attention.
As a general rule of thumb, visit your doctor for an evaluation if you experience back pain that persists for longer than two weeks and holds you back from regular activities. If you experience severe back pain, visit a doctor sooner than after two weeks. Additionally, seek out immediate medical care if you have:
Whatever its origin, there’s no reason to live with back pain, as a variety of treatment options exist for all their causes. Women wondering how to help lower back pain may consider physical therapy, medication, or even lifestyle changes to alleviate back pain caused by spinal conditions.
Physical therapy can help with lower back pain by helping relieve tension in the back muscles. Additionally, physical therapy exercises can target and strengthen the muscles that support the back.
Over-the-counter pain and anti-inflammatory medications may help women manage lower back pain in the short term. These medications can also help alleviate menstrual cramps and the associated back pain.
However, women experiencing back pain caused by more complex conditions, such as endometriosis, should speak with their doctors about the available prescription medications for the condition.
Lifestyle changes may help you naturally achieve relief from lower back pain. For example, in women experiencing back pain in pregnancy, gentle, low-impact exercise may offer relief. Women with back pain caused by cramps during menstruation can consider lifestyle changes including quitting smoking, cutting down on alcohol consumption and adding more high-fiber foods to their diet. Additionally, women with spinal conditions, such as spinal stenosis, may need to modify their activities to avoid straining the spine.
Surgery is rarely required for women with back pain. However, if the back pain doesn’t resolve within six months of conservative treatment, your doctor may recommend spine surgery for lasting pain relief.
Among women for whom spine surgery is recommended, there are multiple surgical approaches to consider. Thankfully, advanced microsurgical techniques and stabilization systems provide effective treatments for potentially disabling spinal conditions.
Decompression spinal surgery is a commonly performed spinal procedure for conditions including spinal stenosis, spondylolisthesis, and herniated disc. In this procedure, a portion of the vertebra that’s impinging on a spinal nerve is removed. Decompression surgery can have a dramatic and immediate impact on back pain associated with prevalent spinal conditions.
Spinal fusion surgery has traditionally been performed in conjunction with spinal decompression. This process involves fusing adjacent vertebrae at the affected segment to stabilize the spine.
Unfortunately, while spinal fusion may offer pain relief for patients suffering from chronic back pain, it has numerous drawbacks. For one, spinal fusion eliminates the patient’s motion at the affected segment. As a result, the patient loses the ability to bend, twist, and flex that area of the spine.
Additionally, spinal fusion can lead to adjacent segment disease. This fusion complication occurs when the vertebrae surrounding the fused bone degenerate faster than usual. As a result, the patient may experience back pain, stiffness, and/or neurological symptoms.
Alternatives to spinal fusion are available and can help patients avoid the drawbacks of spinal fusion. The TOPS™ System from Premia Spine, in particular, provides a superior, clinically-proven outcome when compared to spinal fusion back surgery.
Unlike spinal fusion, the TOPS™ System preserves the vertebrae’s range of motion. Having been used since 2005, the system has enabled patients around the world to maintain their full range of activities following decompression surgery. TOPS™ has further advanced the treatment of common but potentially debilitating spinal conditions.
Women experiencing back pain from spinal conditions should consult their doctors to learn about the complete range of spinal treatments available today.
Spinal stenosis is a prevalent spinal disorder in the U.S. and across the globe. In fact, the condition affects an estimated 250,000 to 500,000 U.S. residents.
This spinal disorder can occur in the lower, or lumbar, region of the spine, which is known as lumbar spinal stenosis. Or, it may occur in the neck, or cervical, region of the spine, which is known as cervical spinal stenosis. Lumbar spinal stenosis is the most common form of this condition, and it’s the topic of our article.
Spinal stenosis is a common condition, especially among patients who are aged 50 and over. It occurs when the spinal canal abnormally becomes narrower. The word “stenosis” can be traced back to ancient Greek and refers to narrowing, or constriction.
As the spinal canal progressively narrows over time, it strains the nerves that extend outward from the spine and travel into the extremities. This can cause a range of symptoms.
The symptoms of lumbar spinal stenosis can differ from patient to patient. However, pain, tingling, and numbness in the extremities are among the most common signs of this spinal disorder.
Other symptoms of lumbar spinal stenosis may include:
There might be other non-specific symptoms of spinal stenosis. So, please consult with your doctor for a precise diagnosis.
Most cases of spinal stenosis occur for unknown reasons. However, the causes of lumbar spinal stenosis are rooted in specific parts of the spine’s anatomy, such as:
An intervertebral disc is located between each of the bones in the spine. It provides cushioning for the bone and prevents damage by absorbing impact. These discs break down with age and may even become herniated, meaning that the disc interior protrudes from a crack in the disc interior.
A damaged intervertebral disc can take up extra space in the spinal canal, potentially leading to spinal stenosis.
The facet joints connect the vertebrae of the spine to one another. These joints support a large amount of weight and undergo a significant amount of stress. As a result, they’re vulnerable to wear and tear, as well as various injuries. Damage to the facet joints (and the cartilage within these joints) can trigger spinal stenosis.
When the spinal cord and/or the nerve roots become compressed, it may trigger pain and neurological symptoms. When the spinal cord and nerve roots are involved in spinal stenosis, the patient is rarely asymptomatic.
The narrowing, or tightening, of the spinal canal, may result from abnormal bone and/or tissue growth. or due to a hereditary disorder. This is referred to as inherited spinal stenosis.
Some people are born with a spinal canal that’s narrower than average. This can cause the patient to experience spinal stenosis symptoms much earlier in life than the average patient. Additionally, patients who are born with scoliosis may experience spinal stenosis.
Scoliosis is an atypical, sideways curve of the spine. It’s commonly recognized and diagnosed in children and adolescents. In patients with scoliosis, the curved spine may place stress on the spinal cord, potentially leading to spinal stenosis.
Degenerative spinal stenosis refers to cases of this condition that are caused by wear and tear on the spine. This is the most common type of spinal stenosis.
Spinal degeneration is a normal effect of aging. It occurs as the intervertebral discs and facet joints weaken from repeated strain over time. Factors including a sedentary lifestyle, poor posture, obesity, injuries, smoking, and other spinal disorders (such as scoliosis) can speed up the process of spinal degeneration.
Effects of aging that can contribute to the development of degenerative spinal stenosis include:
Leading a healthy lifestyle by exercising, eating a nutritious diet, and maintaining an optimal weight can help prevent spinal stenosis.
Options for spinal stenosis treatment include:
Various exercises can help with spinal stenosis by improving strength and mobility in the affected areas. You can perform these exercises at home to support your lumbar spinal stenosis recovery.
Examples of spinal stenosis exercises include:
This exercise engages the glute muscles, which support the pelvis and can help reduce the strain on the lumbar spine.
This simple exercise engages the transverse abdominis, which is a deep abdominal muscle that promotes proper spinal alignment and helps protect the lower spine.
This exercise stretches and helps relieve tension in the lower back muscles. It also flexes the spine, which relieves pain from spinal stenosis by temporarily creating more space in the spinal canal.
Physical therapy may improve symptoms of lumbar spinal stenosis by relieving pressure on the spinal cord. For lumbar spinal stenosis, physical therapy typically involves stretches for the lower back, legs, and hips, as well as strengthening exercises for the abdominal muscles, which support the lower spine. Your physical therapist may work with you on mobility exercises to improve your range of motion in the lower back.
Additionally, physical therapy may involve treatments that can help with pain, tension, and inflammation. These treatments include heat/cold therapy, electrostimulation, massage, etc.
Both over-the-counter and prescription medications may be used to reduce pain and inflammation from lumbar spinal stenosis. Talk to your doctor before starting a new medication for spinal stenosis symptoms in the lumbar spine.
In extreme cases, surgery for lumbar spinal stenosis may be recommended. Typically, doctors don’t recommend lumbar spinal stenosis surgery unless the patient has first undergone at least 6 months of conservative treatment.
For lumbar spinal stenosis, spinal decompression surgery is often performed. This type of surgical procedure involves removing portions of the vertebrae that are impinging on the roots of nerves emanating from the spine. By relieving this pressure, the procedure gives patients symptom relief and provides the spinal nerves with enough space to heal.
Laminectomy is the most common form of spinal decompression surgery for spinal stenosis of the lumbar region. In this procedure, the surgeon removes all or part of the lamina, which forms the ceiling of the spinal canal. Other types of spinal decompression surgery include foraminotomy and discectomy.
Following the spinal decompression procedure, spinal fusion back surgery has traditionally been performed to stabilize the spine. Spinal fusion involves placing bone graft material in between the affected vertebrae. Over time, the bone graft will cause the vertebrae to permanently fuse.
Unfortunately, this stabilization procedure eliminates the independent motion of the fused vertebrae and can contribute to the deterioration of adjacent vertebrae. Patients can lose a significant amount of motion in the lower back after spinal fusion.
Spinal fusion alternatives, such as non-fusion implants, can offer stability without limiting the patient’s mobility after spinal stenosis surgery. The TOPS™ System, for example, provides an alternative to spinal fusion that maintains the spine’s full range of motion. It’s been proven in clinical studies conducted worldwide to provide superior outcomes than spinal fusion following spinal decompression surgery.
Patients seeking surgical relief for an abnormal narrowing of the spine now have access to a wider range of treatment options than ever. Talk to your doctor about the best course of treatment for your needs.
Spinal stenosis is a prevalent spinal condition that can cause neck or back pain and neurological symptoms. In some patients, spinal stenosis is debilitating and limits their day-to-day activities.
If spinal stenosis symptoms don’t improve despite several months of non-invasive treatment, your physician may recommend surgery. There are many possible surgical methods for spinal stenosis, one of which is laminoplasty.
In this article, we’ll discuss the surgical process for laminoplasty and what patients can expect from this spinal treatment.
Laminoplasty is a surgical procedure for treating spinal stenosis. The goal of the procedure is to alleviate pressure on the spinal nerves and the spinal cord by creating more room in the spinal canal.
The laminoplasty procedure is done through a small incision. Once the surgeon has accessed the spine, they will cut into the lamina of the vertebra that’s affected by spinal stenosis. The lamina can be thought of as the outer sheath of the vertebra. It protects and supports the posterior side of the spinal cord.
Specifically, the surgeon will create two cuts that are positioned nearly opposite one another. One cut will extend through the entire lamina, while the second cut will simply act as a groove to create a hinge. This cut allows the lamina to swing open, similar to a door. In fact, this procedure is often referred to as an “open door laminoplasty.“
The tips of the spinous processes may be removed in laminoplasty to create room for the bone to pull open. The lamina is then closed, using small pieces of bones as wedges to ensure the spinal cord is no longer compressed at that level.
This surgical spinal stenosis procedure immediately relieves pressure on the spinal cord. Although it’s an invasive procedure and, therefore, involves certain risks, it can dramatically improve back pain and neurological symptoms for spinal stenosis patients.
Spinal stenosis is the main condition for which laminoplasty is performed. Commonly referred to as an unnatural narrowing of the spinal canal, this spinal disorder is a common cause of mild to severe lower back pain and restricted mobility.
The most prevalent cause of spinal stenosis is osteoarthritis. This refers to the joint degeneration that occurs gradually with age. With osteoarthritis, the cartilage in the facet joints of the spine wears out, potentially leading to bone spurs that may press on spinal nerves.
Spinal stenosis can also result from:
A herniated disc is a spinal condition that affects the intervertebral discs. With this condition, the interior of the disc protrudes from a crack in the disc exterior. The damaged disc takes up space in the spinal canal and, as a result, may cause spinal stenosis.
Spinal fractures, most commonly caused by osteoporosis, may encroach on the spinal nerves and lead to spinal stenosis symptoms.
The ligaments that support the spine can thicken as a result of age and arthritis. As the ligaments thicken, they take up more space in the spinal canal and may press on spinal nerves.
Some patients are born with a spinal canal that’s smaller than usual. This is known as congenital spinal stenosis. Additionally, patients who are born with scoliosis may experience spinal stenosis, as the abnormal curve of the spine can limit the space in the spinal canal.
A variety of conservative therapy methods for spinal stenosis are available, including spinal stenosis exercises, medications, and injections.
These non-invasive therapies are often successful in relieving the symptoms of spinal stenosis. But, if they prove ineffective after several months, spinal surgery may be recommended to help the patient make a full recovery.
Numerous surgical procedures are available for spinal stenosis. Tools and therapies have undergone great advances in recent years, providing better outcomes and fewer complications for patients. The open door laminoplasty technique is one example of these advances in treatments for spinal stenosis.
Laminoplasty is most commonly performed in the cervical spine (cervical laminoplasty) or the lumbar spine (lumbar laminoplasty). The cervical spine refers to the neck region, while the cervical spine is located in the lower back.
Laminoplasty and laminectomy are both spinal surgical procedures involving the lamina. Additionally, both of these procedures fall under the category of spinal decompression surgery. However, there are key differences between these surgical methods.
Laminoplasty surgery recovery is similar to that of other spinal procedures. Immediately after the surgery, patients may need to remain in the hospital for a few days.
After returning home from the hospital, patients will likely experience a mild discomfort and need to limit their activities for a few weeks. After two to four weeks, most laminoplasty patients can return to work.
Although patients need to rest after laminoplasty, gentle movement is encouraged to stimulate healing and prevent stiffness in the spine. Your doctor may prescribe a physical therapy program to help you recover from the procedure.
The laminoplasty recovery process can continue for up to a year after the procedure, especially if the patient undergoes spinal fusion.
Spinal fusion back surgery may be performed in conjunction with laminoplasty to stabilize the vertebra. As a method for preventing spinal instability after surgery, spinal fusion has been performed since the early 1900s. Unfortunately, fusion also comes with numerous downsides.
Arguably the most significant downside is that spinal fusion eliminates the natural flexion and rotation of the individual vertebra. This means that many patients lose the ability to partake in their favorite activities. In some cases, spinal fusion patients lose the ability to pick up items from the floor.
Additionally, spinal fusion poses the risk of adjacent segment disease. This spinal fusion complication occurs when the vertebrae surrounding the fused segment undergo increased stress as a result of the fusion. This leads to an increased rate of degeneration in the adjacent segments.
It’s also worth noting that spinal fusion can largely increase the laminoplasty recovery time. This may require patients to take more time off of work and physical activity after the procedure.
Today, there’s a new option for preventing spinal instability in laminoplasty surgery: the TOPS™ System.
TOPS™ is a non-fusion spinal implant that stabilizes the vertebrae while permitting the natural flexion and rotation of the individual vertebra. It’s proven to provide superior clinical outcomes to spinal fusion surgery for spinal stenosis patients.
Spinal problems and back pain are among the most common and debilitating medical ailments. If you suffer from the symptoms of spinal problems, you have a variety of treatment options. Talk to your doctor to ensure that you’re familiar with all of the medical procedures available to you.