What is Lumbar Spinal Decompression?

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. 

Why is Lower Back Pain So Common?

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.

Lumbar Spine Disorders

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.

• Bulging disc

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. 

• Herniated disc

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

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

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.

What is a Lumbar Decompression Surgery?

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.

How is Lumbar Decompression Surgery Performed?

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:

Laminectomy and Laminotomy

Laminectomy and laminotomy are two surgical methods of lumbar decompression that involve the lamina. The lamina acts like the roof of the spinal canal and protects the spinal cord. 

• In a laminectomy, the surgeon removes the majority of the lamina at the affected spinal segment. 
• In laminotomy, the surgeon only removes a small portion of the lamina. 

Laminoplasty

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. 

Foraminotomy

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

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.

Lumbar Decompression Surgery With Spinal Fusion

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:

• Reduced range of motion

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. 

• Damage to adjacent vertebrae

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. 

Are Alternatives To Spinal Fusion Available?

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.

How Long Does It Take to Recover From Lumbar Decompression Surgery?

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.

Is Lumbar Decompression Surgery Serious?

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. 

Causes of Back Pain in Women

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.

What Causes Back Pain in Females?

Here, we’ve listed what can cause lower back pain in a woman. 

Menstruation

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

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.

Stress

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.

Osteoporosis

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. 

Spinal Conditions

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. 

What Female Organs Can Cause Lower 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. 

• Reproductive organs

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

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. 

• Kidney

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. 

• Colon

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. 

How Can a Woman Find Out That Their Lower Back Pain is Serious?

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:

• Fever with back pain
• Sudden weakness in the arms or legs
• Unexplained weight loss with back pain
• Lost bladder or bowel control
• Back pain following trauma, such as a car accident

Lower Back Pain Treatment For Women

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

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. 

• Pain medication

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

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. 

Spine Surgery For Back Pain in Women

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 Surgery For Back Pain in Women

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

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.  

Spinal Fusion Alternatives For Women With Back Pain

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. 

What is Lumbar Spinal Stenosis?

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. 

What is Lumbar Spinal Stenosis?

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.

What Are Lumbar Spinal Stenosis 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:

• Numbness or tingling in a foot or leg
• Weakness in a foot or leg
• Pain or cramping in one or both legs
• Lower back pain

There might be other non-specific symptoms of spinal stenosis. So, please consult with your doctor for a precise diagnosis.

What Causes Lumbar Spinal Stenosis?

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: 

• The intervertebral discs

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

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.  

• The spinal cord

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. 

What is Inherited Spinal Stenosis?

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. 

What is Degenerative 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:

• The cartilage in the facet joints gradually wears down, which increases friction in the spine and may cause bone spurs to form. 
• The intervertebral discs become drier, flatter, and weaker. The discs may become damaged, leading to a slipped or herniated disc. 
• As the cushioning in the spine from intervertebral discs decreases, the spinal cord and/or nerve roots can become strained. 

Leading a healthy lifestyle by exercising, eating a nutritious diet, and maintaining an optimal weight can help prevent spinal stenosis.

What Are The Best Treatments For Lumbar Spinal Stenosis?

Options for spinal stenosis treatment include:

• Spinal stenosis exercises

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:

• Bridges

This exercise engages the glute muscles, which support the pelvis and can help reduce the strain on the lumbar spine. 

• Pelvic tilts

This simple exercise engages the transverse abdominis, which is a deep abdominal muscle that promotes proper spinal alignment and helps protect the lower spine. 

• Knee-to-chest exercise

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

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. 

• Medication

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.

Surgery For Lumbar Spinal Stenosis

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.   

Spinal Fusion in Lumbar Spinal Stenosis Surgery

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.

Alternatives to 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. 

What is Laminoplasty?

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. 

What is Laminoplasty Surgery?

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 Incisions of Laminoplasty

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.

Creating a “Door” With The Lamina

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. 

When is Laminoplasty Performed?

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

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

Spinal fractures, most commonly caused by osteoporosis, may encroach on the spinal nerves and lead to spinal stenosis symptoms. 

• Thickened spinal ligaments

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.

• Genetics

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. 

Non-Surgical Treatment Methods For Spinal Stenosis

A variety of conservative therapy methods for spinal stenosis are available, including spinal stenosis exercises, medications, and injections.

• Spinal stenosis exercises and physical therapy can help release tension in the back, improve spinal posture, and strengthen the spine’s supportive muscles. Many cases of spinal stenosis can be resolved with physical therapy. 
• Certain medications can be used to alleviate pain and inflammation caused by spinal stenosis. However, medications are rarely recommended as a long-term solution for chronic spinal stenosis-related back pain. 
• Epidural steroid injections can help with spinal stenosis pain by reducing swelling and pressure on the irritated spinal nerves. However, doctors recommend that patients receive no more than three to four steroid injections per year. At a higher frequency, steroid injections can cause tissue damage. 

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.

Where is Laminoplasty Performed?

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. 

What Is The Difference Between Laminoplasty and Laminectomy?

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 vs. Laminectomy

• Laminotomy involves removing a small portion of the lamina in the injured section of the spine. 

• Laminoplasty involves severing one side of the lamina and opening it to create more space in the spinal canal. Unlike laminotomy, laminoplasty doesn’t fully remove the affected lamina.

What Can I Expect After Laminoplasty Surgery?

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. 

Laminoplasty With 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. 

Alternatives to Spinal Fusion For Laminoplasty Patients

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.

How Scoliosis Affects Life for Elderly People

Scoliosis is prevalent among children and teenagers. However, it can also have a large, far-reaching impact on the elderly population. 

While scoliosis can develop with no apparent cause, it can also form as a result of age-related spinal degeneration. Although wear and tear on the spine is inevitable with age, it can diminish elderly individuals’ quality of life. 

Here, we’ll discuss scoliosis, its impact on the elderly, and how scoliosis treatment with the innovative TOPS spinal implant can provide symptom relief. 

What is Scoliosis?

Scoliosis refers to an atypical sideways curvature of the spine. Usually, scoliosis appears in childhood or during adolescence.  

The normal curvature of the spine is an S-shape when it’s seen from the side. With this curve, the neck (cervical spine) has a small forward curve, the upper/middle part of the back (thoracic spine) has an outward curve, and the lower back (lumbar spine) has an inward curve. 

From the back, a spine with a normal curvature is straight. The vertebra, which are the bones of the spine, are stacked on top of each other. With scoliosis, some of the vertebrae curve sideways.  

How is Scoliosis Diagnosed?

Most often, scoliosis is diagnosed in patients when they are aged between 10 and 15. Early diagnosis of this condition is ideal, as it allows physicians to implement scoliosis treatments while the body is still developing. In fact, with early intervention, it’s often possible to limit the progression of the abnormal spinal curve.  

With that said, not all cases of scoliosis are diagnosed at a young age. Cases that are seen in adulthood can vary in cause. 

What Causes Scoliosis in The Elderly?

Idiopathic Scoliosis

When scoliosis is idiopathic, it means that there’s no apparent cause for the abnormal spinal curve. This is the same type of scoliosis that’s often found in teenagers. Idiopathic scoliosis can begin during adolescence, but not cause symptoms until the patient is an adult. 

In cases of idiopathic scoliosis, if the spinal curve is significant, it can become more severe over time. This can lead to adverse symptoms in adulthood.

However, cases of idiopathic scoliosis that don’t worsen can still lead to pain and other symptoms in adulthood. This is because the spinal asymmetry can gradually damage the patient’s spinal discs, muscles, and joints. 

Degenerative Scoliosis

Degenerative scoliosis, which is also called adult-onset scoliosis, occurs as a result of spinal degeneration. With this type of scoliosis, the spinal wear and tear that naturally occurs with aging causes the spine to curve sideways.

Many cases of adult scoliosis are at least in part impacted by spinal degeneration. It triggers symmetry in the spine that gradually becomes worse as the patient ages. As degenerative scoliosis progresses, the facet joints and intervertebral discs that support the spine continually break down. 

Degenerative scoliosis can be asymptomatic, especially in its early stages. However, if it does cause symptoms, patients may experience:

• A dull ache in the back
• Sciatica, which is pain that radiates from the lower back down one (or both) legs
• Back pain that’s exacerbating by standing for prolonged periods and gets better with rest

Traumatic Scoliosis

Traumatic scoliosis is a type of scoliosis that occurs after the spine is subject to a trauma, such as a car accident. The sudden trauma can create fractures in the spine, which may compromise spinal strength and alignment. This can result in scoliosis. 

Scoliosis in The Elderly

While scoliosis is commonly thought to primarily affect teenagers, it has a large impact on the elderly. 

In a study that measured the prevalence of scoliosis in adults between the ages of 60 and 90, 68% were found to have scoliosis. 

Symptoms of adult scoliosis can be disabling, especially for elderly individuals. Examples of symptoms of severe scoliosis in the elderly include:

• Fatigue
• Shortness of breath
• Difficulty walking
• Difficulty standing straight
• Having the sensation of being full very soon while eating
• Bone spurs

Ultimately, scoliosis in the elderly can lead to reduced mobility, difficulty completing daily tasks, and chronic pain. Older adults with scoliosis may no longer be able to participate in activities that they used to enjoy. 

A variety of treatment options can be implemented to help reduce the impact of scoliosis on an elderly patient’s day-to-day life. Physicians generally begin with non-surgical treatments, such as physical therapy and lifestyle modifications.

Exercises For Scoliosis in The Elderly

Targeted exercise for scoliosis in the elderly can help improve spinal flexibility and alignment. Examples of exercises that you can try include:

• Pelvic tilts

Lie on your back and bend your knees so that the soles of your feet lie flat on the ground. Contract your abdomen so that your pelvis tilts up to the ceiling, with your lower back flat against the ground. Hold it for 20 seconds, release, and repeat. 

• Latissimus dorsi stretch

This stretch can support the lat muscles, which often become tense in patients with scoliosis. Stand up straight and place your hands above your head. Begin to bend at one side of your body, leaning gently until you feel a stretch along your side. Hold for 10 seconds, return to the original position, and repeat to the other side. 

• Child’s pose

This yoga posture can help release tension in the back. Kneel on the floor, placing a blanket beneath your knees and shins if needed. Move your hips towards your heels, reach your arms forward, and place your hands flat on the floor. Breathe and relax in the stretch. 

If non-surgical scoliosis treatment methods fail after several months, consider spinal surgery to improve scoliosis symptoms. 

Spinal Surgery For Severe Scoliosis in The Elderly

For cases of degenerative scoliosis in the elderly, spinal decompression surgery is a viable treatment option.

Decompression surgery involves removing a portion of a spinal bone (vertebra) along with other spinal tissues, if needed. This relieves pain and sciatica symptoms caused by nerve compression. 

By creating more space in the spinal canal, decompression surgery is often a successful treatment for degenerative scoliosis. It encourages the healing of damaged tissues while relieving pressure on nearby nerves. 

However, after decompression surgery, there’s a risk of spinal instability. So, this scoliosis treatment is generally paired with spinal fusion to restore spinal stability. The TOPS System is a spinal fusion alternative that can stabilize the spine without many of the downsides associated with fusion. 

Spinal Fusion in Scoliosis Surgery

Spinal fusion is commonly completed at the same time as spinal decompression. It involves placing bone graft material in between two vertebrae in the treatment area. After the procedure, the bone graft will gradually cause the vertebrae to fuse into one bone. 

By fusing the vertebrae, spinal fusion prevents spinal instability. However, it also prevents motion in the fused portion of the spine. Especially in elderly individuals, spinal fusion can diminish mobility and hold you back from participating in various activities. 

Additionally, the healing process for spinal fusion requires the bone to heal. This makes for a lengthy, often painful recovery. 

Spinal Implants

TOPS is a spinal arthroplasty system that replaces the spinal tissues that are removed during decompression surgery. Unlike spinal fusion, this mechanical implant device preserves the motion of the spine while preventing spinal instability. 

After spinal decompression is performed, a surgeon can place the TOPS spinal implant into the targeted area. This system is designed for use between the segments L2 and L5 of the lumbar spine. Once implanted, the TOPS device controls the motion of the spine without inhibiting its flexibility. 

Patients who undergo spinal decompression with the TOPS System for degenerative scoliosis can bend and twist the spine soon after the procedure. Additionally, the recovery process for decompression surgery with TOPS is much shorter than that of spinal fusion. 

To learn more about the TOPS System in spinal decompression surgery for scoliosis treatment, contract Premia Spine today. 

What is Neural Claudication?

Recently, we addressed the topic of claudication. Claudication refers to pain typically felt in the legs as a result of vascular (blood vessel) problems or back problems (such as spinal stenosis) that can cause pinched nerves in the lower back.

Neurogenic claudication is a common symptom of lumbar spinal stenosis, which is the abnormal narrowing of the spinal canal in the lumbar (lower) spine. Neurogenic refers to the condition’s genesis in the nerves, while claudication (Latin for limp) refers to painful weakness or cramping in the legs.

The Basics of Neurogenic Claudication

Also called pseudoclaudication, neurogenic claudication occurs as a result of compression of the nerves in the lumbar spine. Neurogenic claudication is widely considered a syndrome, meaning that it involves a group of symptoms that usually develop collectively. 

Causes

As aforementioned, most cases of neurogenic claudication are triggered by spinal stenosis, which occurs when the space around the spinal cord diminishes.

Understanding Spinal Stenosis

Spinal stenosis is estimated to affect 8% to 11% of adults in the United States, according to the American Academy of Orthopedic Surgeons. It’s the most prevalent in adults over the age of 50.  

Common causes of spinal stenosis include bone spurs, bulging discs, and the thickening of ligaments in the spine.  

• Bone spurs are solid lumps of extra bone that can develop as a result of wear and tear on the spine, such as osteoarthritis. 
• Bulging discs, which may also be called herniated discs or slipped discs, occur when there’s a tear in the firm exterior of a spinal disc. The soft interior of the disc may push out through this crack and place stress on spinal nerves.  
• The ligaments that support the spine and keep the vertebrae connected can stiffen with age. As a result, the ligaments may thicken and begin to take up extra space in the spinal canal. 

These spinal conditions can trigger the impingement of spinal nerves, which leads to the symptoms associated with neurogenic claudication. 

Bilateral vs. Unilateral

This syndrome may be bilateral (in both legs) or unilateral (in one leg). However, most cases of neural claudication are bilateral. 

Symptoms 

Symptoms of neural claudication typically include pain, cramping, weakness, and tingling. These symptoms most often appear in one or both legs, the lumbar spine, and the buttocks. 

Pain from neural claudication may be triggered by walking or prolonged standing and is generally alleviated by changing position or bending the waist. Unlike vascular claudication, neural claudication can’t be alleviated simply by resting.

In severe cases, pain from this syndrome may be persistent. Without treatment, spinal stenosis and neural claudication can become a source of chronic pain. 

Treating Neural Claudication

Diagnosis

First, your physician will need to run tests to provide a diagnosis. An x-ray, MRI, and CT scan are all often used to diagnose neural claudication and can identify stenosis, bone spurs, and slipped discs.

• X-rays use electromagnetic beams of energy to create images of the patient’s bones. Although the spinal cord, spinal nerves, and other soft tissues generally can’t be viewed using an x-ray, this test allows for a general examination of the bone tissue in the spine. 
• MRIs (magnetic resonance imaging) use radiofrequency energy, magnets, and computers to develop bone and soft tissue images. Unlike an x-ray, an MRI can help physicians evaluate soft tissue injuries in the spine, like a slipped disc. 
• CT (computed tomography) scans combine x-rays and a computer to form images of soft tissues and bones.

These tests can evaluate the general condition of the spinal bones and soft tissues to determine if neural claudication is present. This, along with a physical exam and patient interview, will help your physician diagnose your spinal symptoms. 

Conservative Treatments

Conservative treatments may be sufficient to relieve neurogenic claudication. Physicians generally start patients out with a conservative treatment plan before considering surgery. 

Some of the most common non-surgical treatments for neurogenic claudication include:

• Physical therapy

Physical therapy for neural claudication usually involves exercises for spinal flexion, abdominal exercises to improve stability, and lifestyle recommendations. Massage and heat/ice therapy may also be implemented for pain relief. 

• Medications

Anti-inflammatory medications can help relieve pain and inflammation caused by neurogenic claudication. These medications may be found over-the-counter or prescribed, depending on the severity of the case. 

• Injections 

Epidural steroid injections can be used to relieve pain from irritated nerves in the spine. When injected into the affected area, the steroid medication works to reduce pain signals from the injured nerves, leading to less pain and discomfort. 

Keep in mind that epidural steroid injections should generally only be applied three to six times annually. If you get too many injections, there’s a risk of decreasing the strength of the vertebrae and adjacent muscle tissue. 

In moderate to severe cases of neurogenic claudication that don’t respond to conservative protocols, surgery may be recommended. Spinal decompression surgery can improve your comfort and quality of life if neurogenic claudication is interfering with your daily activities. 

Spinal decompression surgery is typically performed to remove portions of the vertebrae that are impinging on a nerve. This pinched nerve is the source of pain, weakness, and cramping in cases of neurogenic claudication. 

Any procedure that relieves pressure on spinal nerves to resolve symptoms of spinal compression, including neurogenic claudication, is referred to as spinal decompression surgery. There are a few different approaches to spinal decompression, including discectomy, laminotomy, laminectomy, foraminotomy, foraminectomy, corpectomy, and osteophyte removal. 

Your surgeon will determine the best method of spinal decompression to suit your circumstances. 

Spinal Fusion

Following the spinal decompression treatment, a secondary operation is performed to stabilize the spine in the area where vertebral material was removed. In the past, spinal fusion back surgery was the sole available surgical stabilization procedure performed with spinal decompression.

Spinal fusion involves connecting neighboring two vertebrae so that they eventually form one bone. To do this, the surgeon will position bone graft material in between the vertebrae.

To keep the vertebrae in position during the bone graft’s healing process, your surgeon may also perform posterior fixation. This involves using screws and rods to reinforce the alignment of the spine. 

Downsides

Although spinal fusion can prevent further damage from spinal instability, it has several downsides. For one, patients commonly need to stay in the hospital for up to four days after spinal fusion. After the patient returns home, it can take many months for the vertebrae to fuse together and for the spine to heal. 

Spine fusion surgery eliminates the natural independent motion of the fused vertebrae. It can contribute to the deterioration of adjacent vertebrae, potentially leading to further complications.  

Additionally, spinal fusion compromises the mobility of the spine. Patients may require special tools to pick up items off of the floor because they can no longer bend over after spinal fusion. 

Alternative Solutions

The TOPS (Total Posterior Solution) System provides an alternative to spinal fusion that preserves the full range of natural motion of each vertebra. It’s a mechanical device that supplants the tissues removed during spinal decompression. 

With the TOPS spinal implant, it’s possible to reinforce the stability of the spine after spinal decompression surgery without compromising the patient’s range of movement. This device moves with the spine so that the patient can resume their normal activities soon after surgery. 

The TOPS device also provides a faster, more comfortable recovery process after spinal decompression. This spinal implant reduces the trauma on the spinal tissues after decompression. 

If you experience pain that interferes with your quality of life, seek qualified medical help and get the facts about all of your treatment options. Today’s advanced procedures provide excellent outcomes for spinal conditions including neural claudications. 

What is Degenerative Joint Disease?

Osteoarthritis, commonly referred to as Degenerative joint disease, is a problem that often affects people in their advancing years and can cause pain and discomfort, as well as reduce a person’s mobility.

In this article, we will describe what causes the disease, the possible symptoms and how it may be treated.

Degenerative Joint Disease explained

“What is a degenerative joint disease and how did I get it?”

That’s a common reaction from spinal patients after receiving a diagnosis of osteoarthritis, also known as degenerative joint disease. The degeneration usually results from the normal process of aging, typically beginning in middle age with the breakdown of cartilage, the rubbery tissue that serves as a cushion between bones and around joints. 

Degenerative joint disease is the most common joint disorder and is frequently seen in the joints of the spinal column due to the many stresses and strains put on these joints. 

Occupations that involve physically demanding kneeling or squatting can also predispose one to degenerative joint disease, and injury or disease can also contribute to degenerative changes in the affected area later in life. Excessive weight, lack of exercise, smoking, and a poor diet can also exacerbate the degeneration.

What causes degenerative joint disease?

Degeneration in the spine is characterized by a breakdown of the cushioning spinal discs. This leads to bones rubbing against each other, resulting in pain, stiffness, swelling, the reduced motion of the joint, and other associated symptoms.

What are the symptoms of the degenerative joint disease?

Common symptoms caused by osteoarthritis (degenerative joint disease) are:

• Pain – Joints that are affected by osteoarthritis may become painful when a person is active, or immediately afterward. This could include even the most simple of movements.
• Tender to the touch – The joints may be tender to touch, even under the lightest of pressure on, or around the problem area.
• Swelling – You may experience inflammation of the soft tissue around the joint which can cause visible swelling.
• Rigidness – The joints could become stiff, impacting a person’s flexibility and mobility. This is likely to occur first thing in the morning or during a long period of sitting still. 
• The joint is inflexible – You may notice a significant decline in the flexibility of the joint and you may no longer be able to move it freely and enjoy a full range of motion. 
• Discomfort – When moving the joint you may experience a sensation similar to grating, this may be combined with unexpected sounds such as cracking, or popping.
• Bone Spurs – This is when extra parts of the bone form around the affected joint which can feel like hard lumps underneath the skin. These can potentially come into contact with the nerve root, causing pain. 

What are my options to treat degenerative joint disease?

A number of treatment options are available for a degenerative joint disease of the spine, including physical therapy, medications, and injections. 

Although the condition cannot be cured, steps can be taken to stop it from worsening and to reduce the symptoms.

Here is a summary of the treatment options available to degenerative joint disease sufferers:

• Regular exercise
• Physical Therapy
• Medication and painkilling injections
• A healthy diet to lose weight or prevent further weight gain
• Suitable footwear
• Using a brace, or other devices to reduce the strain on your joints
• Spinal Decompression Surgery

Spinal Decompression Surgery

For patients with moderate to severe osteoarthritis not improved by conservative approaches, spinal decompression surgery may provide relief by reducing pressure on pinched nerves resulting from the reduction in cushioning the degenerative joint disease causes. 

Spinal Fusion Surgery

The decompression procedure has historically been performed in tandem with spinal fusion surgery, to stabilize the spine by fusing two vertebrae together at the point where the decompression procedure was performed. 

Is there a better alternative to spinal fusion?

The TOPS™ System provides a clinically proven superior alternative to spinal fusion, enabling patients to maintain the full range of motion of each individual vertebra. You may not be able to stop natural degenerative changes, but a range of effective medical options are available to treat them. A qualified specialist can help you choose the one that’s right for you.

The key benefits of the TOPS System are:

• More controlled movement compared to spinal fusion
• A reduction in pain
• Regain your ability to do regular activities
• Improve your overall quality of life

Living with degenerative joint disease

As a long-term condition, the degenerative joint disease requires lifestyle changes to help you cope with the symptoms and the impact it may have on the overall quality of your life. This is why it is always important to speak to medical professionals who can offer support and advice to ease the strain of osteoarthritis. 

Preventing degenerative joint disease

Preventing the condition entirely is not possible as it is simply a result of aging, affecting millions of people across the globe. However, it is possible to minimize the risk of osteoarthritis by maintaining a healthy and active lifestyle and creating ‘good habits’. 

Exercise – Regular exercise is a great way to limit the chances of the condition but workouts that put excessive strain on the joints, such as running and weight lifting can have the opposite effect, and in fact accelerate the wearing down of the joints.

Activities like swimming and cycling are great ways to keep in shape while controlling the strain placed on your joints. Two and a half hours of steady exercise each week, including some strength exercises, can build muscle strength and maintain healthy joints.

Work on your posture – Try to correct your posture at all times and avoid bending in an unnatural position for too long to keep your spine in a healthy position. Adjust the height of your chair when working in an office and try to walk around every so often to encourage blood circulation. 

Eat healthily – Carrying extra weight is one of the main reasons a person can suffer from joint-related issues, including osteoarthritis. Eating healthily and trying to lose weight can significantly reduce your chances of developing such issues. 

What is Failed Back Surgery Syndrome?

Failed back surgery syndrome (also called FBSS, or failed back syndrome) is a generalized term used to describe ongoing pain after back surgery. After going through a spinal surgical procedure, of course, both you and your surgeon desire your complete painlessness. However, even with the best spinal surgeon and the best indications for spinal surgery success, there is always a small chance that back pain may continue after surgery and recovery (studies report continued back pain after 5% of all spinal surgeries).

What causes Failed Back Surgery Syndrome? 

There are many reasons why a back surgery might not result in a completely pain-free existence, partially owing to the fact that spine surgery is only able to accomplish stabilizing a painful joint and decompressing a pinched nerve. If your back condition involves more than these two pain-causing situations, your spine surgeon will need to continue your care and explore additional solutions to your back pain condition.

It should be understood that back surgery is not guaranteed to reduce a person’s pain levels and is primarily a procedure to improve the condition of your spine and prevent any further damage in the future.

How successful is back surgery?

Back surgery is reported to be 95% successful at changing anatomy that causes pain and correcting the physical results of a back injury.  But it’s also important to realize that back surgery isn’t a cure-all for every type of back pain-causing condition. Since the spine is a very complex part of your anatomy, with many vertebrae, nerves, and cushioning between your discs, it can be a complex process to get to the root of what’s truly causing you pain.

How do you know if you require back surgery?

Your back surgeon will thoroughly assess your back pain condition and use top technology to diagnose your back pain causes, but it’s important for you to have realistic expectations of what back surgery can and cannot accomplish for you. If you experience Failed Back Surgery Syndrome, your skilled physician will then conduct additional tests and map out a plan of action to remedy as much of your back pain as possible. All valuable things take time, so don’t set yourself up for possible disappointment by expecting a quick fix to any back pain. It may take an extra procedure or extra treatment after your back surgery to get you feeling much better.

If you do have great success after your back surgery, then you’re in that fortunate 95% of back pain patients whose symptoms lessen and whose lifestyle will very soon be active and more comfortable again.

Procedures that could lead to Failed Back Surgery Syndrome

Discectomy/ Microdiscectomy – To remove a herniated lumbar disc that causes back or leg pain. This operation has a high success rate when treating leg pain and the outcome is very predictable, however, the chances of success are significantly lower for back pain. 

Spinal Fusion Surgery – Surgery to provide stability to the spine by fusing vertebrae together using a bone graft, in addition to metal pins, rods, and sometimes a plate. This is often the solution for a person suffering from spondylolisthesis. Although improved stability is usually guaranteed, the likelihood of reduced pain levels is much lower.

In some cases, this procedure could result in fusion and/ or implant failure where the body effectively rejects the foreign materials. Spinal fusion surgery could also lead to a transfer lesion, this is when one of the vertebrae next to the problem area is damaged, leading to the degeneration of what was previously a healthy bone.

Lumbar Decompression Surgery – Lumbar decompression surgery also offers no guarantees, with some chance that spinal stenosis or disc herniation could recur. It is also possible that the decompression of the nerve root was not sufficient enough, or that the damaged nerves do not heal correctly following the procedure. The surgery may even cause additional damage to the nerve roots, potentially worsening the pain. 

Scar Tissue – Epidural fibrosis is the result of excessive scar tissue near a nerve root following surgery, most common following spinal surgery. The scar tissue effectively attaches itself to the nerve root and causes significant pain. Unfortunately, epidural fibrosis could even occur following a successful operation and is somewhat of unavoidable risk. 

These issues may require postoperative rehabilitation to fix the secondary pain caused by an unsuccessful procedure. 

What are my options if I have Failed Back Surgery Syndrome?

Fortunately, FBSS can be managed and anyone suffering from the failed back surgery does not need to expect long-term and constant pain. There are many ways in which a person can manage their failed back surgery syndrome so they can ease pain levels and return to a normal way of life. 

Physical Therapy – One of the most effective ways of managing FBSS is by employing the services of a physical therapist who can work closely with you to help strengthen your back muscles, achieve proper posture and help to manage any pain you may be experiencing. 

Lifestyle Adjustments – Ensuring you are doing all you can to limit the impact of FBSS is one of the simplest ways to manage the problem. This can be as simple as sleeping in the correct position (on your back or side, as opposed to your stomach), making sure you wear appropriate footwear on certain occasions, and watching your diet to avoid weight gain.

Regularly seeing a masseuse is also a good way to reduce inflammation. 

Medication – Prescribing medication for FBSS is somewhat of a controversial topic as it can be easy for a person to become overly dependent on painkillers, or possibly even addicted. This is why it is extremely important to carefully manage your medication, ensuring it is only used whenever the pain reaches significant levels. Other forms of treatment such as physical therapy and lifestyle adjustments should be the primary methods used to reduce pain. 

Medication can also result in numerous side effects when taken frequently, including; depression, constipation, damage to the immune system, and deterioration to your overall health. 

Spinal Cord Stimulation Devices – These devices have been gaining in popularity in recent years, especially among FBSS sufferers as they have proven successful in reducing severe pain symptoms. They work by using neurostimulation to stop pain signals from reaching and registering with the brain and are an alternative to medication and traditional treatments.

Focus on your mental health – Do not let your symptoms get you down and focus on maintaining a healthy lifestyle, with plenty of exercises. If you feel like your mental health is deteriorating then please pay a visit to your doctor who can refer you to a specialist.

Can You Get Blood Clots From Spinal Surgery?

Spinal surgery has made significant advances in both its safety and efficiency in correcting many back problems, from traumatic spinal cord injury to degenerative diseases like spinal stenosis, spondylosis, and slipped disc. Many of these advances in spinal surgery have come in recent years due to minimally invasive microsurgical tools and techniques. Nonetheless, back surgery is a severe operation, and surgical candidates need to be aware of all facets of the procedure they’re considering – not only the benefits of the surgery but also the potential risks. One of the risks of spinal surgery is that of developing blood clots.

Any injury to the body increases the risk of a blood clot, as the injury itself stimulates the clotting process. Surgery constitutes an injury or trauma, and the body responds accordingly. Spinal surgery – which the body interprets as an injury to the spinal cord – can lead to the formation of blood clots within the veins. If such a thrombus becomes dislodged, it can block a blood vessel as it narrows, causing a stroke or heart attack, possibly resulting in paralysis or death. Proper postoperative care, medications, and the patient’s active role in the recovery process can minimize the risks of blood clots.

Table of Contents

What is deep vein thrombosis (DVT)?

Risks for thrombosis

Treatment and prevention of DVT

Why choose the TOPS™

Conclusion

What is deep vein thrombosis (DVT)?

That’s a postoperative disease associated with thrombus forming in the deep veins of the lower extremities. Often, it is induced by muscle atony or, simply put, lack of movement. 

DVT symptoms include:

• swelling of the feet;
• sudden shortness of breath;
• acute chest pain;
• coughing up blood;
• increased pulse rate;
• fainting;
• dizziness.

To understand why you get blood clots after surgery, it’s worth analyzing the typology of thrombus. So, the hemostasis of the human body is maintained by forming blood clots (e.g., during wound healing). But sometimes, such a phenomenon has a negative impact on the body’s functioning. The thrombus is formed as a result of activation of the blood coagulation system in response to a vascular injury. The occurrence of thrombosis is also associated with a violation of the venous wall. That’s life-threatening because pulmonary embolisms from deep vein thrombosis (DVT) may happen later. A blood clot breaks off and goes through the bloodstream to the lungs, settling in the pulmonary arteries.

It may also cause some ischemic strokes or blood clots near the spine while blocking the artery that supplies the spinal cord. Its signs usually appear suddenly and can feel like a tight bandage wrapped around a torso. That’s precisely the point where the blood supply is disrupted. The thickening or narrowing of the arteries that carry blood to the spinal cord often triggers cerebrospinal strokes. 

Risks for thrombosis

Treating conditions such as slipped discs, spinal stenosis, and spondylosis is much less likely to cause complications than a hip or knee replacement. The cumulative incidence of deep vein thrombosis or DVT, also known as blood clot after surgery, steadily increases during the first two weeks and depends on the professional hospital care and factors of the patient’s preoperative condition, for example:

• general well-being;
• age (for older patients, it is often difficult to rehabilitate since muscle tone is weakened);
• previous surgical procedures;
• comorbidity (diabetes and other chronic diseases);
• smoking, alcohol, drug status (e.g., contraceptives);
• osteoporosis (patients are at increased risk of complications if the bone mineral density is low);
• excess weight (pressure on the spine will be increased – this will entail negative consequences and be crowned with severe pain syndrome, especially in the first weeks of recovery);
• pregnancy (operating on pregnant women is rare; however, they are safe for the mother and fetus if modifications of anesthetic and surgical methods are applied); 
• genetic bleeding disorders.

One of the misconceptions is regarding the existence of inflammatory bowel disease (IBD) as a risk factor. The reality is that postoperative complications don’t occur; for the most part, they may be comorbid.

The most important concern after an operation is to prevent any negative consequences. In this case, we’re talking about two serious diseases: deep vein thrombosis and pulmonary embolism. 

Treatment and prevention of DVT

Since the thrombus has a high density, thinning drugs, namely anticoagulants, will prevent blood clotting (e.g., warfarin/ coumadin, heparin).

Note! Use the article for informational purposes only. Follow the therapeutic instructions of your doctor.

Clot busters are injected intravenously and break down clots. Filters settled in large veins can sometimes be used during therapy. Their function is to prevent pulmonary embolism. Compression stockings may also prevent puffiness (one of the signs we’ve noted above). 

Prevention of the illness in the postoperative period consists of maintaining normal body weight and good physical shape. Thus, you need to play sports, walk and avoid prolonged inactivity constantly. So, for example, it’s essential to take short walks. Discuss with your doctor how vulnerable you’re at risk of blood clotting, tell your medical history. If you suffer from comorbid diseases, such as diabetes or heart failure, ensure to report it. During the preoperative period, your goal should be to achieve a stable state of health. 

Blood clots in the back can be triggered by an invasive operation, trauma, disease. In 40% of cases, people who have suffered a cerebrospinal stroke can walk independently, 30% move with a cane, 20% are confined to a wheelchair. The scary data only makes you want to stay out of that 20% and 30%, right? Therefore, the preparatory period is significant: systematic; targeted treatment will help eliminate possible negative consequences. Anticoagulants, drugs that lower blood pressure, occupational therapy to preserve muscle function – these are all standard manipulations for preventing and treating cerebrospinal stroke. By the way, don’t forget to stick to a healthy diet – foods rich in fiber will help avoid the risks of intestinal inflammation. So take care of yourself now, not when you reap the rewards of a poor lifestyle.

Why choose the TOPS™

Anyone considering back surgery should also be aware that some procedures for treating a spinal problem may present lower risks or provide better outcomes than others. For example, the TOPS™ (Total Posterior Solution) procedure, which may be performed after spinal decompression surgery to stabilize the spine, provides better clinical outcomes than spinal fusion surgery, which was the traditional choice for spine stabilization before the introduction of the TOPS system. 

The TOPS provides for minimally invasive spine surgery and thereby significantly reduces the risks associated with DVT. Previously, when knowledge in spine treatment wasn’t as developed as today, the fusion procedure was the only available and most innovative option. The vertebrae were “glued” into a relatively rigid structure, which significantly limited movement. Even though flexion and extension weren’t possible, and the risks were very impressive, the fusion continues to be performed today. However, TOPS™ surgery has become a more acceptable alternative to treating degenerative spondylolisthesis of lumbar spinal stenosis for many younger physicians. Its advantage is movement in all axial directions, as well as stability.

The structure is implanted using a traditional posterior surgical approach, but the TOPS system exerts less force on the screws than other configurations. 

Conclusion

After the operation, the blood clotting mechanism in the body is very active because it’s aimed at stopping bleeding. Damage to the blood vessels around the surgical site is often the cause of DVT. Thrombus can form in the veins of the lower extremities but travel to the pulmonary veins with the blood flow, generating pulmonary embolisms, which are life-threatening. This process can last for weeks, and some symptoms can be identical to other diseases. The same shortness of breath or coughing are often warning symptoms, and if the convalescent neglects visits to the hospital or rehabilitation center, then often valuable time can be wasted. 

The TOPS solution has the added benefit of preserving the spine’s full range of motion and also has significantly lower risks of thrombosis, unlike spinal fusion, which permanently fuses adjacent vertebrae. If you’re a candidate for back surgery, make sure you understand not only the upsides and downsides but also all the alternative surgical solutions that can help you minimize the already low risks associated with advanced spinal procedures.

How soon can you return to athletics after spinal surgery?

Near the top of the list of questions from almost every spinal surgery, the patients indicate how long they will have to wait for the following surgery before resuming their everyday activities. When it includes athletics – golf and tennis, bowling and the like, pastimes that put tremendous strain on the back – the answer becomes more complex. The factors influencing the time before patients can get back in the game include their physical condition and health. Just because one engages in strenuous physical activity doesn’t mean they are in good physical condition or health. Recovery times are faster for surgery patients in good physical shape because their bodies heal more quickly. Of course, the operation itself will play a significant role in deciding when you’ll be back on the tennis courts, golf course, taking a job, or engaging in a simple walk. The postoperative physical therapy program also plays a significant role. But the type of back surgery is the primary factor affecting the time required to get back into sports activities.

How to recover from surgery if you are an athlete or cannot live without daily activity – read further in this article.

Table of contents

1. What does it mean to be in recovery?
2. Exercises after surgery
3. Conclusion

What does it mean to be in recovery?

While many people consider back surgery as the end of a promising sports career, Olympic, amateur, or professional athletes have returned to their competition after many common types of operations. General physical condition, professionalism during surgery, and spine rehabilitation affect how quickly you return to the game. Here are some tips for athletes planning to return to sport after a minimally invasive intervention. 

Follow your doctor’s recommendations

In most cases, surgeons consult about postoperative care. They depend not only on the patient’s health and medical history but also on the desire to return to sports. We previously discussed lower back surgery recovery: diet, exercise, physical therapy, massages, proper wound care, and medication support are vital aspects of recovery. Of course, you shouldn’t neglect motivation and grit to achieve success. And if your competition is right around the corner, and you’re still in the hospital ward, this is not a reason to be upset. Your orthopedic surgeon will take this into account when planning your postoperative period. Of course, everyone wants to leave and start an everyday life immediately. Still, following the recommendations, you’ll be able to return to sports faster than causing implicit harm to your body during self-rehabilitation. Returning too early cancels not only the healing but the operation’s effectiveness. 

So, a doctor’s advice may include:

• doing certain exercises
• wearing compression bandages, insoles, and stockings to avoid the risk of complications
• A diet that includes vitamin and mineral complexes
• A set of particular activities after back surgery.

Define your limits

You’d also talk to your coach about your career prospects or options (if you’re an amateur athlete) when getting approval from your PCP to return to athletics. It’s essential to be careful and aware of the limitations.

The postoperative stage depends on the patient, understanding the symptoms of complications, and a quick reaction if something goes wrong. E.g., accurately characterizing the level of pain and discomfort, reporting aches, numbness of the limbs, dizziness, suppuration in the wound area doesn’t mean a step back in the rehabilitation progress, but on the contrary, the ability to accelerate after a slight slowdown. Try to protect the spine, especially in the early stages of recovery. Respect your body and its healing times. 

Don’t forget about the course of drugs

Infections at the site of the surgical incision most often occur 2–4 weeks after the intervention. Most often, the following symptoms appear:

• redness and suppuration at the incision site;
• back pain that gets worse;
• fever and fever;
• change in consistency, odor, and color of drainage.

It’s essential to treat any of these and some other signs as they arise. If ignored, unavoidable consequences may occur. 

For patients with deep infection, a course of intravenous antibiotics is often given for about two months. Chronic contamination leads to the removal of the implant. 

Keep the wound clean: it must be washed with water and soap at least once a day. Remember to keep the wound dry for healing and crusting. It’s undesirable to utilize ointments, lotions, body creams on the operated areas. After two weeks, when the staples or stitches are removed, you may return to bathing or swimming. 

For opioid pain relievers, discontinuation usually occurs within the first few weeks, at most a month. There are other pain management options, such as using acetaminophen or non-steroidal anti-inflammatory drugs. But, as in the first case, they have their pros and cons and depend on the medical history. By combining medicines with physical therapy, you can achieve impressive results. 

It’s no secret that athletes’ dedication to the postoperative rehabilitation program greatly influences their subsequent success. Depending on overall progress in physical therapy, you may get consent to exercise, but return to activity must be gradual and gentle to avoid unnecessary risks.

Exercises after surgery

Patients, who have undergone minimally invasive TOPS™ procedures, can usually regain a full and painless range of motion. They have the greatest likelihood of returning to sport at pre-injury levels. Conversely, most exercises after spinal fusion aren’t available to athletes, and the possibility of injury increases – they’re less likely to return to athletics. Any collisions and falls will negatively affect health.

In any case, physiotherapy is a panacea for healing – movement combined with other aspects of rehabilitation can give you a chance for a better life. Let’s consider the leading practices that are useful for patients in the postoperative period.

Walking

It’s worth moving daily to improve blood circulation and speed up the healing of muscles and spine tissues. E.g., an essential therapy is walking, which can support the normal functioning of the heart and lungs. An upright position of the body is the best activity for the spine after surgery – this way, you can protect the discs from unnecessary stress. So, start with simple walks, and then work with your coach to develop your exercise program.

Bench press

That’s one of the simplest and effective therapies utilized in various types of operations. For instance, laminectomy recovery exercises are invaluable as they help protect discs and strengthen your back muscles.

This exercise is valuable because the discs hold the lower back during flexion and extension of the lumbar spine. So, to perform the training, you need to do the following steps:

1. Lie face down with your arms parallel to your body.
2. The back and hips should be relaxed. Gently lift your upper body while leaning on your stomach. Feel light pressure in your lumbar region.
3. Hold this position for about two seconds and slowly lower yourself to the floor. Do ten hikes.

Straight leg raise (SLR) 

To strengthen the muscles of the lower back, it’s worth doing the SLR exercise. To do this, while lying on your stomach, slowly and alternately lift each leg up. In doing so, try to tighten your abdominal muscles. Do an exercise with a delay of two seconds at the highest point of the limb position. As before, do ten reps per set. Such a physiotherapy approach is appropriate for laminectomy, fusion, microdiscectomy, decompression, and of course, implantation.

In some cases, the surgical treatment chosen for a given spinal condition will affect not only the time needed to get back on the playing field but the degree to which you will ever be able to recover your old form. Take the stabilization procedure following spinal decompression surgery, for example. Spinal decompression is performed to relieve pressure on nerves within or emanating from the spine caused by conditions including spinal stenosis, spondylolisthesis, and other degenerative changes or as a result of spinal cord trauma. Spinal fusion back surgery has been the primary stabilization procedure. But the fused vertebrae lose their independent motion following stabilization. Often, patients are restricted from physical activity for up to 6 months while waiting for the biological fusion process to complete. Today, the TOPS™ (Total Posterior Solution) System provides an alternative to spinal fusion. The TOPS™ System, a surgical implant, stabilizes the spine while preserving each vertebra’s independent motion – and the good news is that there are no restrictions on your physical activity after surgery. That’s going to ensure better performance whenever it’s time to get back in the game.

Conclusion

As you improve your range of motion in your spine, it’s time to start doing more challenging activities that will help you get back to working condition. To do this, discuss a possible change in activity with a PCP and trainer and adjust the training schedule. After implantation, you don’t have to worry that you can’t perform some exercises. The TOPS™ System is an alternative to spinal fusion and allows you to perform any range of movements required for warm-up, training, and cool-down.