Spine conditions

Spinal Surgery for a Slipped Disc

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.

Understanding Disc Herniation

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.

Slipped Disc Symptoms

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.

What Can Cause a Slipped Disc?

The most prevalent causes of slipped discs are:

• Spinal degeneration from the natural aging process

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. 

• Injuries caused by excessive stress on the spinal column

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. 

Slipped Disc Treatments

Treatments for slipped disc include:

• Physical therapy

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. 

• Medication to relieve pain and inflammation

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. 

• Surgery

In some cases, surgery for slipped discs is required for the patient to make a full recovery.

When Does a Slipped Disc Require Surgery?

As we’ve already mentioned, slipped discs rarely require surgery and heal with non-invasive methods. However, a slipped disc may require surgery if:

• Non-invasive methods have failed after several months
• The patient is experiencing radiating back pain, (known as sciatica), which isn’t responding to conservative methods
• The patient has constant pain that’s diminishing their quality of life
• The patient’s basic mobility is compromised (i.e. trouble standing and walking)
• The patient has neurological symptoms that are noticeably worsening 

Before undergoing an invasive procedure, patients must talk to their doctors and learn about the slipped disc surgery risks. 

What Kind of Surgery is Done For a Slipped Disc?

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.

How Long Does it Take to Recover From a Slipped Disc Surgery?

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. 

What Is The Success Rate of Slip Disc Operation?

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™. 

• The visual analog scale score for back and leg pain dropped from 56.2 before surgery to 19 7-year post-op mark. 
• The Oswestry disability questionnaire, which is often used to measure back pain, fell from 83.5 before the procedure to 8.8 at the 7-year post-op mark. 
• An MRI examination 7 years after the procedure didn’t show spinal stenosis adjacent to the stabilized segment. 

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.

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 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. 

Back Treatment Options

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

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

When to See a Doctor for Types of Severe Back Pain

 

Back painslows down millions of Americans each year, with symptoms ranging from nuisance soreness to back pain so severe and debilitating that a visit to the emergency room becomes the first step on a path leading to a spinal surgeon’s care. According to the American Association of Neurological Surgeons, back pain is the second most common reason that adults see a doctor.

Back pain can occur anywhere on the back, from the neck (cervical area) to the middle of your back (thoracic area) to the lower back (lumbar area) with the lower back often being the most common location of severe and lifestyle-limiting pain, since the lower back bears most of your weight. That weight can compress the cartilage cushion between your vertebrae. And, over time, you might experience a degeneration of that cushioning cartilage, causing your discs to compress or slide out of place.

Walking, bending, lifting, twisting, even sitting and standing can then become excruciating. Back pain flares up and then goes away on its own after a few days for some people. But for others, sharp pains and limited motion becomes a bigger, more longer-lasting problem requiring medical care.

Here are some of the more severe back pain conditions:

* Disc degeneration. Discs in the spine can deteriorate with age, and the deterioration of discs can lead to inflammation and irritation in the spine, which can cause great pain.

* Sciatica. While many people associate the term ‘sciatica’ with pain in the buttocks area, sciatica can be a painful condition in the back. Sciatica is caused when the sciatic nerve (a bundle of lumbar nerves) become irritated by a herniated disc. This condition is known as spinal stenosis. The sciatic nerve also can be irritated by an abnormality in a vertebra that puts pressure on it. Sciatic pain may be felt in the lower back or buttocks, and may also be felt in the calf and the foot. Sciatica pain can be mild with tingling, or it can become severe, growing worse at night. You might experience worse sciatica pain when you have long stretches of standing or sitting.

* Lumbar spinal stenosis. When spinal degeneration occurs the canal through which spinal nerves travel can narrow. As part of the aging process, discs can dry out and shrink. When these two conditions occur, you might experience painful pressure on a spinal nerve. This can happen with a minor injury, as a symptom of osteoarthritis of the spine, or simply as a symptom of aging. The resulting back pain can be severe.

* Osteoarthritis. Arthritis anywhere in the body can be painful, but when osteoarthritis occurs in the back, you may experience pain and muscle spasms. Osteoarthritis can affect the cartilage in the discs, the vertebrae or both anywhere along the spine, pinching the nerves and causing pain.

*Herniated disc. Also called a ‘slipped disc,’ this condition occurs when a damaged or bulging disc pinches or irritates a nerve root.

When severe back pain occurs, your physician will assess you for any or all of these conditions, and you will likely start on a back pain reduction plan that aims to reduce your discomfort, return your mobility, and manage your back pain flare-ups. Perhaps you and your doctor will decide that spinal surgery is the best solution to remedy the internal causes of your severe back pain, returning you to better quality of life.

The TOPS™ System is one such solution. The TOPS™ (Total Posterior Spine) System provides an alternative to spinal fusion for patients undergoing spinal decompression back surgery. Unlike spinal fusion, TOPS preserves the full range of the spine’s natural motion, and has been shown to provide better outcomes than fusion in clinical studies performed around the world.

Sleep Tips for Back Pain Sufferers

Sleep provides important healing and rejuvenation to your back. When you’re suffering from back pain, it can be difficult to get a solid and healthy good night’s sleep. Lying down can be painful, and sleep simply doesn’t come. One of the many unpleasant symptoms of inadequate rest is being even more sensitive to pain. So it’s essential to take the smart steps necessary to improve your ability to sleep.

It may seem to be an impossible goal, but there are ways to improve your sleep quality while dealing with back pain:

• Get a new mattress. A soft, old mattress that sags and provides inadequate lumbar support may be the culprit causing your back pain. When you sleep with your back arched on a mattress with the slope downward right at your hip level, you’re creating a terrible arch in your spine that can compress nerves and even cause disc damage. Upgrading to a top-quality new, medium-firm mattress that has no sag or slope and can cradle your body in a more natural and healthy position. Yes, a quality mattress is often pricy, but it’s worth the investment to improve your back pain.  Add in a posture-correcting orthopedic-approved pillow for your neck and head.  It will properly position your spine for better sleep and potentially less pain.
• Sleep in a back-supporting position. One preferred position is lying flat on your back, and placing one or two pillows beneath your knees so that your spine is in a neutral, non-arched position while you sleep. If you prefer to sleep on your side, place one pillow between your slightly-bent knees while you lie on your side, and place another pillow against your chest, with your arm draped over it. This second pillow position prevents you from twisting your upper body and keeps your spine in neutral alignment as you sleep. Don’t sleep on your stomach, since this position arches your back and aggravates the spine, nerves and muscles affected in your back pain condition. Some frequent stomach-sleepers place a tennis ball in their pajama front pocket to prevent them from rolling over onto their stomachs during the night.
• Reduce stress. Stress is a cause of chronic back pain, so focus on eliminating the sources of your stresses through meditation or deep breathing methods, journaling, limiting exposure to stressful people, lightening your load of life obligations such as running committees and other stressful jobs, or even getting short-term psychotherapy to deal with larger stressful issues in your life.
• Limit or eliminate caffeine. You might be more sensitive to caffeine than you realize, and even moderate use can affect your sleep quality.
• Don’t eat before bedtime. Limiting your snacking can help prevent nighttime indigestion or acid reflux, and it can also help keep your weight at a healthy level, which is better for your back.
• Talk to your doctor about nighttime pain medications that can help you sleep. Your physician will assess your best pain medication regimen, which might include muscle relaxants, over-the-counter pain relievers, such as aspirin, Tylenol (acetaminophen), or Advil or Motrin IB (ibuprofen) which can be effective for short-term use and might be available in a ‘PM’ formula that can help you sleep.  Naproxen sodium (Aleve) is long-lasting and may offer pain relief throughout the night. Use these medications only as directed and with a doctor’s care.
• Talk to your doctor about gentle exercises. Always consult with your doctor about recommended back pain-calming exercises. Never look online for ‘back pain exercises’ to do on your own, since your back might not be strong enough at this time for some exercises like planks or resistance band work. Your doctor will start you off slowly with a few exercises that can calm your back pain before bed, and then work with you to progress your back-improving movements over time.
• Practice a good bedtime routine. Turn off the television and computer, dim the lights in your room to ready your body for sleep, cool your bedroom with a fan to help you sleep better, and avoid reading or working in bed before sleep. Winding down can prepare your mind, as well as your body, for a deep, restful sleep that lets your body heal better, and after a good eight hours of healthy sleep can make your pain levels easier to tolerate in the daytime.

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.