Spine Surgery

What is a Lumbar Laminectomy?

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

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

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

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

What is a Laminectomy 

Lumbar Laminectomy is a spinal surgery involving the removal of the vertebral bone to alleviate symptoms of spinal stenosis. Laminectomy surgery is relatively common for major surgery. Its main function is to reduce spinal pressure on the cord and nerve roots when they are being unnaturally restricted. This surgery is for those suffering from various ailments, including those sustained from past injuries, herniated disks, spinal stenosis, and tumors. While there are alternative methods to try before getting to this point, such as physical therapy, medication, and even injections, some may find this is the only path to relief.

While determining what is a laminectomy, we should deconstruct the name. Lamina is the scientific name for the vertebral bone. This surgery, Lumbar Laminectomy, is the process of removing the vertebral bone to lift pressure surrounding the spinal canal. Pressure is created by things like impacted bone injury, bone overgrowth, or growing tumors. A decompressive laminectomy increases available space and therefore alleviates any pain sufferers may be experiencing. While the surgery itself is great, so are the results. 

What is a Laminectomy? 

Lumbar laminectomy is a spinal surgery involving the removal of vertebral bone, called the lamina, to alleviate symptoms of spinal stenosis.

The lamina is a piece of bone that covers the back of the spinal canal. It protects the spinal cord and supports the canal as a whole. In removing some of all of it during a laminectomy, your surgeon can decompress impinged spinal nerves, offering relief from conditions like spinal stenosis.

Laminectomy surgery is a relatively common spinal decompression procedure. Its main function is to reduce spinal pressure on the cord and nerve roots when they’re impinged, compressed, or inflamed. This procedure is implemented for those suffering from various ailments, including those sustained from past injuries, herniated discs, spinal stenosis, and spinal tumors.

It’s worth noting that several non-invasive, alternative methods exist and are typically recommended before laminectomy. These include lifestyle changes, physical therapy, medication, and even steroid injections. However, after trying these remedies for several months to no avail, some may find that surgical laminectomy is the only path to relief.

When answering the question “what is a laminectomy?”, we should deconstruct the name. Lamina is the scientific name for the vertebral bone that covers the back of the spinal canal. This surgery, lumbar laminectomy, is the process of removing this vertebral bone to alleviate pressure within the spinal canal.

Pressure may be created by various factors, including an impacted bone injury, bone overgrowth, age-related spinal degeneration, or growing tumors. A decompressive laminectomy increases available space within the canal, therefore alleviating pain and neurological symptoms that you may be experiencing. While the surgery itself is well-documented and considered safe, the results are equally as compelling. 

According to a 2022 study, patients who underwent laminectomy for lumbar spinal stenosis experienced less disability and pain after the procedure. These patients were also able to be more physically active after laminectomy. The rate of reoperation in this study was 14%. 

Laminectomy and other spinal decompression procedures are conventionally performed with spinal fusion to restabilize the spine. However, modern innovations like the TOPS System can improve outcomes from spinal decompression by stabilizing the spine without permanently fusing the vertebrae. These remarkable advancements are available to today’s laminectomy patients, boosting treatment safety, satisfaction, and results. 

What is Spinal Stenosis

If you are considering spinal laminectomy you may likely be suffering from spinal stenosis. Spinal stenosis is one of the most common spinal ailments. Since stenosis means narrowing or restricting, this condition refers to the unnatural narrowing of the spinal canal. This condition often develops for unknown reasons but can be caused by an overgrowth of either bone or tissue. Some cases may be hereditary, while others arise from an unhealthy lifestyle. 

Options Before Surgery

Everyone can benefit from a healthy lifestyle, including those suffering from spinal stenosis or other spine stemming pain. Simple solutions like a healthy diet, regular exercise, and maintaining a healthy BMI can all reduce pain and symptoms. While these are idealistic options, they also are not the solution for everyone. It is possible that someone’s back pain is so great they are limited in the forms of exercise they can partake in.

Physical therapy is another noninvasive option that patients can try before getting a lumbar laminectomy surgery. Because most patients suffer from pain in their back and legs, it can be helpful to have a physical therapist to assist in teaching the body how to move through these debilitating pains in a way that can offer some relief. Physical therapy assigned exercises to have the ability to release pressure similar to surgery, though the effects are often not as long-lasting. 

Medication is also available to those suffering from inescapable pain. Some medications offered can help with both pain and inflammation so that those suffering from spinal stenosis are able to manage their symptoms throughout their day.

While these solutions can help manage and relieve pain, ultimately, they do not offer more stability to a destabilized spine, nor do they permanently create space in the spine where the pressure afflicts. In cases of long-term relief, most find that surgery is necessary to moving forward into a pain-free life.

Laminectomy Surgery

In deciding if surgery is right for you, it helps to know exactly what is to be expected during the procedure. A doctor uses general anesthesia to put the patient under for the duration of the surgery. In the process of the surgery, the surgeon makes a small cut into the back, right over the affected area. They then enter through this cut with small tools to lift the muscle away from the spinal column. The lamina is then removed to create space in the narrowed spinal canal.  In the case of a herniated disk, the doctor can then remove the parts of the disk that have herniated. 

Traditionally after this, the vertebrae would be fused to create stability in the spine to supplement the removed lamina. This is done with either bone graphs, screws, or metal rods. While efficient in rendering the spine functional post-operation, it does create limited mobility that can impede some physical activities.

How to Prepare for Laminectomy Surgery

Laminectomy Surgery is major surgery. Many are intimidated by spinal surgery because it is such a crucial part of our body and people often have a fear of how their life changes after. Here is how to prepare for optimal recovery.

• Consider your new mobility while you recover. With a limited range of motion, you should consider buying a pair of slip-on shoes to avoid bending down and straining.
• Ensure frequently used items are in easy-to-access spots. This may look like lowering things from high shelves as well as heightening objects that previously required bending over to reach them. Remember, this is temporary.  Once healed you should be able to reach all these things again without any pain or discomfort. 
• Do some meal prepping. The less work you have to do while recovering the quicker you heal. This also means you can rely less on others and be more self-sufficient in a time when you may feel dependent on others.
• Finally, on the day of the surgery, make sure you fast before going in. Like most surgeries that require general anesthesia, you are advised to stop eating and drinking by midnight the night before. Some water is allowed the morning of the surgery, but a full stomach can pose complications once you are under.

Laminectomy Recovery

Once you wake from the surgery your care team checks to ensure everything has gone smoothly and your body has responded well to the spinal laminectomy surgery. While a short hospital stay is typical, some people are released the same day. This means that no matter the case, the comforts of home are not too far away.

Upon returning home, rest! Though it is healing in the long run, your body has just sustained a major injury and needs time and care to recover. Give yourself grace and let people help with things like meals and keeping the house running. Letting yourself rest at this time is crucial for long-term recovery.

It is recommended that you do not work for the first few weeks following a decompressive laminectomy. Those with less physically demanding jobs return to work sooner than those with more labor-intensive jobs. If you have a spinal fusion laminectomy recovery takes longer.

How to Make Spinal Surgery Less Traumatic

The results of lumbar laminectomy, while impressive, may take a while to work. There are records of patients taking up to a full year to complete their laminectomy recovery. Those who do go through with the surgery are also sometimes recommended physical therapy as a part of their recovery process.  This leads to a long and involved path back to normalcy.

If you are looking for a way to make your laminectomy surgery and recovery less traumatic, consider a spinal implant. TOPS system uses an implant after decompression is completed to prevent the necessity for spinal fusion. Where traditionally vertebrae are fused after laminectomy surgery, TOPS implants hold the space where the vertebrae were removed, combining the relief of the surgery with all the mobility and freedom you had before. 

Regain your mobility with Premia Spine! Contact us now

Patients who have had a TOPS System implant report faster and easier laminectomy recoveries than those who received traditional spinal fusions. Because the spine is the foundation of the human body it is important you take the path offering the greatest recovery and mobility post-surgery. Does this look like a spine that has been fused together, or upgraded with an implant?

Life After Laminectomy

While it is a big decision to make, ultimately it comes down to regaining your life. Those who have spinal laminectomy are choosing a life free of debilitating pain and getting back the body they once knew. Lumbar laminectomy patients are often happier and healthier, having chosen the care right for them.

Motion Preservation Surgery in The Lumbar Regions of The Spine

The lumbar region of the spine is the most susceptible to pain and injury. This is due to its mobility combined with the amount of weight that it must carry with day-to-day movements. 

Table of Contents

• What is Motion Preservation Surgery?
• Motion Preservation Surgery of The Lumbar Spine
• Motion Preservation Device Example
• What Are The Benefits of Motion Preservation Surgery?

When conditions affecting the lumbar spine (such as spinal stenosis and spondylolisthesis) don’t improve with non-surgical treatment, surgery may be required. Spinal fusion has been widely used over the past several decades to stabilize the spine, namely after spinal decompression surgery. 

The many downsides of spinal fusion, including reduced mobility and the risk of adjacent segment degeneration, have paved the way for better alternatives. Now, motion preservation surgery is being used in place of traditional lumbar spinal fusion for better clinical outcomes.

What is Motion Preservation Surgery?

Motion preservation surgery refers to surgical methods that can be used in place of conventional spinal fusion. As the name suggests, these methods preserve the natural movement of the spine in the affected area.

The goal of motion preservation surgery is to avoid the risks and downsides associated with spinal fusion surgery. 

Motion Preservation Surgery of The Lumbar Spine

Distinct challenges are present for motion preservation surgery of the lumbar spine. As mentioned at the beginning of this article, the lumbar spine is mobile and undergoes a significant amount of weight with normal activities. These characteristics make it difficult to stabilize the lumbar region while preserving its mobility. 

Despite these challenges, patients with spinal conditions affecting the lumbar spine now have multiple options of motion preservation surgery at their disposal, including:

• Interspinous spacer

An interspinous space is placed in between the spinous processes at the back of the spine. It helps alleviate symptoms of spinal stenosis by creating more space in the central spinal canal and foramen. 

• Total element replacement device

A total element replacement device is inserted after spinal decompression surgery to replace all of the elements located in the back of the spine. This provides support and pain relief for patients with spinal stenosis. 

• Facet replacement device

A facet replacement device is also used to treat spinal stenosis, which is often caused by facet joint degeneration. This type of device takes the place of facet joints at the back of the spine for controlled motion and pain relief.  

• Posterior dynamic stabilization device

A posterior dynamic stabilization device acts like a brace for the spine. The goal of this type of device is to allow a controlled, natural range of motion for the spine. 

Posterior dynamic stabilization devices are generally used to treat spinal stenosis, spondylolisthesis, and degenerative disc disease.   

Motion Preservation Device Example

The TOPS System from Premia Spine is a specific example of a posterior dynamic stabilization device that allows for a controlled range of motion in the treated vertebrae. The TOPS System is designed for use at a single level between L2 and L5. As a motion-preserving implant, it allows movement in flexion and extension, rotation, and lateral bending while blocking sheer forces on the lumbar spine. 

The TOPS device replaces structures removed during spinal decompression surgery, like the lamina or facet joint. It includes internal metal stoppers that take the place of the natural bony elements that acted as stoppers in axial rotation. The device’s boot and internal components replace the supraspinous and interspinous ligaments, as well as the ligamentum flavum, which naturally handle flexion. 

Clinical studies carried out since 2005 have shown that the TOPS System relieves chronic lower back and leg pain for patients suffering from moderate to severe spinal stenosis (with or without spondylolisthesis and facet arthrosis). 

Availability of Posterior Dynamic Stabilization Devices in The U.S.

The TOPS System has long been approved and used successfully in Europe and other countries across the globe. In the U.S., clinical trials for the TOPS System are currently underway.

TOPS earned the Breakthrough Device Designation from the U.S. Food and Drug Administration (FDA) in 2021. This designation will accelerate and prioritize the FDA’s review of this device during its regulatory process in the U.S.

What Are The Benefits of Motion Preservation Surgery?

Motion preservation surgery offers several benefits over conventional spinal fusion, including:

Reduced Risk of Adjacent Segment Disease

Adjacent segment disease, or ASD, occurs when the vertebrae surrounding a fused segment degenerate at a faster than normal rate. With all motion eliminated at the fused segment, the adjacent vertebrae must undergo more impact with day-to-day activities. ASD may lead to symptoms including:

• Lower back pain
• Pain that radiates from the lower back to the extremities
• Neurological symptoms
• Pain while walking and/or standing 

By preserving the patient’s range of motion in the spine, motion preservation surgery decreases the risk of ASD. 

Shorter Recovery Period

Since motion preservation surgery omits the extensive bone grafting and fusion process, it involves a shorter, less painful recovery period. It also allows for less blood loss during the procedure when compared to spinal fusion. 

Preserved Spinal Mobility

Though obvious from the procedure name, preserved spinal mobility is a key benefit of motion preservation surgery. Reduced spinal mobility is one of the largest downsides of spinal fusion, as it can have a major, negative impact on patients’ post-op quality of life. Though spinal fusion can alleviate patients’ spinal symptoms, it may also eliminate their ability to partake in their favorite activities. 

One of the prominent goals of lumbar motion preservation surgery is to create a controlled range of motion in the lumbar spine. This provides spinal stability and pain relief without significantly limiting patients’ activities after the procedure. 

Lower Risk of Needing Revision Surgery

Since motion preservation lowers the risk of injury to the adjacent spinal segments, it also lowers the odds that the patient will require revision surgery. An estimated 8% to 45% of spinal fusion patients require revision surgery. 

Motion preservation surgery is an exciting alternative to spinal fusion for patients suffering from lumbar spine conditions and disorders. Contact a spine specialist today to learn more about this treatment option. 

What is Spondylolisthesis?

If you’re struggling with persistent back pain along with numbness, tingling, or weakness, you may have a spinal condition. Spondylolisthesis is one possible condition that can trigger these symptoms and ultimately compromise your quality of life. 

In this article, we’ll dive into the topic of spondylolisthesis and explain what patients can expect from a spondylolisthesis diagnosis. While the prospect of managing this condition may seem intimidating, rest assured that there are numerous effective treatment options for spondylolisthesis. 

What is Spondylolisthesis?

With spondylolisthesis, one of the vertebrae in the spine becomes displaced due to instability. As a result, it moves downward in relation to its proper position, settling on the vertebra beneath it.

This malpositioning can put pressure on the spinal cord, as well as the nerves that emanate from the spinal column. This pressure can lead to pain in the lower back and leg.  

Spondylolisthesis of the lumbar region (meaning that it occurs in the lower back) is the most common. Specifically, the L5-S1 level of the spine is most frequently affected by spondylolisthesis, followed by the L4-5 level. 

Is Spondylolisthesis The Same As a Slipped Disc?

You’ve probably heard the common medical term, “a slipped disc”. While this may seem to indicate the slippage involved in spondylolisthesis, it’s an entirely different condition. 

Spondylolisthesis affects the spinal bones, which are known as vertebrae. A slipped disc is an injury involving an intervertebral disc, which is a cushion of shock-absorbing tissue. There’s an intervertebral disc located in between each of the vertebrae in the spine. 

Given that spondylolisthesis and a slipped disc affect different parts of the spine and develop differently, it’s crucial to distinguish them. A spinal specialist can give you an accurate diagnosis of back pain. 

Spondylolisthesis vs. Spondylolysis

As another spinal condition that’s commonly confused with spondylolisthesis, you may have heard of spondylolysis. This condition, unlike a slipped disc, is related to spondylolisthesis. However, they’re still different conditions. 

Spondylolysis is a stress fracture that runs through the pars interarticularis, a small segment of bone that connects two vertebrae. When the pars interarticularis is fractured, patients may experience back pain that worsens with physical activity. However, not all spondylolysis patients have symptoms. 

Approximately one out of 20 people have spondylolysis, making it a relatively common condition. Additionally, spondylolysis can lead to spondylolisthesis. This is because the pars interarticularis fracture can diminish the stability of the spine and potentially lead to slippage. 

What Are The Most Common Causes of Spondylolisthesis?

Spondylolisthesis has several possible causes, the most common of which include:

• Spinal degeneration

The most common cause of spondylolisthesis is degenerative changes in the vertebral joints and cartilage due to aging. When spondylolisthesis is caused by age-related spinal changes, it’s known as degenerative spondylolisthesis.

• Birth defects

Younger individuals may experience spondylolisthesis caused by a birth defect in the facet of the vertebra. The defect, which is present at birth, can cause the vertebra to slip out of position. This is referred to as dysplastic spondylolisthesis. 

• Spinal trauma

Spondylolisthesis can also result from sudden trauma, such as a sports injury or car accident. This is known as traumatic spondylolisthesis and can occur in people of all ages. 

• Sports injury

In athletes that repetitively strain and overstretch the spine, spondylolisthesis is a relatively common injury. This is especially true in younger athletes, given that their spines haven’t fully developed.  

Key Spondylolisthesis Symptoms 

Lower Back Pain

The most frequent symptom of lumbar spondylolisthesis is lower back pain. The pain typically worsens after exercise and abates when you sit or bend forward.

Reduced Mobility

Decreased range of motion and tightness of the hamstring muscles are common spondylolisthesis symptoms.

Neurological Symptoms

The nerve compression may also result in pain, numbness, tingling, or weakness in the legs, and in cases of severe compression, loss of bowel or bladder control.

Spinal Stenosis

Spinal stenosis isn’t exactly a symptom of spondylolisthesis. However, degenerative spondylolisthesis is a prevalent cause of spinal stenosis, which is an abnormal narrowing of the spinal canal. 

How Is Spondylolisthesis Diagnosed?

A physician specializing in spinal disorders can diagnose spondylolisthesis using radiographs and x-ray imaging, as well as a comprehensive physical exam. You’ll likely stand sideways as the x-rays are taken so your physician can see the vertebra’s slippage clearly.

After your physician has examined the imaging test results, the severity of your spondylolisthesis case will be graded. The grading scale is based on the degree of slippage from the vertebra’s normal position.

Upon making a diagnosis, a physician can recommend appropriate treatments for spondylolisthesis.

What Are Spondylolisthesis Grades?

As aforementioned, spinal specialists use a grading system to determine the severity of spondylolisthesis cases. Spondylolisthesis grades include:

• Grade I: 1% to 25% slippage
• Grade II: 26% to 50% slippage
• Grade III: 51% to 75% slippage
• Grade IV: 76% to 100% slippage
• Grade V or Spondyloptosis: Over 100% Slippage

What Makes Spondylolisthesis Worse?

Several factors can worsen spondylolisthesis, including:

• High-intensity physical activities
• Heavy lifting
• Poor posture
• Being involved in an auto accident

If you’ve been diagnosed with spondylolisthesis, your physician likely recommended lifestyle adjustments to help you avoid the factors listed above. 

Spondylolisthesis Exercises To Avoid

Any exercises that involve heavy lifting and excessive twisting or bending should be avoided with spondylolisthesis. If you enjoy a specific sport, you should talk to your physician about whether it’s safe to participate in that sport while you’re struggling with spondylolisthesis symptoms.  

Sports that tend to exacerbate spondylolisthesis symptoms include:

• Weightlifting and powerlifting
• Running
• Football
• Soccer
• Diving
• Competitive swimming
• Gymnastics
• Certain types of dance, including ballet

Spondylolisthesis Treatment

Treatments for spondylolisthesis include physical therapy, exercises for relieving pressure on the affected spinal nerves, medication, and epidural steroid injections. In many patients, these treatments are sufficient to alleviate the symptoms of spondylolisthesis.

What Does Physical Therapy For Spondylolisthesis Involve?

Physical therapists can help patients manage spondylolisthesis in several ways.

For one, your PT can offer valuable insights and education about how your lifestyle is affecting your symptoms. From your exercise regimen to your footwear to your posture, your physical therapist can identify areas for improvement. In making the recommended adjustments, you can likely reduce the pressure on your spine, leading to an improvement in spondylolisthesis symptoms. 

Additionally, your PT can implement various non-invasive methods of pain management. Targeted heat and cold therapy can help alleviate inflammation and pain. Electrical stimulation is another popular method among physical therapists to gently reduce the transmission of pain signals to the brain. 

Physical therapists can also recommend stretching and strengthening exercises for spondylolisthesis. By stretching to reduce muscle tension, you can gain greater back flexibility. By strengthening various muscle groups, you can gain greater stability in the lumbar spine, hips, and pelvis. 

Does Chiropractic Care Help With Spondylolisthesis?

Many spondylolisthesis patients find that chiropractic care is a helpful tool for alleviating their symptoms. Chiropractors specialize in spinal manipulation to treat issues involving the musculoskeletal system.

Key goals of chiropractic care for spondylolisthesis include improving spinal mechanics, restoring spinal function, and improving posture. In achieving these goals, your chiropractor may alleviate compression on the spinal nerves, which often leads to reduced symptoms. 

One of the main benefits of chiropractic care for spondylolisthesis is that it’s non-invasive. Chiropractors focus on methods including manual and instrument-assisted manipulation to adjust the spine, making it a safe back pain treatment option. 

Which Medications Are Used To Treat Spondylolisthesis?

Physicians often recommend over-the-counter medications to help spondylolisthesis patients manage pain and inflammation. In more advanced cases that don’t improve with over-the-counter options, physicians may instead suggest prescription medications. 

There are a few different types of drugs that may help with spondylolisthesis. The main types include:

• Analgesics

In simpler terms, analgesics are painkillers. These over-the-counter medications’ primary function is to relieve pain. The most common analgesic is acetaminophen, or Tylenol. 

• NSAIDs (non-steroidal anti-inflammatory drugs)

NSAIDs alleviate inflammation along with pain. There are numerous over-the-counter NSAIDs, such as aspirin, Aleve, and Advil (ibuprofen), as well as prescription NSAIDs. 

• Neuropathic agents

This type of prescription medication can be helpful for patients suffering from spondylolisthesis nerve pain. Neuropathic agents target nerve pain directly and can help with spondylolisthesis symptoms including tingling, numbness, and weakness.

Gabapentin and pregabalin (Lyrica) are two of the most commonly prescribed neuropathic agents for spondylolisthesis. 

• Muscle relaxants

Some spondylolisthesis patients experience chronic back pain caused by muscle spasms in the back. In these cases, physicians may prescribe a muscle relaxant to stop the spasms. Soma, Flexeril, Baclofen, Tizanidine, and Robaxin are among the most widely prescribed muscle relaxants. 

Will I Need Spondylolisthesis Surgery?

For patients with moderate to severe spondylolisthesis who don’t respond to conservative therapies, physicians may recommend spinal decompression surgery. The idea of undergoing surgery can be daunting, but note that most patients’ symptoms improve with non-surgical treatment.

If you and your physician determine that surgery is the right route of treatment, you’ll likely discuss the spinal decompression procedure. 

What is Spinal Decompression?

Spinal decompression involves removing portions of the vertebrae that impinge on the spinal cord and nerve roots. There are several different approaches to spinal decompression, including laminectomy, foraminotomy, discectomy, and corpectomy. For spondylolisthesis, surgeons often opt for laminectomy. 

Laminectomy involves removing some or all of the lamina. This is the small section of bone that covers the back of the spinal canal. By removing it, your surgeon can create more space for the spinal nerves and alleviate nerve impingement. 

Spinal decompression can have a dramatic effect, relieving pain and other spondylolisthesis symptoms. However, removing portions of the lamina reduces the stability of the spinal column. So, after decompression surgery, spinal stability remains a key concern for spondylolisthesis patients.

This is why surgeons traditionally perform spinal fusion after spinal decompression. 

What is Spinal Fusion?

Spinal fusion involves placing bone graft material in between the affected vertebrae. Then, screws and rods are implanted to secure the graft in place and provide additional stability.

In the period following spinal fusion surgery, the bone graft material will spur the permanent joining of the affected vertebrae. This prevents all movement between the fused vertebrae, which can prevent instability in spondylolisthesis patients. 

Unfortunately, in stabilizing the vertebrae, spinal fusion eliminates the natural independent motion that gives the spine flexibility. This diminishes patients’ ability to carry out certain movements, namely those that require the bending or twisting of the spine. Fusion has also been shown to promote the deterioration of adjacent vertebrae.

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The TOPS™ System For Spondylolisthesis

In a seven-year study for patients with degenerative spondylolisthesis and lumbar spinal stenosis, the TOPS™ System maintained clinical improvement and stability. Additionally, in a five-year study of the TOPS™ System for 10 patients with degenerative spondylolisthesis and lumbar spinal stenosis, the clinical outcome scores “improved significantly across all scoring systems”. In this study, there were no failures at five years and no patients required revision surgery.   

The TOPS™ device is approved for use in Europe and many other countries. In the United States, the FDA granted Premia Spine approval to begin an IDE investigation of the TOPS™ System. 

TOPS™ Testimonials

Patient and surgeon testimonials are highly encouraging for the TOPS™ System as a spondylolisthesis treatment. Many patients note that they’re able to return to their favorite activities after the TOPS™ procedure, as it preserves spinal mobility. 

We encourage anyone with persistent back problems to consult a physician who specializes in spinal disorders and learn about the latest available treatment options.

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.

Is There a Cure for Lower Back Pain?

Lower back pain is one of the most common medical problems affecting the human population. One reason this problem is so common is because back pain can have many different causes. So if you’re wondering if there’s a cure for your lower back pain, the answer depends on what is causing it. Muscle and ligament strains can cause intense back pain. Many times these strains can be cured with simple rest. Where rest alone won’t relieve the back pain, non-invasive treatments such as medications, steroidal injections, and physical therapy will often ameliorate the symptoms, if not provide an outright cure. For spinal conditions such as spinal stenosis and related disorders of the spine – common causes of lower back pain, with onset typically after the age of 35 – non-invasive treatments may also provide relief. In some cases decompression spinal surgery may be performed to relieve pressure on affected spinal nerves. During this surgery, a surgeon trims away portions of a vertebra that impinge on a nerve. (This impingement is commonly referred to as a pinched nerve.) Spinal decompression surgery can have a dramatic and immediate impact on reducing back pain, providing patients with some level of a “cure.” Traditionally spinal fusion back surgery has been performed in conjunction with spinal decompression, to stabilize the vertebrae where the operation was performed. But spinal fusion eliminates the natural flexion between the fused vertebrae, and can contribute to deterioration of adjacent vertebrae. Today spinal decompression patients have a superior alternative to spinal fusion. The TOPS System from Premia Spine preserves the natural motion of the spine, and has been proven to provide superior results to spinal fusion in clinical trials conducted worldwide.

If you experience lower back pain, the first priority is to identify its cause. Whatever the root of the problem, you will likely have a number of options for effective treatment that will relieve the pain, and in many cases cure the condition.

What is Lumbar Spinal Fusion?

Chronic lower back pain is an extremely common medical issue across the world. In a study conducted to determine the global prevalence of this health concern, approximately 19.6% of individuals aged 20 to 59 were found to experience chronic low back pain. 

Given the high prevalence of persistent low back pain among the adult population, various treatments have gained recognition in recent years. So, anyone who’s had chronic lower back pain has likely heard the term “lumbar fusion”. But, what exactly is lumbar fusion?

Here, we’ll answer that question, along with common queries about recovery from lumbar fusion and fusion alternatives. 

What is Lumbar Fusion?

Lumbar fusion is a surgical procedure performed on the lower, or lumbar, a portion of the spine. Its goal is to stabilize the back after spinal decompression surgery to relieve pain, restore mobility, and/or alleviate other symptoms of pinched nerves in the lower back.

The procedure is also called lumbar spinal fusion, or simply spinal fusion. It takes its name from the fact that two (or occasionally more) adjacent vertebrae are fused as a result of the procedure.

During spinal decompression, the surgeon trims away portions of a vertebra impinging on the pinched nerve. This compromises the strength of the vertebrae. So, lumbar spinal fusion surgery has traditionally been performed in conjunction with spinal decompression therapy to stabilize the spine. 

In lumbar fusion, the surgeon accesses the vertebrae to be fused and secures bone graft material in between them. During the recovery period, the bone graft material will stimulate the fusion of the vertebrae, causing them to combine into a single bone. 

Why is Lumbar Fusion Performed?

Conditions including spinal stenosis, spondylolisthesis, and degenerative disc disease can develop as a result of traumatic injuries or natural age-related degeneration. These spinal conditions can cause symptoms including tingling, numbness, pain, restricted mobility, and even paralysis.

The lower back is more susceptible to injury and degeneration because it’s subjected to bending, twisting, and other physical stresses throughout a lifetime. Poor posture can exacerbate the issue by misaligning the spine, which puts an additional impact on the lower back. 

Physical therapy, medication, and/or steroid injections can relieve many of the symptoms of these spinal disorders. However, when these therapies aren’t effective, a spinal decompression procedure to relieve pressure on these nerves may be recommended.

In short, lumbar fusion may be performed for common spinal problems in patients who don’t respond to six months or more of conservative treatment. 

How is Lumbar Spinal Fusion Performed?

There are several methods of fusion surgery, the most common of which are PLIF, ALIF, TLIF, and XLIF. 

• PLIF

PLIF stands for posterior lumbar interbody fusion. With this method, the surgeon accesses the spine through an incision in the back. This is considered the traditional method of spinal fusion. Unfortunately, it requires the surgeon to pull the muscles away from the spine to access the spinal bones, which can trigger significant pain during the recovery process. 

• ALIF

ALIF is an acronym for anterior lumbar interbody fusion. This method involves accessing the spine from the patient’s front, which is known as an anterior approach. The incision is made in the abdomen, then the surgeon moves aside intestines and large blood vessels to reach the spine. 

The benefit of ALIF is that it doesn’t agitate the large back muscles, which leads to a lower risk of injury and complications than PLIF. 

• TLIF 

TLIF is short for transforaminal lumbar interbody fusion. This method of spinal fusion involves a posterior incision, meaning that it’s made in the back. But, unlike PLIF, the incision used in TLIF is made by way of the intervertebral foramen. 

With TLIF, the surgeon can complete a fusion on the front and back of the spine in one procedure. This is beneficial for patients because it’s less invasive, involves a lower risk of injury, and leads to less scarring. 

• XLIF

XLIF stands for extreme lateral interbody fusion. This method of spinal fusion is considered minimally invasive, making it a highly attractive option for modern patients. 

In XLIF, the surgeon first takes x-rays to find the exact position of the affected spinal disc. Then, the surgeon makes an incision in the patient’s side, completely avoiding the large back muscles and blood vessels that obstruct the spine in PLIF and ALIF surgery. 

XLIF leads to less blood loss, pain, and lumbar fusion surgery recovery time, as well as a shorter hospital stay.   

What Is The Success Rate of Lumbar Spinal Fusion?

Medical professionals often disagree about how to determine the success rate of lumbar spinal fusion. As a result, there are no standard criteria to calculate the success rate of a fusion procedure. Many physicians argue that while fusion successfully prevents spinal instability after decompression surgery, it does so at the expense of the patient’s mobility. 

So, while spinal fusion can help improve patients’ back pain by around 60% to 70%, it’s crucial to consider the lost motion at the fused vertebrae with this percentage.   

How Long Are You in Hospital After Spinal Fusion?

Spinal fusion typically requires a hospital stay of two to four days. This gives the affected vertebrae time to solidify.

During their time in the hospital, patients generally work with physical and occupational therapists to learn how to best carry out daily tasks (like standing, walking, and getting dressed) without disrupting the lumbar fusion recovery process. Additionally, your therapist will talk to you about the exercises to avoid after lumbar fusion.

Before discharging a spinal fusion patient, the hospital staff will make sure that their pain is effectively managed with medication; that there’s no indication of infection; that they can get out of bed and move without assistance; and that they can empty their bladder. 

Can You Live a Normal Life After Spinal Fusion?

The main drawback of lumbar fusion is that it eliminates the natural independent movement of the vertebrae. This inhibits patients from bending, flexing, and twisting the spine as they could before the procedure. Your doctor will advise you of this, as well as other lumbar fusion precautions before you undergo the surgery.

The degree of spinal mobility lost will depend on the location of the fused vertebrae, as well as the number of vertebrae that are fused. However, for many patients, fusion takes away their ability to partake in certain physical activities, such as sports and other athletics. 

After spinal fusion, some patients are no longer able to bend down and pick up items off of the floor. In this case, the patient will require special tools to retrieve objects. 

Other Downsides of Spinal Fusion

Additionally, it’s worth noting that patients may need as long as a year to fully recover from lumbar spine fusion. This lengthy recovery period can significantly impact patients’ quality of life.

In some patients, lumbar spinal fusion leads to a complication known as adjacent segment disease or ASD. With this condition, the vertebrae that are adjacent to the fused vertebrae degenerate at a faster rate. This is because the adjacent segments undergo added stress as a result of the fusion. 

Unfortunately, ASD can cause back pain, stiffness, and neurological symptoms like weakness, numbness, and tingling.  

What are the alternatives to lumbar fusion?

Non-fusion spinal implants are alternatives to lumbar fusion. Today the TOPS™ (Total Posterior Solution) System is one such implant that provides a clinically superior alternative to spinal fusion. It allows the individual vertebrae to maintain their full range of independent motion. 

This is just one reason why lumbar spinal decompression candidates must know exactly what lumbar fusion is, as well as the full range of treatment options available. If you suffer from chronic back pain, ask a spine specialist about the comprehensive selection of therapies at your disposal. 

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. 

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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 much physical therapy do I need after spinal surgery?

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

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

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

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

Are some spinal surgeries more successful than others?

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

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

What is Endoscopic Spine Surgery?

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

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

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