Spine Surgery

What Is XLIF?

Thanks to breakthroughs in spinal medicine, patients today can benefit from treatment regimens and procedures tailored to their individual needs and specific conditions. Among these recent advances on the surgical front is eXtreme Lateral Interbody Fusion, or XLIF.

What is XLIF Spine Surgery?

XLIF refers to a type of spine fusion surgery. In this procedure, the surgeon reaches the spinal disc from the side of the body, which is known as a lateral approach. This is unlike other methods, which access the spine anteriorly (from the front of the body) or posteriorly (from the back of the spine)

For patients suffering from symptoms of spinal conditions, XLIF spine surgery is to assuage nerve root compression in the spine, correct spinal deformities, and resolve spinal instability. 

XLIF Procedure Process

XLIF is among the endoscopic spine surgery procedures performed with microsurgery tools and techniques. It’s generally performed with general anesthesia, so the patient is asleep through the procedure. Additionally, XLIF takes about an hour to complete. 

Electromyography in XLIF

Nerves extending from the backbone are positioned near the psoas, which can be compromised during surgery. To avert nerve damage, the XLIF procedure utilizes electromyography (EMG), a type of neuromonitoring. This enables the surgeon to examine the nerves that emerge out of the spine throughout the procedure, making sure that they’re not inflamed or damaged.

Fusion

XLIF falls into the category of back surgery involving the removal of the disc in the front of the spine. Then, an implant that holds a bone graft is used to replace the disc. The graft enables the two vertebrae to fuse between the disc area in a process known as spinal fusion.

For patients with chronic back pain, XLIF provides a method of spinal fusion for the treatment of several different lower back disorders.

Steps of XLIF

1. The first step of XLIF surgery is to put the patient under general anesthesia. 
2. Next, with the patient positioned on one side of the body, the surgeon will take x-rays. Using the information gathered from these x-rays, the surgeon can define the exact position of the intervertebral disc that will be extracted. 
3. With the position of the disc marked on the patient’s skin, the surgeon will create an incision in the patient’s flank. The flank is located in between the hips and lower ribs. 
4. Next, the surgeon will adjust the peritoneum aside from the abdominal wall. The peritoneum protects and encompasses the organs of the abdomen. 
5. The surgeon will then make a second incision in the side of the body. A dilator will be placed into the incision, and the position of the dilator is checked with an x-ray. The dilator should be positioned precisely above the intervertebral disc. 
6. To gain access to the spine, the surgeon will use a probe to separate the psoas. Then, a retractor can be used to allow spinal access. 
7. With a path to the spine, the surgeon will remove the nucleus (interior) of the affected intervertebral disc. This step, which is referred to as discectomy, preps the area for fusion. 
8. A spacer containing bone graft material will then be placed into the disc area. The spacer maintains the position of the vertebrae and helps with the fusion process. 
9. In some cases, the surgeon may opt to complete posterior fixation with rods and facet/pedicle screws. This step can provide spinal stability after XLIF surgery. 

How Does XLIF Differ From Conventional Spine Procedures?

XLIF differs from the traditional posterior approach for spine surgery, which is called posterior interbody fusion (PLIF). Since PLIF involves reaching the spine from the back, the procedure requires the surgeon to disturb the large back muscles. Doing so triggers a lengthy recovery process, along with significant pain in the post-op period. 

Additionally, XLIF is a minimally-invasive form of spine surgery, unlike PLIF. Along with a shorter recovery period and less postoperative discomfort, minimally-invasive procedures offer the benefit of a lower risk for medical conditions.  

What Are The Benefits of XLIF?

• Requiring only small incisions, XLIF surgery minimizes tissue damage, blood loss. and scarring. 
• XLIF has a relatively quick recovery time, especially when compared to conventional spine surgery.
• Taking as little as an hour to complete, XLIF minimizes the amount of time that the patient spends under anesthesia. 
• Since the back muscles, ligaments, and bones are left undisturbed with the lateral approach of XLIF, patients experience less pain. 
• After XLIF, patients can return to their regular activities faster than through conventional spine surgery. 
• Patients can often walk on the day of the XLIF procedure. 
• Although some XLIF cases may require the patient to stay for one night at the hospital, it typically results in a quicker hospital stay than other spinal procedures. After conventional spinal fusion, patients must remain in the hospital for multiple days after the procedure. 
• XLIF surgery reviews are positive and indicate that the procedure can successfully reconstruct spinal deformities. 

What Are The Drawbacks of XLIF?

A drawback of the XLIF procedure is that it involves fusing vertebrae. Spinal fusion eliminates independent movement between adjacent levels.

Spinal fusion significantly lengthens the recovery period of any spinal fusion procedure. Unfortunately, even after making a full recovery, patients won’t regain a full range of motion in the spine. With each vertebra that’s fused, patients lose a degree of spinal flexibility. 

After XLIF with spinal fusion, patients may no longer be able to bend, flex, stretch, and twist the back like they once could. This can diminish patients’ ability to partake in various physical activities. 

Additionally, when two or more vertebrae are fused, they force the rest of the spine to compensate for their lack of motion. Specifically, the vertebrae on top of and below the fused spinal bone undergo increased impact. This can result in adjacent segment disease, or ADA.

With ADA, the vertebrae that are adjacent to the fused portion of the spine degenerate more rapidly. This can result in chronic back pain and neurological symptoms in the legs and feet. 

Fusion Alternatives

Non-Surgical Treatment Methods

Spinal fusion typically isn’t recommended until patients have undergone several months of conservative treatments. Nonetheless, patients looking to avoid the complications of fusion may consider continuing with non-surgical therapies, such as:

• Physical therapy

Physical therapy can help patients improve their posture, strengthen the spine’s supporting muscles, and alleviate muscle tension. 

• Chiropractic care

Chiropractic care can help relieve tension in the spine by enhancing spinal alignment. 

• Lifestyle modifications and rest

Rest and lifestyle modifications can reduce the strain on the spine. Lifestyle factors including smoking, having a sedentary lifestyle, and having a high body weight can exacerbate spinal conditions.  

• Anti-inflammatory medications

Anti-inflammatory medications can help patients manage chronic pain from spine conditions. NSAIDs, muscle relaxants, and acetaminophen are examples of medications that may benefit patients with chronic spinal pain. 

• Epidural steroid injections

Epidural steroid injections can only be used a few times per year. However, this condition can help alleviate pain and swelling from spinal disorders. 

Spinal Implants

Today, thanks to another advance in spinal medicine – the TOPS™ System –  some patients may be able to avoid the risks and complications associated with spinal fusion. In select cases, a TOPS implant can be used in place of traditional spine fusion surgery to resolve conditions such as spinal stenosis, spondylolisthesis, and herniated discs. 

Unlike fusion, the TOPS System preserves the full range of motion of individual vertebrae. Additionally, the TOPS System has been proven to provide better outcomes than spinal fusion in clinical studies conducted around the world. This adds up to two breakthroughs in the treatment of spinal conditions, promising effective relief for many patients with back problems that require a surgical solution.

With the TOPS System, patients can avoid:

• The lengthy recovery period associated with fusion
• The post-operative pain that patients experience with fusion
• The prolonged hospital stay required after fusion
• The reduced spinal mobility caused by fusion
• The risk of adjacent segment disease and related conditions

If you’re struggling with symptoms of a spinal disorder, talk to your doctor about the available treatment options, such as XLIF surgery and the TOPS System. 

Why are some spinal surgeons more successful than others?

It’s a fact that some spine surgeonshave higher success rates for the operations they perform than their colleagues. What accounts for these differences in surgical outcomes of spinal procedures? A number of factors influence surgical success rates and should be considered when interpreting what the rates say about a particular spinal surgeon’s abilities.

Spine surgery is a highly complex endeavor requiring years of training and experience to perfect. Surgeons with more experience tend to have more successful outcomes than less experienced surgeons. The success rates of board certified or board eligible spine surgeons are also typically higher than those of non-board certified or eligible surgeons. Another factor to consider: some surgeons specialize in specific areas of the spine – such as lumbar spinal surgery – and some specialize in treating particular conditions – such as slipped disc or spondylolisthesis – while other back surgeons do not specialize in any one type of treatment. Specialists have higher success rates than those of their colleagues who do not focus on the type of surgeries they perform.

Beyond the skill of the surgeon, success rates are also linked to the type of procedure chosen to treat a particular problem. The decision to utilize one procedure – perhaps because the surgeon is more familiar with it – rather than an alternative treatment, can also affect a surgeon’s success rate. For example, there is a choice in surgical stabilization procedures to employ following decompression spinal surgery, which is performed to treat conditions including spinal stenosis, spondylosis, and spinal cord injuries. In the past, spinal fusion back surgery has been virtually the only surgical stabilization option, but today an alternative procedure, the TOPS™ (Total Posterior Solution) System has been proven in clinical trials around the world to provide better success rates that spinal fusion. Thus, a back surgeon might have a better than average success rate performing spinal fusion procedures, but still not reach the success rates achieved with a new procedure. That’s why it’s important to be familiar with the full range of available treatment options when evaluating the success rates of any spine surgeon.

Choosing a Spinal Surgeon

Choosing a spinal surgeon is among the most important medical decisions a patient can make. A spinal surgeon does more than perform an operation. A spinal surgeon consults with you, explains options and answers questions, and plans your treatment and recovery. You need to trust your spine surgeon, and to feel free to discuss all medical matters frankly.

You should choose a spinal surgeon who is board certified or board eligible, and trained in a fellowship program. If possible, choose a surgeon who specializes in the area of the spine that requires treatment– for example, a lumbar spinal surgery specialist if your problem is in the lower back. Alternatively, choose a spine surgeon who specializes in treating the specific condition affecting you, such as spondylolisthesis or spinal cord injuries.

Recent years have witnessed tremendous advances in treatment of spinal conditions, such as minimally invasive procedures that provide better outcomes than traditional open back surgery. It is essential that you choose a back surgeon that has experience with advanced procedures, to ensure you have access to the very latest treatments and the greatest spectrum of surgical options. For example, surgery to treat spinal stenosis, slipped disc and a variety of other conditions that can result in pinched nerves, have often utilized spinal fusion back surgery as a means of stabilizing the spine, following spinal decompression therapy. Today the TOPS ™ (Total Posterior Solution) System provides a clinically proven superior alternative to spinal fusion surgery. Moreover, the TOPS implant preserves the full range of movement of the spine’s individual vertebrae, whereas spinal fusion eliminates the spine’s natural motion between fused vertebral segments. Examples like this illustrate why it’s important to work with a spine surgeon who can offer a complete range of surgical options. Thoroughly investigate all your treatment options as well as the qualifications of the specialists you consider working with, and you’ll be sure to make a wise choice when it comes to selecting a spinal surgeon.

Advantages of Medical Tourism

Can you really travel to a foreign destination for a vacation and receive high-quality medical care at the same time? That’s the question many people raise when the subject of medical tourism comes up.

Many people are skeptical of medical tourism, and understandably so. When you receive medical care in your home country, you’ll naturally feel more comfortable with the treatment process. However, there are many advantages that medical tourism can offer. 

For some patients, traveling to a different country for medical care is a worthwhile task. Keep reading to learn more. 

What is Medical Tourism?

Medical tourism is a term used to describe the action of traveling internationally for medical care. 

What Are The Benefits of Medical Tourism?

The following benefits are attributed to the popularity of medical tourism for USA patients:

• Affordable care

This is the key benefit of medical tourism. Many people can attain high-quality medical care at a fraction of the cost by traveling overseas. This particularly applies to patients in the U.S., which lacks a public healthcare system. 

• High-quality care

The quality of care should always be the primary consideration in medical tourism. There are first-rate medical facilities and health care professionals in many areas across the globe. Some of these areas, which are widely considered to be the best countries for medical tourism, include Germany, the United Kingdom, Turkey, Israel, India, Thailand, Singapore, Latin America, Eastern Europe, and Cyprus.

• Advanced treatments

Different areas of the world have different medical regulatory bodies. Here in the United States, the FDA (Food and Drug Administration) protects Americans’ health by regulating drugs, biological products, medical devices, food, cosmetics, and even certain electric products. 

In many instances, medical innovations have been developed, proven to be successful, and used for many years in other areas of the world. But, with the FDA’s regulatory processes, it can take a long time for those proven medical solutions to become available in the United States. This can also apply to residents of other countries who don’t have access to many of the advanced medical treatments in the United States. 

Medical tourism can give patients access to the latest medical technology and, as a result, a higher quality of care. 

Why is Medical Tourism Popular?

The United States has the most expensive healthcare in the world. So, while few people would consider medical tourism to the U.S., many Americans contemplate international travel to lower their medical expenses.

Medical Tourism Statistics

When considering traveling internationally for a procedure, it’s wise to consider medical tourism examples and statistics. 

• In 2017, over 1.4 million Americans sought out medical care from various medical tourism countries around the globe. 
• According to the World Health Organization, an estimated 12 to 14 million people travel abroad annually for medical care. 
• Many countries offer certain medical procedures at 30% to 65% of the cost of care in the U.S. 
• The worldwide medical tourism market is expected to grow at a compound annual growth rate of 32.51% between 2022 and 2030. 

Which Choice Factors Are The Most Important To Medical Tourism Consumers?

Consumers who are interested in medical tourism value a variety of factors. The most prominent of these factors include:

• Finances

Finances are arguably the most important factor to medical tourism consumers. In fact, in a study from the Medical Tourism Association, 85% of surveyed patients who traveled overseas to a hospital reported that the cost of medical care was a very important deciding factor.

The healthcare system in the United States leaves an estimated 9.6% of residents without health insurance, as of 2021. Even among individuals who do have health insurance coverage, high co-pays and deductibles can make it difficult to afford medical care. 

With these facts in mind, it’s unsurprising that cost is a crucial factor for medical tourism consumers. Above all, these consumers want to secure an affordable price for medical care by traveling overseas.

• Quality of care

Quality of care is paramount for many medical tourism consumers. By traveling to other countries, patients can attain a higher quality of care (at a lower cost) when compared to the medical treatment available in their home countries.

However, without the assurances that Americans are accustomed to under the FDA, consumers must consider the laws and regulations surrounding medical care in the country that they’re traveling to, as well as the foreign practice’s certifications. 

• Treatment availability

While discussing the benefits of medical tourism, we mentioned that it can grant patients access to advanced treatments that aren’t available in their home country. With this in mind, the treatments available in other countries are a key consideration for medical tourism consumers. 

• Waiting lists

Waiting lists for health care services are another consideration among medical tourism consumers. As of 2022, in the United States, 28% of patients sometimes, rarely, or never receive a response from their primary physician on the same day. This is a high percentage when compared to many other areas of the globe. However, 27% of patients in the U.S. wait one month or more for a specialist appointment, which is a lower percentage than in many other countries, including Norway and Canada.

With that said, long wait lists are primarily a concern for medical tourism consumers in nations with public healthcare systems.

What Are The Risks of Medical Tourism?

Although medical tourism can provide several benefits, it also presents certain risks and safety concerns, including:

• Infectious disease

Some countries have a risk of complications including HIV, hepatitis B, hepatitis C, blood infections, wound infections, and infections from donor tissue or blood. 

• Communication difficulties

If patients travel to a facility using a language that they don’t speak fluently, doctor-patient communication can be difficult. Given that doctors provide crucial pre-op and post-op information, as well as procedure specifics, this may lead to confusion and errors. 

• Quality of care

Certain areas may not have comparable requirements for medical licensing and accreditation. This creates the risk of low quality of care. 

• Flying after a procedure

Doctors typically advise against air travel immediately after surgery. This is because flying raises the risk of developing a blood clot. Depending on the type of surgical procedure, patients should wait between seven and 10 days before flying. 

To avoid these risks, medical tourism consumers should ensure that:

• The medical facility has been accredited by the Joint Commission International
• The medical facility utilizes the World Health Organization Checklist
• The staff at the facility follows stringent sanitation, disinfection, and hygiene measures
• The provider is board-certified and internationally-recognized

What Is The Best Country For Medical Tourism If You Need a Spine Surgery?

As we’ve already mentioned, a significant benefit of medical tourism is that you can gain access to treatments that have not yet or have only recently been, approved for use in your country. Procedures that have been proven effective and are widely used in certain areas of the world can often benefit international patients.

The TOPS™ (Total Posterior Solution) procedure, performed in association with spinal decompression surgery, is an example of a procedure that has been used extensively in Europe but not yet in the United States. TOPS is an alternative to spinal fusion back surgery.

Spinal fusion is widely used with spinal decompression procedures for conditions like spinal stenosis, spondylolisthesis, bone spurs, and more. Unfortunately, fusion can severely limit patients’ range of motion in the back. Additionally, the complete recovery process for spinal fusion may last for six months to a year. 

The TOPS System preserves the full range of motion between the individual vertebral segments, unlike spinal fusion. It involves a minimally-invasive surgical procedure, which greatly shortens the spinal surgery recovery period. In fact, patients may start moving around the day after TOPS surgery with few, if any, restrictions. 

For certain patients with specific medical conditions, medical tourism could be the ticket to high-quality, low-cost healthcare. If you think you may benefit from medical tourism, make sure to conduct thorough research, find an accredited facility, and evaluate all of the risks before scheduling your appointment abroad. 

How soon can you return to athletics after spinal surgery?

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

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

Table of contents

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

What does it mean to be in recovery?

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

Follow your doctor’s recommendations

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

So, a doctor’s advice may include:

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

Define your limits

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

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

Don’t forget about the course of drugs

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

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

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

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

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

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

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

Exercises after surgery

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

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

Walking

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

Bench press

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

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

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

Straight leg raise (SLR) 

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

Regain your mobility with Premia Spine! Contact us now

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

Conclusion

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

Taking Vitamins Before Surgery

Spinal surgery is stressful on the body. Anyone who is having spine surgery needs to prepare his or her body for the surgery and recovery period by getting in shape, getting the proper amount of rest, and following other healthy habits. Taking vitamins are among the steps that physicians often recommend to help the body heal and recover from surgery as quickly as possible.

Back surgery patients should begin taking vitamins as far as a year in advance of surgery, if possible. A well-rounded multivitamin and mineral supplement with B12, vitamin E, and minerals such as calcium, magnesium and phosphorus are what your body needs to heal. Whole food vitamin and mineral supplements are often recommended because they are made from food rather than synthetic vitamins, and thus are easier for the body to utilize.

Vitamin C is another important vitamin to have on your pre- and post-surgery vitamin list. Vitamin C promotes healing and helps the body defend against illness, which can greatly interfere with surgical recovery. Vitamin A is another important healing vitamin. It protects cells and helps build new tissue, a vital part of surgical recovery.

Some types of vitamins, minerals and supplements should be avoided, as they can contribute to complications such as excessive bleeding. You should have a discussion with your spine surgeon about what vitamins you should and shouldn’t take as part of your early surgical planning.

Just as choosing the right vitamins can help speed recovery, so can choosing the right surgical procedure with the best outcomes. For example, spinal stenosis, slipped disc, spinal cord injury and a host of other spinal problems are often treated with spinal decompression surgery to relieve symptoms of nerve compression. In the past, spinal fusion back surgery was routinely performed in conjunction with spinal decompression to stabilize the spine, though fusion eliminates the natural, independent motion of the fused vertebrae. But today the TOPS™ (Total Posterior Solution) System, an advanced implant device, offers a surgical alternative that has been proven in clinical studies around the world to provide better outcomes than spinal fusion. So by all means take vitamins to speed your recuperation from surgery, but also make sure you are aware of your treatment options, and choose procedures that provide the best and quickest paths to complete recovery.

Should I stop taking medications before spinal surgery?

You have a pinched nerve, slipped disc, a spinal cord injury, or other back problem that has not responded to conservative treatments, and you have reached the decision to have spinal surgery. You and your back surgeon will discuss many aspects of your pre- and post-operative treatment, and the subject of the medications that you are currently taking – and whether you should continue their use – is high on the list of topics.

Usually patients are advised to continue use of prescription medications such as those for controlling blood pressure, even on the day of surgery – provided the medications are taken with just a small sip of water. However, use of blood thinners, aspirin, anti-inflammatory drugs, and diabetic and herbal medications should be discontinued prior to surgery. Your surgeon and staff will ask for a complete list of all medications you are taking, and it’s important to provide accurate answers.

One of the goals of post-operative care is effective pain management, and that requires patients to be free and weaned from any narcotic pain medications and muscle relaxants before the back surgery is performed. Fortunately, the open back surgery procedures of just a few years ago have in many cases been replaced by less invasive surgical procedures performed to relieve common back problems such as spinal stenosis, or symptoms of sciatica. These minimally invasive procedures cause little damage to collateral tissue, and therefore produce less pain and require less palliative medication, further speeding recovery. Other recent advances provide improved post-operative outcomes. For example, patients can now choose the TOPS™ (Total Posterior Solution) System instead of spinal fusion back surgery after a spinal decompressionprocedure. The TOPS System provides better clinical outcomes than spinal fusion, and preserves the full range of the individual vertebrae. Spinal fusion eliminates the independent motion of fused vertebrae, and has been shown to promote deterioration of adjacent vertebrae.

The procedure selected to treat your back problem is also a critical part of the discussions you will have with your orthopedic surgeon. Be sure to discuss all your surgical options, including advanced, proven procedures that can provide the best outcomes for your spinal condition.

Preparing for Spinal Surgery

Whether to treat a slipped disc from age-related spinal degeneration or a traumatic spinal cord injury, spinal surgery is never taken lightly. When lower back surgery is selected as the preferred treatment option, it indicates that the condition being treated is severe.

Spine surgery comes along with the expectation that it will provide a meaningful improvement in the targeted medical condition. This improvement generally includes a reduction in the patient’s pain, as well as restored movement.

With these improvements in mind, there’s actually much to look forward to while you prepare for spine surgery! To ensure that the procedure and recovery go as smoothly as possible, consider these tips:

Get in Shape

So, what’s our top tip for how to prepare for spinal surgery? Get in the best shape you can – mentally and physically.

To improve your physical fitness, exercise thoughtfully and eat a healthy diet. Exercising can be difficult when you’re dealing with a spinal condition. However, maintaining muscle strength and flexibility, as well as reaching a healthy weight, will aid in your spinal surgery recovery. 

Additionally, exercising boosts endorphins, the body’s natural “feel good” chemicals. Endorphins can help you manage stress, pain, and your general mental well-being leading up to spinal surgery.  

Which Exercises Are The Best For Lower Back Pain Surgery?

Certain physical activities are safer and more beneficial for patients with spinal conditions than others. These activities include:

• Walking
• Bicycling and stationary cycling
• Low-impact and water aerobics
• Swimming
• Yoga and tai chi
• Resistance and stretching exercises

We recommend speaking to your physician before starting any new exercise regimen. Your physician can inform you of any exercises to avoid as you prepare for spinal surgery. 

Additionally, as a general rule of thumb, avoid high-impact activities, like running and jogging, while you’re recovering from a spinal condition. High-impact activities can place added stress on the spine and may impede its recovery process. 

How Does Weight Loss Benefit Spinal Surgery Preparation?

Extra weight places stress on the back. In fact, excess weight leads to increased impact on the spine with each step that you take, potentially complicating back surgery recovery.

A 2017 study published in the International Journal of Environmental Research and Public Health found that intervertebral disc disorder and chronic lower back pain are connected to obese and overweight body status. With this in mind, losing weight can support the outcome of your spinal procedure and recovery.

However, lose weight sensibly! Extreme and unhealthy weight loss can compromise your condition leading up to the surgery. 

Here are our top tips for losing weight healthily:

• Eat regular meals, and don’t skip breakfast. 
• Listen to hunger cues. 
• Use smaller plates and bowls for healthier portion sizes. 
• Rather than cutting out foods altogether, treat yourself in moderation. 
• Stay hydrated by sipping on water throughout the day, especially around mealtimes.
• Add high-fiber foods, such as whole grains, legumes, berries, vegetables, nuts, and seeds, to your diet. 

Quit Smoking

If you smoke, it’s in your best interest to quit before spinal surgery. Smoking is detrimental to the success of spinal surgery, as well as the body’s healing process, even for minimally-invasive spine surgery.

Nicotine constricts the blood vessels. This means that when you smoke, the circulation throughout your body decreases. As a result, all of your cells, including those in your spine, will receive less of the oxygen and nutrients that they need to heal.

Decreased blood flow from smoking can also prevent surgical wounds from closing and increase the risk of infection. The infection risk after spinal surgery is further increased in smokers because smoking hampers the immune system. 

Smokers are also at a higher risk of complications from surgery, including stroke, heart attack, shock, and even death.

Several clinical studies illustrate the risk of smoking for patients with spinal conditions:

• A 2015 study found that smoking was linked to increased complications and worse outcomes in three out of four of the largest diagnostic groups. These groups included 136,511 patients admitted for spinal disease treatment.
• A 2017 study found that smoking significantly raises the risk of pseudoarthrosis (spinal fusion failure) in patients undergoing cervical and lumbar fusions. This study also found that smoking increases the risk of other complications including infection, dysphagia, and adjacent-segment pathology. 
• A 2016 study found that smoking significantly influenced the overall perioperative complication rate. 

What If I Can’t Quit Smoking?

If you don’t quit smoking, you’ll be required to stop approximately four to six weeks before the lower back herniated disc surgery and other spinal procedures. You’ll also need to abstain from smoking for two weeks after the procedure. 

Quitting smoking can be difficult, to say the least. Here are a few tips that may help you quit before spine surgery:

• Ask for loved ones to support you in the coming weeks. 
• Consider joining a stop-smoking support group. 
• Avoid scenarios that put you at a high risk of smoking, such as drinking with friends or being around people who smoke.  

Review Medications

Talk to your doctor about all of the medications that you’re taking long before undergoing spinal surgery. Be very thorough, as even herbal supplements can impact your recovery or interact with other medications prescribed for surgery.

There are a few different types of drugs that you generally must stop taking before surgery. These include:

• Anticoagulants

Anticoagulants are also known as blood thinners. This type of medication prevents the formation of blood clots. But, before surgery, blood thinners also raise your risk of bleeding. So, it’s crucial to talk to your prescribing physician and surgeon about the right time to stop taking anticoagulants before surgery. 

Common prescription anticoagulants include warfarin, NSAIDs, enoxaparin, ticlopidine, clopidogrel, and dipyridamole. Additionally, there are several over-the-counter and herbal anticoagulants, including aspirin, NSAIDs (like ibuprofen), vitamin E, ginger, garlic, and ginkgo biloba. 

• Monoamine oxidase inhibitors (MAOIs)

MAOIs remove specific neurotransmitters from the brain. This category of drugs includes certain antidepressants and anti-Parkinson drugs. Unfortunately, MAOIs also interfere with the medications utilized during anesthesia and should be stopped about a week or two before spinal surgery. 

All MAOIs are prescription medications. Examples include tranylcypromine, phenelzine, rasagiline, and isocarboxazid. 

Get Well Informed

Prepare for lower back surgery by learning as much as you can about the facets of your spinal condition, as well as the available treatments. There are numerous lower back surgery types, especially with recent advances in the medical field. Different types of lower back surgery may offer unique benefits and drawbacks.

One essential aspect of education before lumbar spine surgery is to understand the expected recovery period. Spine surgery recovery can last anywhere from a few months to a year if you undergo lower back fusion surgery. 

Learning about the recovery time for lower back surgery well in advance of your procedure will streamline your healing process. With this knowledge, you can better plan how much help you’ll need around the house, how much time to take off of work, and when you can expect to return to your favorite activities. 

Learn About Recent Innovations in Spinal Surgery

The last few years have seen dramatic advances in spinal procedures that can provide significantly improved clinical outcomes and shorter recovery periods. The TOPS™ (Total Posterior Solution) System, often used in the treatment of spinal stenosis, spondylolisthesis, and other back problems involving a pinched nerve, is one such advanced procedure.

TOPS™ is an implant system approved for use as an alternative to lumbar spine fusion surgery after spinal decompression. The TOPS™ System preserves the independent flexion and bending of the individual vertebrae. This is in contrast to fusion surgery of the lower back, which eliminates this independent motion and can contribute to the deterioration of adjacent vertebrae. 

The TOPS™ System has also been shown in clinical studies to provide better short- and long-term outcomes than spinal fusion.

Before undergoing spinal surgery, make sure to learn everything that you can about your condition and surgical options. By thoroughly discussing your treatment plan with your physician and asking any questions that come to mind, you’ll be far better prepared for your back surgery.

What should I expect the day of my spinal surgery?

This is the big day, the day your spinal surgery will be performed and your back condition – be it facet arthrosis or lumbar radiculopathy – gets effective treatment. You’ve had your pre-operative appointment a day or so ago, and had your pre-operative physical assessment and other pre-operative workup. You’ve also met with an anesthesiologist team member to talk about your anesthesia.

Of course you’ve followed your orthopedic surgeon’s directions for the night before your back surgery. You didn’t eat or drink anything after midnight. You’ve consulted with your doctor about medications you are taking, and you’ve complied with all your physician’s directives. You prepared whatever you will bring with you last night, so you don’t feel rushed in getting to the facility at the appointed time. If there’s a keepsake that’s important that you want to bring with you – a ring for example – leave it at home.

If your family is coming with you, you already know where the waiting area is – they’ve probably seen it themselves – and you don’t have to worry about them. The staff will make sure they’re kept informed and comfortable. Following the surgery you will be taken to a recovery room. Much of what happens after the surgery – whether performed for a pinched nerve or an injury of the spinal cord – depends on factors including the severity of your condition, the effort you put into your post-operative physical therapy, and the surgical treatment you selected. Today advanced spine treatments are providing new options with better outcomes for some spinal surgery patients. Not all orthopedic surgeons are familiar with fully approved advanced surgical options such as the TOPS™ (Total Posterior Solution) System. TOPS is an approved implant that provides clinically proven superior outcomes to spinal fusion back surgery after spinal decompression therapy has been performed. Moreover, the spine’s natural range of motion is preserved with the TOPS System, unlike a spinal fusion procedure, which eliminates independent motion of the joined vertebrae, and can lead to deterioration of the adjacent vertebrae.

What’s most important to remember about your day of surgery, is all the care and thought you, your surgeon and your loved ones put into determining the best course of action. You’ve prepared, gotten ready, and now you’re finally moving forward! Congratulations!

Post Op Day 1

You had your back surgery operation yesterday. The day after a lumbar laminectomy, spinal decompression, or other back surgery is likely going to be quite disorienting. You will still be feeling the effects of the anesthesia that knocked you out during your surgery. You’ve probably been given medication to numb the nerves in the area where the surgery was performed. You are, as they say, feeling no pain. Some patients are taken to the ICU, or Intensive Care Unit, from the recovery room, for overnight observation following back surgery. Often, this is planned beforehand, and the patient understands the reasons for this cautionary approach. The patient in ICU may be intubated – that is, have a tube inserted in your throat connected to a respirator that will assist breathing, but will not permit talking.

The day after your back surgery operation a nurse or physical therapist will help you begin your recovery, assist you in sitting on the side of the bed and possibly help you to sit in a chair. It’s not uncommon to need a walker to get across the room. The amount of disorientation on the first day after surgery will be most influenced by the type and extent of the surgery. The more extensive the back surgery, the greater the damage to peripheral and collateral tissue, and the more need for sedating pain medications that render the day after surgery a blur.

Fortunately, today many spinal conditions that previously required open back surgery can now be treated with microsurgical techniques and minimally invasive procedures. These include spinal stenosis, slipped disc and even spinal cord injury. And second generation spine procedures are providing superior outcomes for many spinal problems caused by the natural deterioration of the spin due to age, or by traumatic injury or disease. The TOPS™ (Total Posterior Solution) System, which  provides better clinical outcomes than spinal fusion back surgery following spinal decompression therapy, is one example of these advances. Make sure you work with a spine surgeon who is familiar with, and experienced in advanced spinal surgery procedures, to ensure you get the best care possible. That will help ensure your Post Op Day 1 is the first day of a smooth recovery period!