Spine Surgery

What is Lumbar Spinal Decompression?

Lower back pain has long been a prevalent health concern around the world. In 2017, the prevalence of lower back pain was estimated to be approximately 7.5% of the world’s population. This totals about 577 million people.

There are numerous causes of lower back pain, as well as countless treatments that can help relieve it. Lumbar spinal decompression is one treatment strategy for alleviating lower back pain caused by a pinched nerve. 

This article will discuss lumbar spinal decompression, when it’s implemented, and what patients can expect from the procedure. 

Why is Lower Back Pain So Common?

Imagine if the branches of a tree were as large at the top as they are at the bottom. Now, imagine that a heavy load is placed on the ends of the very highest branches. This would put an enormous amount of stress on the lower portion of the tree trunk.

This is comparable to what we experience as humans with our spinal columns. The human spinal column is like the trunk of a tree, but we’re as large on the top of the trunk as we are at the bottom. This puts a high amount of stress on the lower back, which is also called the lumbar region of the spine.  

The strain of lifting objects and twisting the spine over the course of a lifetime is exacerbated by degenerative spinal changes that occur with age. So, it’s not surprising that most of the back problems that bring patients to spinal specialists are centered in the lower, or lumbar, region of the spine.

Lumbar Spine Disorders

The stresses discussed above, along with disease and/or injury, can result in a host of spinal disorders. Bulging or herniated discs, spinal stenosis, and spondylolisthesis are among the most common.

• Bulging disc

A bulging disc is a spinal disorder that occurs when the exterior of an intervertebral disc weakens, typically from the natural aging process. This can cause the disc to bulge out into one side of the spinal canal. 

• Herniated disc

A herniated disc is essentially one step further than a bulging disc. It occurs when the soft interior of the disc protrudes out through a crack in the weakened disc exterior. 

• Spinal stenosis

Spinal stenosis can result from a bulging or herniated disc, as well as a range of other factors. It’s a spinal condition characterized by an abnormal narrowing of the spinal canal.

Reduced space in the spinal canal can place stress on the spinal nerves or the spinal cord. But, decompression for lumbar spinal stenosis can effectively alleviate this stress. 

• Spondylolisthesis

Spondylolisthesis is a condition that develops when one of the vertebrae is unstable and slips out of its regular position. The displaced vertebra settles on the vertebra beneath it. 

These disorders can place unnatural pressure on the nerves that emanate from the spinal column. This may cause pain, restricted mobility, and other symptoms of a pinched nerve.

What is a Lumbar Decompression Surgery?

Spinal decompression is a method of easing pressure on impinged spinal nerves. It can be performed either non-surgically or surgically. Lumbar spine decompression simply refers to decompression procedures performed on the lower portion of the spine.

The surgical solution for a lumbar pinched nerve involves removing a small amount of tissue from vertebrae in the lumbar region. The surgeon will remove the tissue that’s impinging, or putting pressure, on a nerve. This process is referred to as lumbar spinal decompression surgery.

How is Lumbar Decompression Surgery Performed?

There are various types of lumbar decompression surgery that may be implemented for different spinal disorders. The most common forms of surgical lumbar decompression include:

Laminectomy and Laminotomy

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

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

Laminoplasty

Laminoplasty is a procedure that involves making two cuts in the lamina so that it swings outward, like a door. After creating a hinge with the lamina of the affected vertebra, the spinal surgeon will position small bone wedges to keep the “door” from closing. Commonly referred to as open-door laminoplasty, this procedure can effectively alleviate pressure on the spinal nerves without removing the lamina. 

Foraminotomy

In foraminotomy, the surgeon creates more space around the area where nerve roots exit the spinal canal. This area is known as the intervertebral foramen. It acts as a passageway, linking the spinal canal to the periphery. 

By opening up the intervertebral foramen in foraminotomy, the spinal surgeon can alleviate pressure on the spinal nerves. 

Discectomy

Discectomy is a spinal decompression procedure that involves removing damaged intervertebral disc tissue. The spinal surgeon may remove some or all of the damaged disc, depending on the patient’s needs.

Lumbar Decompression Surgery With Spinal Fusion

Removing tissue in lumbar decompression surgery can lead to spinal instability. So, historically, spinal fusion back surgery has been performed in conjunction with lumbar decompression surgery to stabilize the spine. 

In spinal fusion, the surgeon places bone graft material in between the affected vertebrae. As weeks and months pass after the procedure, the vertebrae will fuse, forming a singular bone. By completely preventing motion in this segment, fusion effectively prevents instability following spinal decompression surgery.  

Unfortunately, lumbar decompression and fusion can have certain negative effects on the body, including:

• Reduced range of motion

The key downside of spinal fusion is that it prevents all motion in the fused segment. This eliminates the patient’s ability to flex, twist, and bend the spine normally. As a result, patients may no longer be able to partake in their favorite sports and activities after spinal fusion surgery. 

• Damage to adjacent vertebrae

The spinal segments that are adjacent to the fused vertebrae must undergo additional stress to compensate for the fusion. This can lead to a complication known as adjacent segment disease (ASD), with which the adjacent vertebrae deteriorate at a more rapid rate. ASD can lead to lower back pain, radiating pain, difficulty walking or standing, and neurological symptoms. 

Are Alternatives To Spinal Fusion Available?

Today, the TOPS™ (Total Posterior Spine) System provides an alternative to spinal fusion that preserves the spine’s natural full range of motion. This advanced spinal implant has been shown to provide better outcomes than fusion in clinical studies performed around the world. 

The TOPS™ System provides an important additional treatment option for individuals with moderate to severe pinched nerve symptoms. It can provide a major improvement in lower back pain for patients who don’t respond to non-surgical lumbar spinal decompression therapy.

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

The recovery period for lumbar decompression surgery can vary depending on the exact procedure and whether or not spinal fusion is performed. However, patients can generally expect to wait four to six weeks before reaching their expected degree of mobility and returning to work. 

Spinal fusion prolongs the recovery process for lumbar decompression surgery. It can take up to a year to fully recover from fusion. With this in mind, the TOPS™ System can significantly reduce the lumbar decompression surgery recovery time, allowing patients to return to physical activity much sooner.

Is Lumbar Decompression Surgery Serious?

Lumbar decompression surgery is an invasive procedure. So, as with any surgical procedure, it comes with certain risks.

With that said, lumbar decompression is widely performed and considered safe. Advancements in medical technology have even made minimally-invasive lumbar decompression surgery possible. This allows for greater safety and a lower risk of complications. 

If you have symptoms of a pinched nerve, don’t hesitate to talk to your doctor about the complete scope of treatment options available to you. 

Back Treatment Options

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

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

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 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.

How to Prepare for Spinal Fusion Back Surgery?

Spinal fusion is often performed in conjunction with spinal decompression surgery for various spinal conditions. Decompression surgery alleviates pressure on pinched nerves that extend from the spine. This process reduces pain and restricted mobility stemming from nerve compression.

Unfortunately, spinal decompression also involves removing portions of the vertebrae. This makes the spine weaker and less stable at the affected segment. To prevent further injury, spine specialists commonly use spinal fusion to stabilize the spine after decompression.

Spinal fusion involves fusing two or more adjacent vertebrae into a single bone with a bone graft. As a major surgery, spinal fusion requires extensive preparation and recovery to achieve the best possible results.

What Should You Do Before Spinal Fusion Surgery?

The process of preparing for spinal fusion surgery is similar to preparing for any other spinal operation. However, there are a few specifics to be aware of. 

How To Prepare For Lumbar Spinal Fusion?

Firstly, be prepared to undergo a thorough examination before the surgery. This is essential for your physicians to plan every aspect of the operation. Radiograph assessments for spinal stability, electromyography (EMG) for nerve function, and an MRI, CAT, or other imaging tests to identify nerve compression are often performed.

Your doctors will also assess your overall physical condition to ensure that you’re in sufficient health to undergo the rigors of the surgery. You’ll need to discuss all pre-existing medical conditions with your physicians. These conditions may need to be further evaluated before proceeding with spinal fusion surgery.

With this in mind, one of the most important ways to prepare for spinal fusion is to get into the best possible physical condition. This may involve quitting smoking, improving your diet, and increasing your physical fitness (while following all of your doctor’s instructions). Being in good physical condition translates into fewer complications during surgery and a faster recovery afterward.

How To Equip Your Home For Better Recovery After Spinal Fusion

Most patients are cleared to return home two to four days after spinal fusion. Make sure to plan ahead and have someone drive you home from the hospital. Typically, patients aren’t allowed to drive for a few weeks after lumbar fusion.

There are several ways to equip your home for smooth spinal surgery recovery. Our best tips include:

1. Plan for simple meals after the surgery. Consider subscribing to a grocery delivery service or, better yet, a meal kit service. Many meal kits require little to no preparation and are delivered straight to your doorstep. This will help simplify your meals after the surgery.
   
   For a DIY version of delivery meal kits, consider meal prepping before the procedure and placing the dishes in the freezer. When you’re at home post-fusion, you can defrost the meals to stay nourished without the need to cook.
   
   Keep in mind that the ideal post-spinal surgery diet should be high in protein and fiber. Additionally, try to avoid processed foods and stick with whole grains, nuts, seeds, beans, lean protein, fruits, and vegetables. 

2. Purchase ice packs and heating pads, if you don’t have them already. Both cold and heat therapy are useful after spinal surgery. Cold therapy can help alleviate inflammation, while heat therapy can help ease muscle tension.
   
   Make sure to take your doctor’s advice for heat and cold therapy, and limit your use to 15 to 20 minutes at a time. 

3. Consider a walker or cane. Moving around your home can be difficult in the early days and weeks after fusion. A walker or cane can help provide stability and prevent accidents. 

4. Place everyday items in an easy-to-access location that you won’t need to twist or bend over to reach. You can also consider purchasing a reacher/gripper/grabber device, which will help you retrieve items without straining your spine. 

5. Prep the bathroom with a toilet riser and shower seat or mat. These devices will make it easier to use the toilet and to spend more time in the shower, which can help alleviate pain and tension. 

6. Sleeping can be difficult after spinal fusion. To make it easier, consider purchasing a body pillow, which may help you find more comfortable sleeping positions.  

How Many Years Does a Spinal Fusion Last?

The results of spinal fusion are permanent. This means that the affected vertebrae are permanently fused and can’t be separated. However, there are some instances in which patients require revision surgery, including:

• Fusion failure

Fusion failure occurs when the targeted vertebrae fail to combine into a single bone after the procedure. When this occurs, the patient will continue to experience back pain and neurological symptoms. Patients who have used corticosteroids are at a higher risk of fusion failure, as are patients who underwent fusion without fusion hardware.

• Hardware failure

Hardware is often used during spinal fusion to stabilize the bone graft. Rarely, this hardware may become damaged or malfunction after the procedure. In these cases, the hardware may move around and irritate the neighboring tissue, leading to pain.

• Adjacent segment disease, or ASD

Adjacent segment disease can develop when the vertebrae adjacent the fused segment break down at a faster-than-usual rate. Since the fusion eliminates all motion at the fused segment, the adjacent vertebrae must undergo added strain. Adjacent segment disease can lead to back pain and neurological symptoms, creating the need for revision surgery.

• Scar tissue

The body produces scar tissue during its natural healing process. Generally, scar tissue doesn’t cause any problems. However, after spinal procedures like spinal fusion, scar tissue may irritate or constrict a nerve root, which can cause neurological symptoms.

What Are The Long-Term Effects of Spinal Fusion Surgery?

In a perfect world, spinal fusion surgery would rid all patients of chronic back pain without future complications. But, in reality, spinal fusion creates the risk of various complications later in life.

Can spinal fusion cause problems later in life?

Future complications that may result from spinal fusion surgery include:

• Adjacent segment disease
• Spinal muscle injury, which may lead to instability and further injuries
• Chronic pain at the bone graft site
• Spinal nerve damage
• Poor spinal mobility at the site of the fusion, which can limit patients’ activities

Alongside chronic pain, poor mobility is a major concern among patients facing spinal fusion. Without the ability to bend, flex, or twist at the fused segment, many patients lose the mobility required for their favorite activities. Some patients may always need a reacher device to pick up items off of the floor.

With these possible complications in mind, spinal surgery of any kind, including spinal fusion should only be considered a last resort. Physicians only recommended it if more conservative treatments have proven ineffective.

Are Lumbar Spinal Fusion Alternatives Available?

Considering the prominent downsides of spinal fusion, it’s unsurprising that many patients with spinal conditions seek out alternative treatments. Now, patients undergoing spinal decompression have an alternative procedure to consider.

The TOPS (Total Posterior Solution) System has long been used in Europe and Australia, with better outcomes than spinal fusion. Now, it’s being used across many states in the U.S. and has earned the FDA breakthrough designation.

TOPS is a non-fusion lumbar spine implant that stabilizes the spine without eliminating the independent motion of the individual vertebrae. With TOPS, patients recover with far fewer restrictions and in a much shorter time frame than with spinal fusion.

One of the best ways to prepare for spinal fusion is to discover if an alternative solution like the TOPS System from Premia Spine makes more sense than spinal fusion for you or a loved one. Contact your spinal specialist to learn more about all of the treatment options available today.

Preparing for Spinal Fusion Surgery, Part II

In our last blog we began addressing the topic of preparing for spinal fusion back surgery.  We touched upon tests that may be performed, and the need to prepare physically through a conditioning regimen so your body is ready for the rigors of surgery. Here are additional points anyone considering spinal fusion should remember:

One potential complication of spinal fusion surgery is excessive bleeding. Several commonly used medications can increase bleeding, including aspirin, ibuprofen and other NSAIDs, as can anticoagulants such as warfarin. You will need to discontinue use of any such medications. Should your physician or surgeon be concerned about the risk of excessive blood loss during your spinal fusion operation, you may bank your own blood, called an autologous blood donation, before the surgery.

Be sure to discuss all the medications you are taking with your physicians, and they will advise you when (and if) you should stop taking them. Some medications could cause adverse affects in combination with the anesthetics or other medications used during the operation, and anti-inflammatory medication such as cortisone and chemotherapy can compromise the body’s ability to heal.

Failure of the bone graft to heal, called pseudarthrosis, is one of spinal fusion’s most problematic post-surgical complications. Smoking is associated with this complication, and nicotine has been shown to compromise the ability of bone cells to grow. It is imperative that smokers stop smoking prior to the surgery, and not smoke before their recovery is complete.

Before resigning yourself to spinal fusion surgery, remember that spinal problems often respond to more conservative treatments, such as physical therapy and healthy lifestyle changes. Alternative surgical procedures may also be available. For example, many candidates for spinal fusion can choose the TOPS^TM(Total Posterior Solution) System instead. The TOPS System not only preserves all the natural flexion of individual vertebrae, unlike spinal fusion, but it has also been shown to have better outcomes in clinical trials around the world. Indeed, investigating alternative options is another productive way to prepare for a spinal fusion operation.

How Soon Can I Get Out of Bed After Spinal Fusion Surgery?

We’ve addressed preparations for back surgery in recent blogs and specifically the surgery for spinal stenosis and fusion operations. Yet, the recovery process is just as necessary as the back surgery itself to your long-term health, so prepare well for postoperative routines and realities before the surgery is performed.

Among the first questions patients often ask about the spinal fusion back surgery recovery process is how soon they will get out of bed following the operation. Patients typically get out of bed the day after their surgery – with the help of attendants, who will assist you in sitting up, getting your legs over the side of the bed, standing up, and walking. You’ll be glad that you spent time getting in shape before your operation. The preparation pays off at times like this, as being in good health will help throughout your healing and recovery, as the body responds to the trauma of surgery and works to repair itself.

Movement is indeed critical to proper healing, and since you’ll spend a good deal of time in bed in the first days after the spinal fusion operation, it’s essential to learn how to move correctly in bed.  We’ll show you the best way to turn over, sit up, and move in ways that will promote proper healing, strengthen muscles and minimize pain.

Table of Contents

Tips to prep for surgery and ease recovery

How to heal faster after back surgery?

Conclusion

Tips to prep for surgery and ease recovery

All surgeries involve certain risks in one way or another, such as infection, bleeding, or nerve damage. E.g., if you suffer from osteochondrosis, problems with other discs may occur. In most cases, such complications are associated with the rigid spinal fusion structure, where the load on the vertebrae is unevenly distributed. Therefore, people may feel unable to do some movements. Joints perform a dual function that leads to degenerative changes. 

On the other hand, a spinal stenosis surgery implant is a more effective treatment for certain spine diseases. But the healing process can take several months, especially if the patient is overweight or has poor muscle tone. At the stage of preparation for surgery, you’d change your lifestyle and take the following steps: 

• Stop smoking cigarettes, drinking alcohol, or taking drugs – these can reduce the ability to heal;
• Control the course of any illness, including colds, flu, or herpes;
• Talk with your healthcare provider about your current medications and how your treatment will change after invasive therapy. That includes anticoagulants (for example, warfarin), and non-steroidal anti-inflammatory drugs (aspirin, ibuprofen, etc.).

Getting out of bed after back surgery will go smoothly, and you’ll be able to get up and walk unaided in a few days and soon even go home to recover. Some elderly or debilitated patients may consider visiting a rehabilitation center for about a week. That will help strengthen a back and learn how to move safely. 

The hospital regimen in the first days after the operation provides instructions on how to get around, as flexibility will be limited. Patients often receive pain relievers and wear a brace to maintain the correct spine position. By the way, prescription opioids shouldn’t be consumed with alcohol. You can also replace them with more traditional methods – e.g., cold or heat wraps for 15-20 minutes with a break of 2 hours between procedures. A separate topic is the resumption of a diet consisting of solid food. Also, general anesthesia requires fasting for at least 8 hours before the intervention. On the day of surgery, only a sip of water is allowed to take medicine. 

When you’re in better physical condition before surgery, healing time can be shortened, e.g., doing all kinds of exercises recommended by doctors, physical therapy, undergoing a course of massages, etc. This is how you can strengthen your back muscles. Subsequently, they’ll better support the spine, and you won’t wonder how to get in and out of bed after back surgery. In any case, a sedentary lifestyle puts a greater risk of wear and tear on the vertebrae located above and below the immobilized part.

How to heal faster after back surgery?

Anything that was inconvenient or seemed impossible before the operation became available. Postoperative care is directly related to the initial preparation phase, namely the layout of your home. Oddly enough, but it’s essential to have a spacious bathroom with a shower and a rug so as not to slip, a firm mattress so that the process of getting in and out of bed after back surgery is as painless and gentle as possible for the operated area. Consider placing a portable small refrigerator and cooler in the room, as well as blankets and other supplies so that you can easily access them. You can also utilize a grabber to lift items off the ground and shelves (find them in pharmacies or specialized stores). For elderly patients who have difficulty walking, sticks or walkers are recommended. A soft lounge chair, unlike a regular chair, can reduce the load on the lumbar region. In general, you need to take care of preventing falls: remove objects through which there is a possibility of tripping, install handrails as required (e.g., in the shower, on the stairs). This way, you can recover in a safe environment. Household chores after discharge are also best left to family members, a home care aide, or a caregiver.

Here are some tips on how to get out of bed after back surgery faster.

Take short walks

For recovery to take place as quickly as possible and for the load on the spine to be optimal, it’s necessary to take short walks every 30 minutes. For example, if you sit for most of the day, you’d learn the most ergonomic position. Use supports with a low back or unique chairs that allow you to maintain correct posture. 

Please note that after surgery, you’d avoid long car trips.

Learn to sit properly

Sitting with knees higher than hips has a negative effect on the spine. Therefore, try to get up slowly: move to the edge of the seat and utilize the armrests to push upward. Focus on your feet.

Avoid some movement

Bending, lifting, twisting, and driving – all these activities are prohibited in the early stages of recovery. For example, flexion at the knees and hips is perfectly acceptable, but not the spine. Remember: don’t lift anything that weighs more than a gallon of milk (about 8 pounds)! It’d also be borne in mind that due to drowsiness, impaired judgment, and poor coordination – side effects of prescription opioid pain relievers, driving is prohibited during the recovery period.

Sleep in a new way

Sleep is critical to the body’s recovery – the immune system is involved in reducing inflammation. Of course, it can be difficult to fall asleep at times, especially since now you have to consider the new rules of rest.

So, utilize the log technique – keep your knees together and keep your back straight. Remember how geisha slept in ancient Japan? They rested their necks on wooden supports while the load was transferred to the upper spine and shoulders. You have to do something similar in everyday life: sleep with your head in the pillow, with a rolled-up blanket under your knees. So your legs will be slightly bent, so there will be no intense pressure on the operated area.

Take care of the wound

It would be best if you did manipulations to cleanse the wound daily. In addition, it’s worth checking it for infection. If you notice signs of suppuration, redness, swelling, or palpation of the wound that causes too painful sensations, you’d urgently consult your doctor. Occasionally, an infection may cause fever and chills. Don’t take a bath; take a shower instead and use a soft sponge only. 

Today, many candidates for spinal fusion surgery can opt for the TOPS (Total Posterior Solution) System instead. The TOPS™  implant has been shown to have better clinical outcomes and fewer post-surgical complications than spinal fusion. And unlike spine fusion procedures, the TOPS™ device preserves the full range of each vertebra’s motion. Patients concerned about how soon they can get out of bed following spine fusion back surgery should make sure they’re familiar with all their surgical options, as the choices they make can also affect their recovery.

Conclusion

Your caregivers will have plenty of valuable tips for helping ensure a smooth, steady recovery from spinal fusion. For example, such simple tips will help you rehabilitate more quickly and with less discomfort:

• using slip-on shoes, eliminating the need to bend over and tie laces;
• having pajamas with button tops, so you don’t have to lift your arms and pull the PJs over your head
• drinking liquids from a squeeze bottle, so there’s no need to bend the neck when drinking from a cup.

But it’s essential to take care of your physical condition even before the operation since the timing of your recovery depends on it.

What is Failed Back Surgery Syndrome?

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

What causes Failed Back Surgery Syndrome? 

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

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

How successful is back surgery?

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

How do you know if you require back surgery?

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

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

Procedures that could lead to Failed Back Surgery Syndrome

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Common Questions About Back Pain: Do You Need Back Surgery?

Back pain affects an estimated eight out of 10 people over the course of their lives. So, it’s no surprise that this widespread medical condition sparks many questions among patients. 

One of the most prevalent questions that spine specialists receive from back pain patients is whether or not they’ll need surgery. Understandably, most patients want to avoid back surgery and the risks that it involves. 

In this article, we’ll answer some of the most common questions about back pain and back surgery. With this information, we aim to give you peace of mind in the range of treatments available for back pain today. 

Do I need surgery for persistent back pain?

If you’re experiencing ongoing or severe back pain, you may be wondering if you’ll need back surgery to finally eliminate that constant backache. To answer this question and get on the path to relief from debilitating back pain, you’ll likely need to consult a spinal surgeon.

Your spinal surgeon will need to assess your back symptoms, take a full medical history, and review your general health. But, don’t start worrying about the prospect of surgery. Back surgery is generally only needed in a small percentage of back pain cases. 

How many people require back surgery for back pain?

According to the UT Southwestern Medical Center, only 10% of back pain cases require surgery. Additionally, among back pain patients who require surgery, minimally-invasive procedures are widely successful. 

So, for most patients, back pain can be resolved with a range of non-surgical options. These trusted treatments can keep you off of the operating table and quickly restore your quality of life. 

When conservative treatments don’t help, your physician may recommend back surgery. This is often the case when the doctor is looking to provide relief from severe, disabling back pain that’s limiting your lifestyle, interrupting your sleep, and preventing you from being active.

What non-surgical treatment options are available for back pain?

The most common non-surgical treatment options available for back pain include:

• ice or heat therapy,
• anti-inflammatory medications,
• physical therapy,
• chiropractic care,
• massage therapy.

In some cases, patients may benefit from epidural steroid injections, which can alleviate pain and inflammation in the spine. Unfortunately, steroid injections can also trigger tissue damage if they’re used in excess. Most physicians recommend that patients undergo no more than three to four injections per year. 

Additionally, lifestyle changes are often very helpful in treating back pain without surgery. Specifically, changing your diet to lose weight can help remove pressure from the spinal nerves. This can help the irritated tissue heal and recover, as well as lessen neurological symptoms. 

Your physician may recommend rest for back pain after your initial diagnosis. However, it’s important to stay active with low-impact activities to prevent stiffness and maintain strength. Once back pain and inflammation have decreased, you’ll likely be able to increase your activity level.  

What are the best exercises for back pain?

Exercise is beneficial for back pain because it prevents stiffness in the ligaments and tendons. It can help you maintain mobility in the back while increasing circulation to the injured tissue. 

However, high-impact, strenuous exercise can do more harm than good for back pain patients. So, it’s crucial to choose your activities wisely. 

Some of the best types of exercise for back pain include:

• Walking
• Swimming and water aerobics
• Biking
• Resistance exercises
• Yoga

While exercising with back pain, remember to start slowly with short periods of activity. Make sure to rest in between your workouts. If you feel any pain or other concerning symptoms, such as numbness or tingling in the extremities, stop exercising and consider other activities. 

What causes lower back pain?

The most common lower back pain causes include:

Strains and Sprains

Strains and sprains are the most common causes of lower back pain. Strains involve stretching or tearing of the muscles or tendons, while sprains involve stretching or tearing of the ligaments. 

The causes and treatments of strains and sprains are similar. Overexerting the back while lifting a heavy object, suddenly twisting the back, or falling are possible causes. To treat lower back sprains and strains, physicians typically recommend rest and at-home care, such as heat/cold therapy. 

Patients may benefit from physical therapy for sprains and strains. A physical therapist can recommend stretching and strengthening exercises to alleviate tension while improving support for the back. 

Age-related Spinal Degeneration

The spinal structures, including the vertebrae, facet joints, and intervertebral discs, naturally degenerate with age. This degeneration can contribute to spinal conditions like a herniated disc, spinal stenosis, spondylolisthesis, degenerative disc disease, and osteoarthritis. All of these spinal conditions can lead to chronic lower back pain. 

What does one-sided back pain mean?

Lower left back pain and lower right back pain can be caused by any of the common back pain causes listed above. However, if you have one-sided back pain along with other symptoms, such as fever and/or pain while urinating, the pain could be stemming from an internal organ. So, in this case, make sure to receive a medical evaluation promptly. 

Can sports injuries cause lower back pain?

Especially in young adults, participating in sports is a key risk factor for lower back pain. According to Medscape, 7% to 13% of all sports injuries in college athletes are lower back injuries. Additionally, certain sports are more likely to trigger back pain than others. 

The sports that present the highest risk of lower back pain include gymnastics, soccer, and dance, according to a 2009 study published in Sports Health. 

Which medical conditions require back surgery?

Here are the symptoms and conditions that might make back surgery an optimal solution for you:

• Spinal nerve compression

Back injuries and conditions that compress your spinal nerves can cause debilitating back pain and/or numbness, tingling, and weakness in the legs.

• Intervertebral disc damage

With a bulging, ruptured, or herniated disc, the rubbery discs that cushion and separate the bones in your spine are injured. So, the spinal structures are subject to more impact with day-to-day movements. 

• Vertebral fracture

A fractured vertebra typically causes back pain and spinal instability. Many vertebral fractures heal on their own, while others require surgery. or other damage to your spinal column from a back injury. A fractured disc will cause pain, and also leaves your spine unstable, often causing additional back pain.

You may also be diagnosed with a condition that causes back pain and additional progressive nerve compression:

• Scoliosis, a curvature of the spine that can compress nerves in the back
• Spinal stenosis, a narrowing of the spinal canal typically caused by arthritis
• Spondylolisthesis, the forward slippage of a spinal segment
• Degenerative disc disease, the development of pain in a disc as a result of its normal wear and tear over time
• Radiculopathy, the irritation, and inflammation of a nerve caused by a herniated disc
• Kyphosis, a humpback deformity

What are the main lower back surgery types?

For lower back pain relief in severe cases, spinal surgeons may recommend one of the following types of lower back surgery:

• Spinal decompression

Spinal decompression is the most common lower back pain surgery. It involves alleviating pressure on the spinal nerves by removing certain spinal tissues. 

Several procedures fall under the umbrella of spinal decompression, including:

• Laminectomy: Widely used for spinal stenosis, this procedure involves removing some or all of the lamina, which covers the back of the spinal cord. 
• Discectomy: Commonly used for lower back herniated disc surgery, discectomy involves removing damaged disc tissue. 
• Foraminotomy: This procedure involves creating more space in the intervertebral foramen, where the nerve roots leave the spinal canal. 
• Lower back fusion surgery

During fusion surgery in the lower back, your surgeon will secure bone graft material in between one or more vertebrae. This process permanently fuses the targeted vertebrae to prevent spinal instability. 

Unfortunately, lower back fusion eliminates all independent motion of the vertebrae. This significantly diminishes patients’ back flexibility and may keep them from performing certain activities. Fusion also largely prolongs the recovery time for lower back surgery. 

Recent innovations in spinal surgery, such as the TOPS™ System from Premia Spine, can prevent spinal instability after decompression surgery without compromising the patient’s mobility. The TOPS™ System is a non-fusion spinal implant that moves with the spine, protects neighboring segments from degeneration, and preserves spinal mobility. 

Your spinal surgeon’s primary goal is to eliminate your back pain and restore your quality of life.  When a progressive condition is diagnosed through testing and examination, back surgery may certainly move to the forefront of your surgeon’s mind. It’s their job to consider the best, most individualized treatment options to eradicate back pain before it becomes worse.

Common Questions About Back Pain: What are the Different Types of Back Surgery

There are several different types of back surgery proving successful at resolving patients’ back pain issues, each involving the highest level of surgical technology available today, as well as the skill of a board-certified spinal surgeon. If your spinal specialist advises back surgery, you’ll embark upon a learning process about the different available back surgery procedures – guided by your physician. You always want to get your information directly from your spinal surgeon, since back surgery information online can be outdated or incorrect, and Googling back surgery topics can sometimes cause unnecessary anxiety.   The best course of action for researching back surgery procedures is to prepare a list of questions for your surgeon, and request all of the back surgery literature possible that your doctor can provide you with so that you can fully understand what will be done during your surgical procedure.

Overall, back surgery can accomplish several different pain-relieving goals, including removing portions of the bone to widen the narrowed area in your vertebrae, which can cause back pain. Your spinal surgeon may remove the gel-like middle section of a ruptured disc to relieve pressure on pinched nerves in the back. And sometimes, the damage to a disc is so severe, your doctor has to remove the entire disc and then fuse together the remaining discs.

Below is a list of some of the different types of back surgery that may be the customized choice for your back damage or condition:

• Discectomy. In this type of back surgery, your spinal surgeon will remove the herniated portion of a disc to relieve irritation and inflammation of a nerve.
• Laminectomy. This back surgery procedure involves removing the bone overlying the spinal canal, which then enlarges the spinal canal to relieve nerve pressure caused by spinal stenosis.
• Fusion. Spinal fusion permanently connects two or more bones in your spine. When the vertebrae are fused, you get added stability to your spinal movements, or relief of pain from a spinal fracture. Occasionally, spinal surgeons will opt for spinal fusion to eliminate painful motion between vertebrae that can result from a degenerated disc or injured disc.
• Vertebroplasty. During this type of back surgery, your surgeon will inject bone cement into compressed vertebrae to stabilize fractures or compressed vertebrae, which can relieve pain. A balloon-like method may be used to expand the vertebrae area, allowing your surgeon to inject the bone cement into the treatment area for optimal results.
• Artificial discs. Your spinal surgeon may find that your discs are in an advanced stage of degeneration, and that implanted artificial discs are necessary for the creation of a spine that functions better and without compression to the nerves. Artificial disc technology is advancing every day through rigorous studies and testing, and your surgeon can introduce you to the materials and information about having new discs implanted for your spinal pain relief.
• TOPS (Total Posterior Spine) System.  A mechanical implant device that stabilizes the spine without eliminating the independent motion of the individual vertebrae, as spinal fusion does.

Since back surgery is a complex procedure, work with your spinal surgeon to explore all your options.  Every situation is different and you need to feel secure that you have fully researched which type of back surgery would be best for you, and if back surgery is necessary at all. And of course, your doctor will guide you through all the information you need regarding recovering from back surgery and what you can expect for your post-surgery lifestyle.

reference: www.mayoclinic.com