TOPS System

What is Spinal Decompression?

Though you may not realize it, spinal decompression is an important topic for many people suffering from debilitating back pain. Spinal decompression refers to the process of relieving pressure on one or more pinched (or impinged) nerves in the spinal column. The pressure on such nerves can cause pain, restrict mobility, and a host of other physical problems.

A vast range of spinal conditions, including spinal stenosis, disc degeneration, bulging, herniated or slipped discs, and facet syndrome, can place pressure on nerves emanating from the spinal column. This may create the need for spinal decompression surgery. 

This article will dive into the specifics of spinal decompression and how it could benefit your recovery from chronic back pain. 

Defining Spinal Decompression

So, what is spinal decompression? It’s a treatment for various spinal conditions that can be performed both surgically and non-surgically.

Non-surgical spinal decompression utilizes mechanical, computer-controlled traction devices to reduce the pressure placed on nerves in specific portions of the spine. Inversion therapy, in which patients hang upside down, is another form of non-surgical spinal decompression. Certain spinal decompression exercises may also be effective for alleviating back and nerve pain. 

For patients who don’t respond to non-invasive methods, spinal decompression surgery can provide dramatic symptom improvement. In this surgical procedure, portions of the bone or tissue of the spine that impinge on a nerve are cut away, relieving the pressure.

Historically, the spinal fusion procedure has been performed in conjunction with spinal decompression surgery. Fusion stabilizes the spine at the point where the decompression procedure was performed.

Unfortunately, spinal fusion, which fuses two (or more) vertebrae to enhance spinal stability, eliminates the independent motion of the fused vertebrae. This may accelerate the degeneration of adjacent vertebrae.

Today, the TOPS™ (Total Posterior Spine) System provides a spinal fusion alternative for patients who are considering spinal decompression surgery. In contrast to fusion, TOPS preserves the complete range of the spine’s natural motion and has been shown to provide better outcomes than fusion in global clinical studies.

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Why Would You Do a Spinal Decompression?

A large nerve pathway extends through the middle of the spinal canal. When these nerves become compressed and irritated, whether due to an injury or age-related degeneration, you may experience lasting pain. With this in mind, patients undergo spinal decompression for relief from spinal nerve compression symptoms. 

Non-surgical spinal decompression is performed as a conservative treatment option for persistent back pain. Whether caused by a condition like spinal stenosis or simply poor posture, back pain can benefit from non-invasive spinal decompression. 

Surgical spinal decompression, on the other hand, is typically done only for severe spinal conditions. It’s generally only considered after the patient has undergone six to 12 months of non-surgical treatment without experiencing improvement. 

Additionally, surgical spinal decompression is typically implemented for patients experiencing severe spinal nerve compression and who are at risk of permanent nerve damage. 

What Conditions Does Spinal Decompression Treat?

Spinal decompression, both surgical and non-surgical, may be used to treat:

• A bulging disc

The tough outer shell of an intervertebral disc becomes weaker and thinner with age. Eventually, the disc may flatten and bulge out into the spinal canal.  

• A herniated disc

A herniated or slipped disc goes one step beyond a bulging disc. When a disc becomes herniated, it means that the soft disc interior protrudes through a crack in the disc exterior. 

• Sciatica

Sciatica occurs when the sciatic nerve, which extends from the lower back through the backs of both legs, becomes irritated. This results in symptoms including burning, tingling, numbness, pain, and/or weakness along the path of the sciatic nerve. 

• Degenerative disc disease

Degenerative disc disease refers to back pain and other symptoms caused by a degenerated intervertebral disc. This degeneration typically occurs from age-related wear-and-tear. 

• A pinched spinal nerve

A pinched or compressed spinal nerve causes symptoms like pain, tingling, numbness, and weakness. 

• Spinal stenosis 

Spinal stenosis occurs when the spinal canal gradually becomes narrower. This condition limits the amount of open space in the spinal canal, which can trigger spinal nerve compression. 

• Spondylolisthesis

Spondylolisthesis develops when one of the vertebrae in the spine shifts out of its regular position and settles on the bone directly beneath it. In some cases, the displaced vertebra compresses nearby nerves. 

What Happens During Spinal Decompression?

Non-Surgical Spinal Decompression

During non-surgical spinal decompression, the patient is positioned on a motorized device like a traction table. This device uses motorized traction to gently stretch the spine. This process alters the alignment of the spine, as well as the forces placing stress on the spine. 

When non-surgical spinal decompression is successful, it removes pressure from the nerves and other spinal structures. It also increases the flow of oxygen, nutrients, and water to the spine, which promotes healing.

Surgical Spinal Decompression

Although the goal of surgical spinal decompression is the same as its non-surgical counterpart, the process is completely different. For one, numerous techniques of surgical spinal decompression exist, namely laminectomy/laminotomy, foraminotomy/foraminectomy, and discectomy. 

• Laminectomy and laminotomy involve removing some or all of the lamina. The lamina is a piece of bone positioned at the back of the spinal canal that acts like a roof. By eliminating some or all of the lamina, surgeons can create more space in the spinal canal and resolve nerve compression.
• Foraminotomy and foraminectomy decompress spinal nerves by surgically enlarging the openings (foramen) around the nerve roots. 
• Discectomy simply involves removing a portion of an intervertebral disc. This process can resolve nerve compression caused by a damaged spinal disc. 

Do Chiropractors Do Spinal Decompression?

Chiropractors perform non-surgical spinal decompression therapy. Only a qualified, licensed spinal surgeon can perform spinal decompression surgery. 

A spinal decompression chiropractor stretches and manipulates the spine to alleviate back and leg pain. This process is entirely non-invasive, making it a safe, low-risk choice for patients to consider. 

Your chiropractor may also be able to recommend spinal decompression stretches. You can perform these stretches anywhere, at any time, making it possible to undergo spinal decompression at home. For example, reaching your arms above your head, interlacing your fingers, and trying to touch your palms to the ceiling is one stretch that can help decompress the spine.   

How Quickly Does Spinal Decompression Work?

Most patients who undergo non-surgical spinal decompression therapy from a professional chiropractor will experience symptom relief after four to six weeks. In this period, patients may undergo weekly spinal decompression sessions. Some patients may notice pain relief after just one session, while others will need more sessions to experience significant symptom improvement. 

Surgical spinal decompression works differently. Patients will likely experience soreness and inflammation for a few days after the procedure. Post-operative pain will gradually improve, with most patients needing approximately four to six weeks to regain their mobility. 

Spinal decompression surgery is commonly paired with spinal fusion. As aforementioned, the goal of fusion is to prevent spinal instability by permanently connecting the affected vertebrae. Spinal fusion significantly lengthens the recovery time for spinal decompression surgery, requiring up to a year for patients to make a full recovery. 

When Does Spinal Decompression Surgery Become a Necessity?

Spinal decompression is typically considered necessary if:

• The patient has already undergone six to 12 months of non-surgical therapies and their symptoms haven’t improved (or have gotten worse). 
• The patient is experiencing debilitating back pain and/or neurological symptoms that are diminishing their ability to get through the day. 
• The patient is disabled due to back pain and/or neurological symptoms. 
• The patient is at risk of permanent nerve damage.

If you’re a patient whose pinched spinal nerve is not responding to non-invasive decompression methods, make sure to discuss all of your surgical options with your physician.

5 Ways To Avoid Spinal Fusion Surgery

Table of Contents

• What to Expect After Spinal Fusion Surgery?

• Risks of Spinal Fusion Surgery

• What Are The Alternatives to Lumbar Fusion?

• 5 Ways to Avoid Spinal Fusion Surgery

• Future Complications From Spinal Fusion

When back pain from a spinal condition becomes chronic, physicians may present the option of spinal fusion surgery to patients. However, few patients want to undergo spinal fusion unless it’s the last resort. Spinal fusion involves all of the risks of other surgical procedures, along with the prospect of significantly reduced spinal mobility. 

Thankfully, medical advancements in recent decades have made way for spinal fusion alternatives. This article will discuss strategies for avoiding spinal fusion surgery while obtaining relief from persistent back pain. 

What is Spinal Fusion Surgery?

Spinal fusion surgery is a medical procedure that involves fusing two or more spinal vertebrae so that they can heal and become a single bone. This procedure eliminates motion between the targeted vertebrae while preventing irritation to the surrounding nerves and ligaments.

To perform spinal fusion, the surgeon extracts a bone graft from the patient’s pelvis or uses a synthetic bone graft. The graft is then positioned and secured between the affected vertebrae. Metal plates, screws, and rods are sometimes used to hold the two spinal vertebrae together while the bone graft heals. This surgical procedure improves stability and corrects spinal deformities. 

How Long Does It Take to Recover From Spinal Fusion Surgery?

Usually, it takes about 4 to 6 months to return to gentle activities after spinal fusion surgery. It can take between 6 and 12 months to make a full recovery from the procedure.

Keep in mind that the healing process can differ from person to person, and several factors can influence recovery. Diet, weight, age, and lifestyle can go a long way in determining how fast the patient will recover from the surgery. 

Patients are advised to undergo physical therapy, avoid strenuous activities, and maintain a healthy diet after spinal fusion surgery to enhance the recovery process. You’ll likely need to take four to six weeks off of work after fusion surgery, or longer if your occupation is physically demanding.  

What to Expect After Spinal Fusion Surgery

Just like any other spinal surgery, spinal fusion surgery comes with several risks; a nerve could get damaged, there could be infection, bleeding, blood clots, poor wound healing or pain in the pelvis area where the bone graft was harvested, loss of bowel or bladder control may occur too. 

Spinal fusions can also put pressure on the bones that are above and below the fusion, which can cause them to break down and degenerate more quickly. Subsequently, this leads to an increased likelihood of further surgery in the nearest future. 

Spinal fusion is a surgery that risks leaving patients in pain or needing the procedure again in the future.

The only time you should think of undergoing spinal fusion surgery is when you know that you are capable of taking a long time from work without your finances being affected, say 4 to 6 months. Or you have good insurance that can cater to you and your family. 

If you can not confidently boast of any of the above then it is advisable for you to avoid spinal fusion surgery. 

Risks of Spinal Fusion Surgery

Just like any other spinal surgery, spinal fusion surgery comes with several risks, including:

• Nerve damage
• Infection
• Bleeding
• Blood clots
• Poor wound healing
• Pelvic pain at the area where the bone graft was harvested
• Loss of bowel or bladder control, in severe cases

Spinal fusion can also place pressure on the bones located above and below the fusion. This may cause them to break down and degenerate more rapidly. Known as adjacent segment disease, or ASD, this spinal fusion complication leads to an increased likelihood of future revision surgery. 

Patients should generally only consider undergoing spinal fusion surgery if:

• Several months of non-surgical treatments have failed
• They’re capable of taking a long time off of work (around 4 to 6 months) without their finances being affected, say 4 to 6 months
• They have good insurance that can cover the cost of the procedure 

Additionally, patients should speak at length with a spinal specialist before considering fusion to ensure that they’ve exhausted every other available treatment option. 

What Are The Alternatives to Lumbar Spinal Fusion?

In addition to non-surgical treatment approaches, advanced non-fusion spinal implants present an alternative to lumbar spinal fusion for many patients. One such implant is the TOPS System from Premia Spine. 

The Premia Spine TOPS System is a non-fusion spinal implant that provides a genuine alternative to spinal fusion. It’s a mechanical device positioned between two titanium plates that offers stability while retaining spinal mobility in all directions. It replaces the spinal structures, such as the lamina or facet joint, that are removed during lumbar spinal decompression surgery. 

Regain your mobility with Premia Spine! Contact us now

The TOPS System is designed to be used between the L2 and L5 spinal segments, which are often affected by lumbar spinal stenosis and spondylolisthesis. It re-establishes a controlled range of motion within the lumbar spine to alleviate pain without limiting the patient’s activities. 

In a 7-year clinical study, the TOPS System was found to maintain clinical improvement and radiologic stability over time in patients with spinal stenosis and degenerative spondylolisthesis. 

Get in touch with a medical professional to discuss your treatment options today.

5 Ways to Avoid Spinal Fusion Surgery

1. Physical Activity and Targeted Exercises

Many people believe that taking enough rest from physical activity is the best way to care for back pain. There’s no denying that rest can prevent you from overstressing the spine. Additionally, rest is essential to the healing process for many back injuries, namely acute back injuries and sports injuries. 

However, many spinal injuries and conditions benefit from physical activity. Exercise increases blood flow and, as a result, the flow of oxygen and nutrients to the spine. This stimulates the healing process while helping to alleviate stiffness that can worsen back pain. 

Despite the benefits of physical activity for spinal pain, certain precautions will ensure that your exercise routine doesn’t do more harm than good:

• Avoid high-impact activities, like running and weightlifting, which can cause further injury. Low-impact activities, such as walking and water aerobics, are safe options. 
• Talk to your doctor before starting any new exercise routine, and ease into it. 
• If you experience spinal pain (not muscle soreness) while exercising, stop and rest. 

Additionally, targeted exercises can benefit your recovery from spinal conditions. Exercise can strengthen the muscles that support the spine, namely those in the back and abdomen. By strengthening these muscles, you can reduce the impact exerted on your spine with day-to-day motions. 

Here are a few simple exercises to try at home: 

• Lie on your back, bend your knees, and place your feet flat on the floor. Gently lift your buttocks a few inches off the floor toward the ceiling. Complete three sets of 10 repetitions.
• Lie on your back and hug your knees to your chest. Gently roll side to your side, just a few inches, to massage and stretch your lumbar back area. Return to the starting position and repeat to the other side. 
• From a standing position, bend at the waist with your fingers reaching for the floor. Go only as far as your body naturally permits. Now, just hang there and breathe naturally for one minute. With each breath, let your back and legs relax and stretch. Repeat three times.

2. Physical Therapy

Physical therapy is almost always recommended for patients struggling with chronic back pain from spinal conditions. While your physical therapist may recommend exercises for muscle development like those listed above, they can offer unique insight and recommendations for your recovery process. In general, physical therapy improves strength, mobility, and stamina for patients with spinal pain. 

Your physical therapist can specifically target the problem areas of your spine. They may correct abnormalities in your gait, posture, and lifting techniques to reduce spinal compression. Paired with targeted training and pain management strategies, these methods work to alleviate symptoms of spinal conditions. 

It may take several months for physical therapy to improve your back pain and other symptoms. However, patients often find that physical therapy allows them to exercise with less frequent and less severe pain. PT also frequently improves patients’ ability to comfortably complete day-to-day activities, like grocery shopping and gardening. 

Talk to your doctor before scheduling an appointment with a physical therapist. Your doctor can likely refer you to a PT that specializes or is highly experienced in your condition.

3. A Healthy Diet and Weight Loss

As the saying goes, an apple a day keeps the doctor away. While an apple might not keep your back pain at bay, maintaining a healthy weight is crucial to your spinal health. 

Being overweight increases the strain on all of your joints, as well as your spine. Each extra pound adds to the impact exerted on your spine with every stride or repetition at the gym. 

Clinical research has supported the claim that body weight is related to back pain. A 2010 review in the American Journal of Epidemiology found that the risk of lower back pain is directly linked to body mass index or BMI. 

Additionally, a 2017 study conducted at the University of Tokyo Hospital found that after reviewing 1,152 men’s medical histories from 1986 to 2009, a patient’s BMI and body fat percentage correlated to the risk and incidence of back issues. 

Eating a diet rich in vegetables, fruits, whole grains, and lean protein can help you maintain a healthy diet. Avoid consuming foods that are high in sugar and cholesterol, as well as trans and saturated fats). These foods can contribute to inflammation throughout your body and in your spine, which may worsen spinal pain while inhibiting your recovery process. 

Additionally, eating a nutritious diet and maintaining a healthy weight will support the health of your entire body. With greater overall health, patients can often recover from spinal conditions more rapidly.

4. Spinal Manipulation

Spinal manipulation is a technique typically performed by chiropractors to restore spinal alignment. It can help resolve back pain and nerve compression caused by spinal misalignment. Additionally, by realigning the spine, spinal manipulation can improve the flow of blood (and, as a result, oxygen, and nutrients) to the injured spinal tissues.

There’s a range of different techniques that chiropractors may implement for spinal manipulation. However, the most common technique is the high-velocity low-amplitude (HVLA) thrust.

The HVLA thrust often causes a “pop” that patients can hear. When using this method, the chiropractor will apply an abrupt force to a joint with their hands while the body is in a specific position. 

In some cases, chiropractors may opt for a gentler method known as spinal mobilization or low-force methods. These techniques don’t require twisting the body or applying a sudden force to the body. They may be implemented to suit the patient’s comfort level, preferences, or size, or for specific conditions (like osteoporosis, for example. 

Many spinal conditions can be exacerbated by spinal misalignment and, therefore, benefit from spinal manipulation. The most common of these conditions include spinal stenosis, spondylolisthesis, and herniated disc.

When combined with other treatment options listed here, spinal manipulation and other chiropractic methods may help patients avoid spinal fusion surgery. However, if your back pain has resulted from a traumatic injury, like a spinal fracture, this treatment likely won’t work for you. 

5. Epidural Steroid Injections

Epidural steroid injections can help calm pain caused by an irritated or compressed spinal nerve. These injections contain powerful anti-inflammatory medication that can offer relief within just a few days.

While steroid injections are quick and accessible, they’re not generally used as a long-term solution. Undergoing more than three to four injections per year can lead to tissue damage. Additionally, make sure to consult your doctor about the benefits and drawbacks of steroid injections for your particular spinal condition. 

Future Complications From Spinal Fusion

Given that spinal fusion surgery may be correlated with accelerated degeneration of the joints surrounding the fused vertebrae, many professionals believe that fusion can lead to future spinal issues. This is especially true for patients who undergo spinal fusion relatively early in adulthood. 

This implies that the longer you live after undergoing spinal fusion surgery, the higher your chances are to experience future spinal problems. 

According to a study published in the Journal of Spine Surgery, revision spinal surgery after the initial spinal fusion procedure takes place in 8% to 45% of cases. The reasons for revision include non-union, implant failure, recurring spinal stenosis, adjacent segment disease, infection, and flatback syndrome. 

Complications from spinal fusion may contribute to chronic back pain in the future. Whether caused by adjacent segment disease, spinal muscle injuries, hardware malfunction, or graft site pain, pain after spinal fusion can be debilitating. 

With these risks in mind, it’s generally recommended to avoid spinal fusion whenever possible and opt for safer options. Thankfully, medical advancements have paved the way for spinal fusion alternatives that can provide lasting stability and pain relief, like the TOPS System. These alternatives can improve your quality of care, alleviate your back pain, and give you a greater overall quality of life. 

The Premia Spine TOPS System. Filling a Clinical Void in Spine Surgery

Premia Spine is proud to offer TOPS™ System which has taken spine surgery to the next level and achieved life-changing results for patients.

This safe and dynamic alternative to spinal fusion is the ideal option for people who suffer from degenerative spondylolisthesis and spinal stenosis worldwide. TOPS™ System has been designed with the well-being of the patient and their future mobility in mind.

TOPS™ System is a dynamic implant that provides stability in the spine without the need to fuse any of the bones together. Spine surgery with the TOPS™ System can help patients experience immediate pain relief following the operation and in some cases, a person can be on their feet and walking within 24 hours. 

In conjunction with a strength and rehabilitation program delivered by a physical therapist, a person can return to their best condition in years, no longer living with the stress of back pain which can hinder a person in many aspects of their life, including; their career, fitness, and social life.

The implant allows patients to walk normally, bend and maintain flexibility, while reducing pain, this is still possible even if a person is suffering from the effects of sciatica. 

Spinal fusion is effective at easing pain levels but the end result is two vertebrae that are fixed together, forming a rigid area of the spine, hampering mobility and flexibility. For example, simple tasks such as bending over to pick something up off the floor may not be possible after the procedure.

Steve Michael De Luca UPMC, TOPS Pivotal Study Investigator, says: “TOPS provides excellent range of motion while maintaining stability, which is very unique to this device. 

Get in touch with Premia today to find out how the TOPS system can help improve your quality of life.