BACK AND SPINE

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Types of Back Pain
Upper Back Pain

Upper Back Pain Causes

Chronic Back Pain 

Depression & Chronic Pain
 

  CONDITIONS TREATED

Herniated Disc
Bulging Disc
Degenerative Disc Disease
Facet Joint Disease
Spinal Stenosis
Foraminal Stenosis
 

TREATMENT OPTIONS

Foraminotomy
Discectomy
Laminectomy
Laminotomy
 

LOWER BACK PAIN

Low Back Pain
Causes of Low Back Pain
Low Back Pain Treatment
Epidural Steroid Injections
Surgery For Low Back Pain
 

SURGERY PROCEDURES

Surgical Procedures
Types of Back Surgery
Spine Surgery
Spine Fusion
Spinal Disc Replacement

 

PATIENT RESOURCES

Back Pain Relief
Back Pain Treatment
Back Surgery
Artificial Discs
Insurance Carriers

 
 

Low Back Pain Surgery

The majority of the time surgery is rarely used as a method for lower back pain treatment.  In fact, many times surgery may not even help.  Most surgeries for the lower back are performed to treat herniated discs.  However, even those with herniated discs do not need surgery.  It is generally only recommended if a disc causes severe and disabling sciatica.

While surgery is not likely, it is still a possibility depending on the cause of your pain.  The following are some instances where surgery may be a possibility; however, surgery may still not be needed in these conditions:

  • Spinal Stenosis

  • Spinal Fracture

  • Spinal Infection (such as osteomyelitis or abscess)

  • Unstable Spine (such as Spondylolisthesis)

  • Spinal Tumor

If nonsurgical treatment has not been successful and your doctor suggests that you consider surgery, the type of procedure he or she recommends will depend on the cause of your back problems and the experience and preference of the surgeon.

  • Herniated disc surgery removes disc material that is pressing on the spinal cord or a nerve root.

  • Spinal stenosis surgery (spinal decompression with or without spinal fusion) widens a narrowed spinal canal and relieves pressure on the spinal cord or a nerve root.

  • Spinal fusion (arthrodesis) for spondylolisthesis and other "unstable spine" conditions joins vertebrae together to relieve pressure on the spinal cord or a nerve root and to stabilize the spine.

  • Vertebroplasty or kyphoplasty may relieve pain from compression fractures.

  • Surgery for infection includes debridement with or without joint fusion, or drainage of an abscess.

  • Disc replacement surgery removes a spinal disc that is severely damaged by degenerative disc disease (DDD), and replaces it with an artificial disc. This is currently only for carefully selected patients, and it is done by specially trained surgeons.

  • Surgery for spinal tumors includes tumor removal and stabilization with or without fusion. Understand that surgery is a last resort.  Discuss the option with your doctor with the understanding that back surgeries are not always successful.   You will also likely have to commit to physical therapy after the surgery.

Spine Surgery for Leg Pain or Lumbar Decompression Surgery

If most of the patientís pain is leg pain (radiculopathy), the pain may be due to a pinched nerve. If the leg pain does not start to resolve with conservative treatment after 4 to 6 weeks, an imaging study (such as an MRI scan) may be recommended to determine whether or not there is nerve pinching (e.g. from a herniated disc).

If there is pressure on the nerve, then either injections or a lumbar decompression spine surgery to take pressure off the nerve may be recommended. Back surgery for a pinched nerve can usually be done with a minimally invasive approach, and will usually result in early return to normal function (1 to 3 weeks). The success rate for decompression spine surgery is high, with approximately 90% of patients experiencing good relief of the leg pain after the surgery.

Surgery for Low Back Pain

Surgery to treat low back pain can be a far more extensive type of back surgery, with a longer healing period and a somewhat lower success rate, than back surgery for a pinched nerve (leg pain). If the patient does not get low back pain relief after 6 to 12 months of conservative treatment, however, a fusion surgery may be a reasonable option. When the patient has the right indications, low back surgery to stop the motion at a painful motion segment and remove the pain generator should reduce the patientís lower back pain.

Recovery after Surgery for Low Back Pain or Leg Pain

After a spine fusion surgery, it takes 3 to 12 months to return to most normal daily activities, and the success rate in terms of pain relief is probably between 70% and 90%, depending on the condition the spine surgery is treating. Soon a total disc replacementóor artificial disc surgeryómay also be available as a treatment option for patients with certain types of conditions that cause ongoing low back pain. For patients who are 55 or older, symptoms of back pain and/or leg pain are much more likely to be due to degenerative arthritis (osteoarthritis) that might result in a narrowing of the canal (spinal stenosis) and/or instability of one vertebral segment. Generally, the low back pain and/or leg pain created by these back conditions will get worse with walking and will improve with sitting. Often, the symptoms will have been present for years, and may get worse at a very slow rate. Once a patient gets to the point that he or she can no longer adequately function because of the low back pain, lumbar decompression with or without spine fusion may be recommended to help increase the individualís activity tolerance and quality of life.

When Spine Surgery is an Emergency

The vast majority of spine surgery procedures to treat severe back pain and/or leg pain are elective. However, there are a few symptoms that are possible indications of a serious medical condition, and patients with these symptoms should seek emergency medical care. These symptoms include:

  • Sudden bowel and/or bladder incontinence (either the inability to retain or hold waste) or progressive weakness in the legs. Either of these symptoms could indicate nerve damage or cauda equina syndrome.

  • Severe, continuous abdominal and back pain, which could indicate an abdominal aorticaneurysm.

Any patients with either of these symptoms should seek immediate medical attention as they may need emergency spine surgery.

 

 

 

 
         

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Patient Resources

Anatomy of The Lower Back  -  Misdiagnosing Low Back Pain  -  Functions of The Low Back  -  Before Your Surgery  -  After Spine Surgery

Spine Surgery Questions  -  Anatomy of The Spine  -  Back Pain Definitions  -  Obesity and back pain  -  Orthopedic Surgeons  -  Spine Surgeons

Back Pain Myths  -  Back Pain Medication

 

 

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