When Spinal Surgery is Right for You (Pt. 3)

Now that we’ve come to part three of my spinal surgery blog series, we will cover even more spinal conditions, how they can be treated, and if surgery is necessary, specifically, those of the degenerative nature.

Degenerative spinal conditions often come with age, and can lead to chronic pain disruptive of one’s daily activities and lifestyle. Consider the constant weight and pressure applied to the spine and neck day in and day out. This, over a long period of time, can lead to loss of function. More specifically, discs begin to lose elasticity, ligaments start to calcify, and arthritic pain in general is increased.

Like with all conditions, medication and physical rehabilitation can provide more or less relief for certain individuals, but surgery may be required in more severe situations. Surgeries performed for degenerative disorders involve removing whatever part of the spine is causing the compression in order to relieve stress on the surrounding nerves, and thus, relieve pain. Some of those conditions include herniated discs, degenerated discs, and bone spurs.

  • herniated disc is when the inner material of said disc is exposed, compressing nearby spinal nerves. The surgical consideration to correct this includes removing the exposed material, or the entire disc.
  • Degenerative disc disease can occur in any motion segment /joint along the spine. When the cartilage lining the joints begins to wear out, those joints become irregular, much more stiff, and can begin to swell; another source of pressure being applied to the surrounding nerves. Surgery can range from complete removal/replacement of the joint causing the pain, to relieving the pressure in the nerves in order to relieve pain.
  • Bone spurs are the human body’s natural response to spinal column stresses. The bones attempt to straighten themselves out, which typically results in growths along the spine affecting nerve passages. Undergoing surgery for this requires removal of the spurs, or the entire joint depending on their severity.

If you or someone you know is affected by degenerative disc disease, herniated discs, arthritis, or bone spurs, consult your medical professional to discuss options before deciding on surgery. Regular rehabilitation can help in relieving pain, but minimally invasive surgery has been proven to be a safe, successful alternative.

Originally published on GilTepperMD.com


When Spinal Surgery is Right for You (Pt. 2)

Welcome back, friends. As discussed in my previous blog, spinal conditions and the types of surgeries that ensue can be complex. Exploring a number of other spinal issues, I thought covering the following would be appropriate.

At times, a stabilizing spinal reconstruction with disc replacement or fusion technique may be most suitable for return to action. There are several types of options here, one of the most common being spinal fusion surgery. This is done by a surgeon fusing two vertebrae together to form a single, stable cohesive unit that prevents movement, which is often the cause of pain.

Patients suffering from spondylolisthesis are the best candidates for this surgery, as this is an unstable misalignment of two or more vertebrae that causes painful movement. Fusing said vertebrae with proper alignment, using rods and screws can prevent continued and progressively deteriorating pain. However, spinal fusion is not for everyone, and is not considered a long-term option. The joint can wear over time, leading to the familiar pain that was once cured. That said, I have been performing this surgery successfully since the early 90’s and have followed some pleased patients for nearly 20 years.

Motion sparing procedures have gained FDA approval recently and are increasing in popularity. Here choices include interspinous devices and artificial disc replacement (ADR). Spinal disc replacement or arthroplasty may serve in select patients as an appropriate choice for procedure. It combines a minimally invasive technique and motion sparing principles while decompressing the nerves and stabilizing the segment. As a principle FDA investigator on such artificial disc since 2003, I have performed this operation with remarkable and sustainable success over the years. I am pleased with the recent adoption and FDA approvals.

Laser spine surgery seems to be more of a dated technique now that minimally invasive surgery not including a laser has become a staple among hospitals across the world, and has been found to be much more effective. In the past, patients may have undergone this procedure due to spinal stenosis, herniated discs, or sciatica. However, the actual use of lasers was later discovered to be not much more effective than traditional methods, paving the way for minimally invasive surgery.

Coflex is another alternative to standard surgical practices that involves a stabilization procedure excluding rods and screws for patients suffering from spinal stenosis. Coflex’s signature device is a titanium implant that stabilizes the spine following surgical decompression, helping maintain your spine’s normal foraminal height and motion. This implant allows for much more flexibility compared to rods and screws, but is much stronger as well thanks to its titanium makeup. Additional benefits of this procedure include a much shorter recovery period, lasting relief for years to follow, minimal blood loss upon being surgically implanted, and more natural movement.

When Spinal Surgery is Right for You (Pt. 1)

Enduring back pain and debilitating discomfort can be incapacitating for patients of all ages. If traditional forms of conservative treatment do not seem to be alleviating this suffering, spinal surgery may be the next appropriate step.

It’s important to understand conservative spinal care for those who feel they may need surgery to see if these strategies relieve pain beforehand. These can include applying ice or heat, physical therapy, moderate exercise, or simply waiting. Non impact home exercise routines, stretching, rolling and core build up programs can be both helpful and prevent future bouts. Swimming breast stroke for 20-30 minutes daily builds up supporting spine muscles. Back pain can go away with time, but know signs of a serious case when waiting to seek the help of a medical professional. Should you experience a fever or decreased bowel/bladder control, consult a physician immediately.

Though spine surgery should be a last resort option for many people, back surgery of any kind can be extremely effective in relieving persistent pain. One common debilitating symptom is radiating pain. Sciatica is often a strong indicator of someone suffering from a damaged disc. This is an intense pain that can be felt in the lower back, buttocks, thighs, and legs. If you or someone you know experiences this sensation, traditional forms of rehabilitation are recommended before considering surgery. Up to 90 days in which a patient exercises and takes care of their back have been shown to alleviate this pain, but surgery can do so at a faster rate depending on the severity of one’s pain.

Microdiscectomy is a type of surgery for patients suffering from such damaged spinal disc, due to disc tear and deterioration over time with protrusion. This can cause the sides of the damaged disc to bulge outward and apply pressure to any surrounding nerves. In more extreme cases, the disc core can herniate and compress the more delicate interior of the spine. With the advent of improved magnification and illumination in surgery this can be performed in a non disruptive minimally invasive fashion. One can expect to return to an active routine much improved in a short time.

Spinal stenosis is common among older patients. This is when the area surrounding the spine is narrowed, leading to a higher risk of pain through protruding discs or ligaments. A few signs of this include leg pain upon standing up or walking short distances that is then relieved when sitting, pain leaning forward or backward, and sciatica. Spinal fusion or a laminectomy can help if physical therapy and medication fails to do so.

In my next blog, I will be covering a number of other spinal conditions and how to treat those as well.