Back Surgery

Elements of Spinal Fusion

Spinal Fusion Recovery

Spinal Fusion History

Sometimes, both an anterior lumbar interbody fusion and a posterolateral gutter fusion surgery will be performed and both the front and back of the spine will be fused.

Are you trying to avoid spine surgery?

spine-health — Wed, 12 Dec 2007 00:03:15 -0800

While spine surgery may be the right option for certain patients, many people suffering from back pain have decided that they will do almost anything to avoid surgery. If avoiding surgery is an option for you, it's worth exploring some of the less common options. This newsletter features several treatments you may not know about that might be worth trying.

Assertiveness skills to prepare for back surgery

spine-health — Wed, 12 Dec 2007 00:03:11 -0800

Importance of assertiveness with a spine surgeon

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Benefits of psychological preparation for back surgery

spine-health — Wed, 12 Dec 2007 00:03:16 -0800

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Bone stimulators

spine-health — Wed, 12 Dec 2007 00:03:18 -0800

Bone stimulators, which emit low electrical currents, can be used to stimulate bone growth and enhance the spinal fusion. Bone stimulators can either be implanted (internal) or worn on the outside of the spine (external).

The internal bone stimulators have a battery pack that is placed under the skin, with wires that lay on top of the transverse processes (a muscle attachment site) in the posterolateral gutter.

Causes of failed back surgery syndrome

spine-health — Wed, 12 Dec 2007 00:03:17 -0800

Diagnostics for failed back surgery syndrome

A comprehensive physical examination and appropriate diagnostic imaging techniques can often pinpoint the responsible pathology. For instance, a definitive diagnosis of recurrent disc herniation or other disorders may be made.

Cervical spinal instrumentation

spine-health — Wed, 12 Dec 2007 00:03:18 -0800

Cervical spinal instrumentation is often used to help provide considerable stability for the spine after surgery.

Common types of instrumentation include:

Anterior cervical plates
Posterior cervical plates
Posterior cervical wiring
Anterior cervical interbody cages
Post-operative cervical braces
read more

Choosing the best spine surgeon for your back pain

spine-health — Wed, 12 Dec 2007 00:03:17 -0800

Choosing the best spine surgeon for your back pain relief - patients' advice

spine-health — Wed, 12 Dec 2007 00:03:12 -0800

Back-to-Back

Patients share advice about choosing the best spine surgeon for your back pain relief
In this section patients share their insights into how they chose the right back surgeon for their back pain relief, including seeking a second opinion, using the internet to research a surgeon, and what they are most (or least) pleased with in the surgeon they chose.

Cognitive techniques to prepare for back surgery

spine-health — Wed, 12 Dec 2007 00:03:12 -0800

Cognitive behavioral techniques are mental exercises that help to change the way a person thinks about a situation in order to feel better emotionally and behave in a healthier way. They help with back surgery preparation in two ways:

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Considering Spine Surgery? What You Need to Know

spine-health — Wed, 12 Dec 2007 00:03:15 -0800

The news that you may need spinal surgery can create many emotions -- hope that you may find more pain relief, fear about the procedure and recovery, and confusion about what to do next. This newsletter presents a series of things patients can do to make the decision-making process about whether to have spine surgery a productive experience.

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Deciding Against Spine Surgery for Chronic Pain Relief Part II

spine-health — Wed, 12 Dec 2007 00:03:12 -0800

Patients share advice about deciding against spine surgery
In this section, patients share their insights about why they made the decision not to have spine surgery.

Putting off surgery until success rates rise

read more

Deciding Against Spine Surgery for Chronic Pain Relief- Patients' Advice: Part I

spine-health — Wed, 12 Dec 2007 00:03:12 -0800

Back-to-Back

Patients share advice about deciding against spine surgery
In this section, patients share their insights about why they made the decision not to have spine surgery.

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Description of kyphoplasty surgery

spine-health — Wed, 12 Dec 2007 00:03:13 -0800

The goals of the kyphoplasty surgical procedure are designed to stop the pain caused by the bone fracture, to stabilize the bone, and to restore some or all of the lost vertebral body height due to the compression fracture.

During kyphoplasty surgery, a small incision is made in the back through which the doctor places a narrow tube. Using fluoroscopy to guide it to the correct position, the tube creates a path through the back into the fractured area through the pedicle of the involved vertebrae.
read more

Disc nucleus replacement as an alternative to artificial disc replacement (Research article)

spine-health — Wed, 12 Dec 2007 00:03:13 -0800

Disc nucleus replacement surgery

spine-health — Wed, 12 Dec 2007 00:03:17 -0800

John Sherman, MD

Facet replacement or total element replacement devices for spinal stenosis

spine-health — Wed, 12 Dec 2007 00:21:07 -0800

The last group of posterior motion preservation devices includes total or partial posterior element replacements. These devices are primarily designed to address facet pain or spinal stenosis (narrowing of the passageways for the nerves). For many patients, spinal stenosis is due to degeneration of the facet joints. These devices replace the facet joints in the back of the spine (or the total posterior elements of the spine) and are designed to maintain movement of the spine.

Failed back surgery and scar tissue: doctor responses to patient questions

spine-health — Wed, 12 Dec 2007 00:03:13 -0800

The doctor is in!

Failed Back Surgery Syndrome: What It Is and How to Avoid It

spine-health — Wed, 12 Dec 2007 00:03:13 -0800

Failed back surgery introduction

Failed back surgery syndrome (also called FBSS, or failed back syndrome) is a misnomer, as it is not actually a syndrome - it is a very generalized term that is often used to describe the condition of patients who have not had a successful result with back surgery or spine surgery. There is no equivalent term for this in any other type of surgery (e.g. there is no failed cardiac surgery syndrome, failed knee surgery syndrome, etc).

Getting a Referral to a Spine Surgeon

spine-health — Wed, 12 Dec 2007 00:03:17 -0800

Introduction to spine surgeon referrals

For patients who are candidates for spinal surgery, the next obvious step is for them to ask their treating physician for a referral to a spine surgeon. However, getting a referral to an appropriate spine surgeon may not always be as straightforward as it may sound. The difficulties are due to several issues, including:

Guidelines for evaluating a spine surgeon

spine-health — Wed, 12 Dec 2007 00:03:17 -0800

While there is no source of clear-cut criteria to compare spine surgeons, there are a number of ways patients can evaluate the surgeon they are being referred to. For example, patients can ask their referring physician several questions about the spine surgeon they are being referred to, they can ask the surgeon questions, and they can use third party information sources.

Healthy habits after back surgery

spine-health — Wed, 12 Dec 2007 00:03:12 -0800

In addition to following the doctor’s post-surgical recommendations, such as rehabilitation and physical therapy, it is a good idea for back surgery patients to examine areas that are under his or her control that will help with their post-surgical recovery process. Here are a few lifestyle changes for patients to consider:

How spinal cord stimulation works

spine-health — Wed, 12 Dec 2007 00:03:17 -0800

The first step in the process is to get a comprehensive evaluation by a spine physician to determine if the patient may or may not be a good candidate for spinal cord stimulation treatment of chronic pain.

Indications and contraindications for neurostimulation

Basic criteria that indicate someone might be a candidate for spinal cord or peripheral nerve field stimulation include:

Chronic back pain with or without leg pain
Chronic neck pain with or without arm pain
read more

How to prepare psychologically for back surgery

spine-health — Wed, 12 Dec 2007 00:03:12 -0800

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How to Select a Spine Surgeon

spine-health — Wed, 12 Dec 2007 00:03:17 -0800

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IDET: a new procedure for discogenic back pain management

spine-health — Wed, 12 Dec 2007 00:03:13 -0800

IDET

(Intradiscal Electrothermal Annuloplasty) provides a new alternative to other surgical procedures for patients who suffer from back pain caused by certain types of disc problems.

It is a fairly advanced procedure made possible by the development of electrothermal catheters that allow for careful and accurate temperature control. The procedure works by cauterizing the nerve endings within the disc wall to help block the pain signals.

If you need to see a spine surgeon for your back pain

spine-health — Wed, 12 Dec 2007 00:03:15 -0800

Expectations from spine surgery

If it is determined that you might need back surgery, the physician will probably ask you questions about what you expect to obtain from the surgery. For example:

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Know your options for degenerative disc pain

spine-health — Wed, 12 Dec 2007 00:03:16 -0800

Age brings many advantages—wisdom, independence and experience. Unfortunately, it can also be pretty tough on our bodies. Spine experts know that by 40 most people will have some level of disc degeneration, and for some this will become degenerative disc disease, the symptoms of which can range from very mild, to significant, debilitating pain.

Kyphoplasty Considerations and Alternatives

spine-health — Wed, 12 Dec 2007 00:03:19 -0800

Timing of Kyphoplasty surgery

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Osteo. Fracture Prevention

Kyphoplasty for vertebral compression fractures

spine-health — Wed, 12 Dec 2007 00:03:19 -0800

Kyphoplasty overview
Kyphoplasty is an elective surgery designed to achieve three main goals in patients suffering from painful vertebral compression fractures:

Kyphoplasty: a new treatment for osteoporotic fractures

spine-health — Wed, 12 Dec 2007 00:03:13 -0800

More Osteoporosis Info

Back Pain and Fractures

Full Osteoporosis Guide

Calcium and Vitamin D

Laminectomy and Spinal Stenosis: Risks and Complications

Ben Parr — Mon, 11 Aug 2008 14:01:59 -0700

Lumbar laminectomy surgery is able to alleviate spinal stenosis pain by removing painful pressure on the nerve root and/or disc space. However, the procedure is not foolproof. Complications can result from a variety of factors.

Spinal Stenosis Info:

Spinal Stenosis Treatments

Lumbar Spinal Stenosis Info

Laminectomy and Spinal Stenosis: Success Rates

Ben Parr — Mon, 11 Aug 2008 14:02:02 -0700

Spinal Stenosis Info:

Spinal Stenosis Treatments

Lumbar Spinal Stenosis Info

Cervical Spinal Stenosis

Spinal Stenosis Videos

Lumbar Decompression Back Surgery

spine-health — Wed, 12 Dec 2007 00:03:18 -0800

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Decompression is a surgical procedure that is performed to alleviate pain caused by pinched nerves (neural impingement).

Lumbar Decompression Back Surgery Considerations

spine-health — Wed, 12 Dec 2007 00:03:13 -0800

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Lumbar herniated disc surgery, doctor answers patient questions Part II

spine-health — Wed, 12 Dec 2007 00:03:15 -0800

Lumbar herniated disc surgery: doctor answers patient questions

spine-health — Wed, 12 Dec 2007 00:03:15 -0800

Lumbar Laminectomy (Open Decompression)

spine-health — Wed, 12 Dec 2007 00:03:18 -0800

A lumbar laminectomy (also known as open decompression) is typically performed to alleviate pain caused by neural impingement that can result from lumbar spinal stenosis. The laminectomy surgery is designed to remove a small portion of the bone over the nerve root and/or disc material from under the nerve root to give the nerve root more space and a better healing environment (see Figure 1).

Lumbar Spine Surgery

spine-health — Wed, 12 Dec 2007 00:03:18 -0800

Two general types of lower back surgery comprise the most common lumbar surgical procedures: decompression and spinal fusion.

Decompression back surgery involves removing a small portion of the bone over the nerve root and/or disc material from under the nerve root to relieve pinching of the nerve and provide more room for the nerve to heal (a microdiscectomy or laminectomy).
read more

Managing and preventing spine fractures

spine-health — Wed, 12 Dec 2007 00:03:19 -0800

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Medical and family history to present to a spine surgeon or spine specialist

spine-health — Wed, 12 Dec 2007 00:03:15 -0800

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Microdiscectomy (microdecompression) Spine Surgery

spine-health — Wed, 12 Dec 2007 00:03:18 -0800

In a microdiscectomy or a microdecompression spine surgery, a small portion of the bone over the nerve root and/or disc material from under the nerve root is removed to relieve neural impingement and provide more room for the nerve to heal. A microdiscectomy spine surgery is typically performed for lumbar herniated disc.

Microdiscectomy Spine Surgery: Risks, Complications, and Success Rates

Ben Parr — Fri, 11 Jul 2008 09:59:30 -0700

Usually, a microdiscectomy spine surgery procedure is performed on an outpatient basis (with no overnight stay in the hospital) or with one overnight in the hospital. Post-operatively, patients may return to a normal level of daily activity quickly.

Minimally Invasive Anterior Approach Spine Surgery

spine-health — Wed, 12 Dec 2007 00:03:15 -0800

The minimally invasive anterior approach for spine fusion surgery is in many ways an ideal technique for gaining access to the disc space in the lumbar spine with minimal risks or unwanted after effects for the patient. The anterior approach (from the front—through the abdomen) allows the surgeon to:

Completely remove the painful degenerative disc while restoring the disc to its native disc height
read more

Minimally invasive spine surgery

spine-health — Wed, 12 Dec 2007 00:03:15 -0800

In-depth information and research on minimally invasive back surgery techniques for spine fusion surgery, kyphoplasty and microdiscectomy

Minimally invasive spine surgery systems

spine-health — Wed, 12 Dec 2007 00:21:06 -0800

The theory with any minimally invasive spine surgery system is that smaller incisions and percutaneous approach will create less tissue damage, less blood loss, shorter hospital stays and faster recovery. However, the advantages of any minimally invasive spine fusion system are still considered to be theoretical and have not yet been proven.

Mr. WW’s Kyphoplasty procedure

spine-health — Wed, 12 Dec 2007 00:03:13 -0800

Mr. WW had an extensive history of medical problems, including high blood pressure, severe coronary artery (heart) disease and a seizure disorder, so he was felt to be at high risk for general anesthesia and thus local anesthesia was employed during the kyphoplasty procedure as the sole pain-numbing agent.

Here is a summary of the kyphoplasty procedure the patient underwent to treat the vertebral compression fracture that was causing his mid back pain. Most kyphoplasty procedures like this one take between 30 and 45 minutes to complete.

New advancements in spine surgery

spine-health — Wed, 12 Dec 2007 00:03:16 -0800

Spine surgery is a high growth and rapidly evolving field. Several important new technologies are in various stages of development and you may want to consider these when making any decision about your treatment options.

Non-fusion options for back surgery

spine-health — Wed, 12 Dec 2007 00:03:16 -0800

This information has been moved. Please see Pain Treatment for more information.

On the horizon of spinal surgery

spine-health — Wed, 12 Dec 2007 00:21:06 -0800

Minimally invasive approaches

Minimally invasive spine fusion surgery may be improved by new imaging systems that are in development. These systems provide computerized three-dimensional images, which increase the accuracy of identifying anatomic structures.

Other considerations for failed back surgery syndrome

spine-health — Wed, 12 Dec 2007 00:03:17 -0800

When scar tissue is not the cause of pain

If the recurrent pain appears years after spine surgery, it is unlikely that the pain is due solely to scar tissue. Scar tissue does not continue to form years after spine surgery, so it is generally not considered a cause of late recurrent pain. Rather, the nerve may be compressed, or “tethered”, by a small disc herniation or by new bone growing near the nerve (stenosis).

Pain relief after a vertebral compression fracture

spine-health — Wed, 12 Dec 2007 00:03:14 -0800

Kyphoplasty for spine fractures

Post-Laminectomy Syndrome

spine-health — Wed, 12 Dec 2007 00:03:16 -0800

History of present illness

The patient is a 47-year-old male who had an L5-S1 discectomy 5 years ago. Although the back surgery relieved his sharp leg pain, he continued to not only have back pain but also leg pain.

Post-laminectomy syndrome: chiropractor viewpoint

spine-health — Wed, 12 Dec 2007 00:03:16 -0800

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Post-laminectomy syndrome: physiatrist viewpoint

spine-health — Wed, 12 Dec 2007 00:03:16 -0800

Given the patient's history, physical examination, and imaging findings, several possible sources of pain come to mind.

Regarding his imaging studies, his L5-S1 disk degeneration with significant disk space narrowing could be painful in itself, but the disk space narrowing may also place increased stress upon the L5-S1 facets, and may cause some degree of neuroforaminal narrowing around the left L5 nerve root.

Post-laminectomy syndrome: surgeon viewpoint

spine-health — Wed, 12 Dec 2007 00:03:16 -0800

Since the patient’s symptoms have been long standing and he has tried conservative treatment he would be a reasonable candidate for surgery. Factors that suggest he would do well with a fusion include the fact that there is a lot of disc space collapse at L5-S1 and that the rest of the discs are all well preserved.

As the disc space collapses the nerve root exiting the level (in this case the L5 nerve) can get irritated and radiate pain down the leg. He does not have a recurrent disc herniation so a discectomy alone will not provide him any relief.

Posterior cervical decompression (microdiscectomy) surgery

spine-health — Wed, 12 Dec 2007 00:03:18 -0800

Some spine surgeons may prefer the posterior approach (from the back of the neck) for a cervical discectomy. This approach is often considered for large soft disc herniations that are lateral to (to the side of) the spinal cord.

The principal advantage of the posterior approach is that a spine fusion does not need to be done after removing the disc.
read more

Posterior cervical laminectomy

spine-health — Wed, 12 Dec 2007 00:03:18 -0800

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Posterior dynamic stabilization systems

spine-health — Wed, 12 Dec 2007 00:21:07 -0800

Devices in this category can best be described as an internal brace – allowing controlled movement of the affected segment of the spine. Most of these devices tend to be derived from the pedicle screw (Figure 6) and rod constructs (used in spinal fusion surgery) of the 1980s and 1990s. Those devices were designed to provide rigid stability to the spine while boney incorporation of the fusion mass was achieved.

Posterior lumbar interbody fusion (PLIF) surgery

spine-health — Wed, 12 Dec 2007 00:03:19 -0800

More Spinal Fusion Info: