Surgery For Back Pain

Back pain is one of the most widespread medical complaints heard by healthcare professionals. Fortunately, most types of back pain can be successfully addressed without resorting to surgery. However, when all else fails, there are a number of types of back surgery that may be recommended by your family doctor, orthopedist, or neurosurgeon.

Surgical options include the implantation of artificial disks, discectomy, laminectomy, spinal fusion, vertebroplasty, and foramenotomy. Each of these types of surgery is generally indicated for a specific set of circumstances and may or may not produce the type of relief you seek.

Disk Replacement and Discectomy

When diagnostic imaging has determined that back pain is being caused by a herniated or degenerated disk in the lumbar region of the spine, doctors may recommend that the compromised disk(s) be replaced with artificial disks. Artificial disks will prevent the pain caused by impingement on the nerves that travel from the spinal column to areas of the back and legs. This is a relatively new procedure and is not fully proven, however, many patients have found relief after such surgery.

Another option that may be recommended in cases where a intevertebral disk is herniated or otherwise deteriorated is a discectomy, which involves the surgical removal of part of the disk in question to alleviate pressure on nerves in the area of the back.

Laminectomy and Spinal Fusion

To relieve pressure on nerves that travel from the spine to portions of the back, buttocks, and legs, doctors may perform a laminectomy, which involves the removal of portions of the bone of the vertebral structure itself. This surgical procedure may be done by itself or done in combination with spinal fusion.

Spinal fusion involves surgical stabilization of the spine at one or more levels to prevent movement of the vertebrae. Such movement can cause pain as it puts pressure on one or more nerves in that section of the back.

Vertebroplasty and Foramenotomy

Fractures of the back almost always require some form of surgical intervention, and one of the more common surgical procedures of this type is the vertebroplasty, in which the surgeon injects bone cement into vertebrae that are either broken or compressed, causing unwelcome pressure on a nerve or nerves as they exit the spinal column.

A foramenotomy is also used to address back pain caused by impingement on a nerve. It may be recommended when the nerve compression is caused by something other than a herniated disk. A foramenotomy involves the removal of bone and tissue to ease pressure on a nerve.

Recovery Time

The time required for recovery from these various forms of back surgery varies considerably, depending on the amount of tissue and muscle that has been cut in the surgical process. In almost all cases, however, the patient will be unable to resume normal activities for at least a week or two. In the case of surgeries that are less invasive in scope, including laminectomies and discectomies, patients will generally be able to get back to normal activity within a couple of weeks but should refrain from any heavy lifting for at least a month. More invasive surgical procedures, including most notably spinal fusion, may require much more lengthy recovery periods, up to six months or more before a full range of activities can be resumed. Driving a motor vehicle puts a surprisingly heavy strain on the back and should be avoided completely or minimized until recovery is complete.

By Renee Cullen

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The Lumbar Artificial Disc Replacement is Approved, But is it Ready?

The latest revolution is spine surgery is the artificial disc replacement. Several different types, by several different manufacturers, have been approved in the last few years.

There has been much public hype about this latest innovation. A poll by Spine-Health.com showed that 49% of people, who are candidates for lumbar fusion, are postponing their surgery, hoping to receive the artificial disc.

All of the excitement is because; this new device appears to solve two of the major problems that occur with fusion of the lumbar spine. Well, at least in theory, it appears to solve it.

Historically, two of the major problems with lumbar fusion are limitations caused by the lack of motion, and accelerated degeneration at the adjacent levels. Increased wear and tear at the neighboring disc levels, often leads to additional surgeries over the next several years.

The new artificial disc seems to solve that problem. It allows normal, or near normal motion, while still replacing the painful or diseased disc. But, this new device presents some problems of its own, and some surgeons think that there may still be some questions that are unanswered.

The two major concerns about the artificial discs are durability, and problems with replacement. Because this appliance is new, data from long term studies is limited, and what information is available, is not great. Some studies show high failure rates, and some manufacturers are telling patients that their artificial disc may have to be replaced within 10 years. This is really the point that some surgeons are concerned about. Replacing a worn out or failed device, is a very complex operation with many risks, and some of the risks are life threatening.

The artificial disc is implanted through an anterior approach to the spine. Surgeons make an abdominal incision, and the abdominal organs are moved aside. Then the great vessels must be mobilized, the aorta and the iliac arteries are most often affected. This involves ligating and severing the small feeder arteries that tether them in place, then gently retracting the vessels to expose the anterior lumbar spine.

This exposure is a difficult and complex procedure, in a young healthy patient, under the best of conditions. Repeat surgeries would be complicated by scar tissue, adhesions, and the age of the patient. This would make handling the great vessels increasingly dangerous with each surgery. For a patient in their 30s, this may mean four or more operations by the time they reach their 70s.

When considering any surgical procedure, you must always consider the risks and benefits. The potential benefits, of increased function and normal range of motion of the artificial disc are noteworthy, and certainly worth investigating. As time passes, surgeons will gain more experience, newer techniques will be developed, and the risks will become more manageable. But, with the current technology the critics appear to raise valid points.

David L. Stevens PA-C
http://www.living-with-back-pain.org

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Chiropractic Health Care Treatment is a Controversial Subject Within Medical Care

The definition of chiropractic health is a lengthy one. One that's hard to understand, even for a writer. What it basically means is that, disorder of the spine and other areas of the musculoskeletal system affect someone's general health through the nervous system. Did you understand all of that? Neither do most doctors.

The Yankee Medical organisation chose to boycott the chiropractic health injury until 1987 when they lost a highly publicized antitrust suit. In released statements the Association called the chiropractic approach an unscientific cult. They point out the fact that no definitive proof has been found to support concepts that chiropractic can help alleviate pain anywhere, but in a patient's back.

Since the ruling in 1987 the methods and treatments involved in chiropractic health have gained a wider acknowledgment. Physicians sometimes endorse their patients to a trustworthy chiropractor. Although it's affect on general health remains debatable, spinal manipulation has proven to be useful in treating back wounds.

The back is a crucial part of our existence that demands in the industry remain constant. However, I do not see family chiropractors coming into the principal anytime soon. The industry remains divided amongst themselves about the right techniques of treating patients or diagnosing sickness. There are two methods of chiropractic health that stand at odds with each other.

Doctors using the 1st approach are called 'Straights'. Straights are recounted to emphasize vitalism, intelligence, and adjustments of the spine. The pioneers of the straight method are D. D. Palmer and his boy B. J. Palmer. D. D. Palmer started what's now know as chiropractic in the 1890s. Straight chiropractors believe that subluxations of the spine or the vertebrae are probably the under lying cause of all illness and diseases. Also, they believe that realigning the vertebrae will cure initial stages of most sicknesses and you should not mix differing kinds of treatments and therapies.

The second kind of chiropractic health doctor is referred to as a mixer. They represent the bulk of chiropractors working today. Mixers are more accepted in the main stream due to their softer more scientific view toward the root of illness and sickness. Mixers accept treatment approaches from many different view points in the medical community and mix them to meet their patients' needs.

Chiropractic health is recognized everywhere in the world, even if it is not accepted. Asian populations tend to lean toward acupuncture to alleviate back pain. By accident, acupuncturists have the same beliefs that straight chiropractors do. Believing that healing aliments of the spine will lead to overall healthiness.

Chiropractic health is most distinguished in Canada, Australia, and the US. Today there are of sixty five, 000 doctors of chiropractic working in English speaking nations. The U.S. has the most by far. Almost 20 accredited colleges in the U.S. Offer doctorates in this type of hospital therapy. With the amount of doctors growing, pressure has been put on the chiropractic health industry to better control itself. This form of medicare has the most grouses of fraud.

Before you investing time in finding relief, go to Triangle Wellness Chiropractic and Holistic Care, to get more information on chiropractic wellness center and chiropractic alternative medicine. Visit us today!

By Janet R Barrett

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