Is Lower Back Surgery or Lumbar Spine Surgery Appropriate?

300px Spinewithcord Is Lower Back Surgery or Lumbar Spine Surgery Appropriate?

Lower Back Surgery: What Happens in lumbar spine surgery- Image via Wikipedia

Lower back surgery is actually a misnomer. What we call “lower back surgery” is specifically lumbar spine surgery or lower spinal surgery.

There are only a few indications for lower spinal surgery. These are…

  • When conservative treatment is not effective in reducing pain
  • When there are signs of focal neurologic deficits, such as leg weakness, sexual dysfunction (impotence), loss of bladder or bowel control (occurs when central lumbar disc herniation causes spinal abscess or cauda equina syndrome)
  • When there are signs of progressive nerve problems caused by herniated discs
  • Spine injury

The various types of lower back surgery each treat a specific cause of lower back pain. A patient may require only one type of surgery, but others may also need spinal fusion to further stabilize the problematic site.

Here are the most common types of lower spine surgery…

  • Discectomy/Microdiscectomy: The procedure involves removing the herniated portion of a disc that has impinged upon a nerve. Discectomy serves to relieve irritation and inflammation on the compressed nerve. The procedure may involve full or partial removal of the posterior portion of the affected vertebra (called the “lamina”) to be able to reach the ruptured disc.
  • Laminectomy: The procedure involves removal of herniated discs or bone spurs that press upon a spinal nerve. Laminectomy also involves enlarging the spinal canal in order to relieve pressure on the nerve caused by spinal stenosis and spondylolisthesis. This procedure may be performed with spinal fusion in order to achieve stabilization in the affected site.
  • Foramenotomy: As its name denotes, it involves the removal of bone and other tissues that impinge upon the nerve as it exits the spinal column via the intervertebral foramen. This is performed when the nerve is being compressed by more than just a herniated disc.
  • Spinal Fusion: This involves permanently connecting two or more bones in the spine by using screws, plates, or by creating bony bridges between vertebrae with bone grafts. This procedure aims to give the spine greater stability and thus reduce painful motion between vertebrae in causes of injured and degenerated discs and spinal fracture.
  • Vertebroplasty: This procedure involves injecting bone cement into compressed vertebrae to help stabilize fractures and thus reduce pain in compressed and fractured vertebrae.
  • Kyphoplasty: A variation of vertebroplasty, this procedure first involves the insertion and inflation of a balloon in between compressing vertebrae in order to expand the bone to its normal size. Cement is then injected to fill the empty space. Kyphoplasty is commonly performed in patients suffering from back pain as a result of osteoporotic and compression fractures, and can help prevent spinal deformities (such as scoliosis, kyphosis and lordosis) and height loss.
  • Spinal cord stimulator implant: A minimally-invasive technique which involves implanting a spinal cord stimulator that relieves pain and other symptoms of sciatica and other chronic radiculopathies (diseases of the nerve roots).
  • Lumbar Artificial Disc Replacement: A new type of surgery being explored as an alternative to spinal fusion. The procedure involves the implantation of artificial discs that would prevent painful compression between two vertebrae because of an injured or degenerated disc.

Clinical trials at the present time have yet to show conclusively the effectiveness of spinal surgery in the treatment of lower back pain. What most studies have shown is that the benefits of spinal surgery are limited when treating degenerative discs with symptoms of spinal pain. Also, there is an increased risk of complications in the use of spinal implants, including risks of blood loss, nerve injury, infection, and even repeat lower back surgery, in comparison to spinal fusion.

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How To Ensure Proper Spine Alignment

Most people are not aware that they have improper spine alignment until the pain sets in. In fact, one of the most common reasons for back pain is the improper alignment of the spine which is why most doctors would check this first before anything else.

The good news is that you don’t need to go to the doctor to make sure that your spine is properly aligned. If you suspect that this could be the root of your back pain or perhaps you simply want to improve your posture, there are methods that you could try doing at home. That being said, following are some exercises you could do to ensure proper spine alignment.

Side Stretch

Start this exercise by standing with your feet aligned with your shoulders. Now start stretching your left arm as far as it could go. This slowly stretches your body without causing stress to any other body part. Once you’ve gone as far as you can, start leaning your body towards the right side. Again, this should be done slowly without taxing yourself. The goal is not to get as far as possible but to make sure that you remain relaxed while doing so. Concentrate on the flow of air in and out of your body. Hold this position for 20 seconds before slowly coming back to your original position. Take several deep breaths before doing the same for the other hand.

Neck Stretch

The neck stretch is actually something you can do anywhere if you have the time. It’s specially made to remove any neck problems you might have as well as any pain on the shoulders. Now, start the exercise by standing with your shoulders down and arms relaxed downwards. Lift your shoulders upward, slowly rotating them and then holding them down. At this point, your arms should still be lax while the feet are only several inches apart with the toes pointing forward. The head should be perfectly balanced on your straight neck while counting up to 16. Hold the position during this time. You can repeat the exercise several times a day, preferably 8 times each set.

Spine Roll

This is something you can perform while lying down. Start with your knees bent and far apart, approximately the same width as your hips. Take a deep breath and as you exhale, pull your core body inwards. Your lower back should be slightly pulled towards the floor. Now, this is the tricky part. Once you’ve pulled your lower body inwards, start peeling the tailbone upwards all the way up to your shoulder blades. The final position would be your hips resting on the air while your shoulder blades are the ones in contact with the floor. Inhale and on your next exhalation, start placing the line of your vertebra on the floor one at a time until the tailbone is once again on the floor. This takes time to master and might be very uncomfortable at first, but it actually helps the spine get in proper position to alleviate back pain and shoulder aches. Try doing it 5 to 10 times a day.

You’ll know when you finally nailed that proper spine alignment when the pain is finally gone and you are more comfortable with your movements. If you check yourself in the mirror, you’ll also notice how your posture has become better, providing you with that straight spine that can boost self confidence.

 

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