Spine Care
Living with a spine condition or back pain can make normal activities uncomfortable or even impossible. We are pleased to be able to offer treatment options that have helped many patients restore quality of life.
How Do You Keep Your Spine Healthy?
The spine supports and keeps your head, shoulders and upper body upright and gives you the flexibility to bend and twist. Understanding the spine can help better understand some of the most common conditions that cause spinal problems or back pain.
Part of taking good care of your spine is knowing several factors that may increase the chance of developing spine pain. These factors may include the following:
- Fitness level – Spine pain is more common among people with obesity whose weak back and stomach muscles may not properly support the spine. People who exercise too strenuously after being inactive are equally prone to developing spine pain.
Tip: Engage in core-strengthening exercises and flexibility training at least twice weekly. - Job-related risk factors – People with jobs that require heavy lifting, pushing, pulling or twisting can injure their back. People working behind a desk have a high risk of developing spine pain, especially if they have poor posture or sit all day in an uncomfortable chair.
Tip: When lifting things, use your legs rather than your back. Try to keep your knees and hips level and your feet flat on the floor when sitting. Make sure your elbows are at right angles, and your forearms are horizontal if you use a keyboard. - Age – Back pain worsens after turning 45.
Tip: Include calcium and vitamin D in your diet for bone health. - Family history – Genes play a significant role in some disorders that cause back pain.
Tip: Avoid activities that increase your risk for back pain, including having an inactive lifestyle and smoking. Having a stressful job, depression and anxiety may also influence your spine.
What Causes Spine Pain?
Spine pain is one of the leading causes of disability and may result in absence from work or difficulty performing daily activities. Various spine diseases, such as the following, can change the structure of the spine or damage the vertebrae and surrounding tissue, which often cause spinal pain and limit a person’s movement:
- Infections
- Injuries, such as spinal concussions
- Conditions such as ankylosing spondylitis and scoliosis
- Worn-out discs
- Bone spurs or malformations
Diagnostic Testing for Spine Pain
Back pain may also be a symptom of a more serious problem. Other symptoms that can indicate a more serious problem include:
- Loss of bowel or bladder control
- Numbness, tingling or weakness in the legs
- Back pain after physical trauma
- Back pain that gets worse at night
- Unexplained weight loss
- Back pain with a throbbing sensation in the abdomen
- Fever
Your doctor may recommend the following tests:
- X-ray – uses radiation to produce pictures of the spine and joint outlines. This procedure is performed to look for potential causes of pain, such as spinal malalignment, tumors, infections, fractures, etc.
- Magnetic resonance imaging – uses powerful magnets and computer technology to produce three-dimensional (3D) images of the spine.
- Computed tomography (CT) scan with 3D reconstruction – shows detailed pictures of the bone, soft tissues and nerves.
- Electromyography or nerve conduction velocity testing (EMG/NCV) – neurophysiologic testing of the nerves to help locate the compression or other neural pathology.
Spine Treatment
Conservative, noninvasive treatments, including pain management and physical therapy, are typically the first step and have shown tremendous results in many patients.
- Medications
- Over-the-counter or prescription drugs which can be taken orally (ibuprofen, naproxen, acetaminophen) or topically (gels, lotions, creams, patches, sprays, which contain ibuprofen and lidocaine)
- Muscle relaxants
- Antidepressants
- Steroid injections
- Opioids
- Other Treatments
- Cold or hot packs
- Physical therapy
- Lifestyle changes
Spine Surgical Procedures
One of the following surgical treatments may be recommended if nonsurgical procedures don’t ease the pain:
- Microdiscectomy – a minimally invasive spine surgery for removing disc material that has herniated or moved to an abnormal location, causing pressure on the spinal cord, sac of nerves or spinal nerve roots.
- Spinal fusion surgery – permanently connects two or more vertebrae in the spine, eliminating motion between them.
- Spinal decompression (laminectomy) – creates space by removing the back part of the vertebra that covers the spinal canal and enlarges the spinal canal to relieve pressure on the spinal cord, sac of nerves, or nerve roots.
- Vertebroplasty and kyphoplasty – a minimally invasive spine surgery to stabilize a spinal compression fracture.
- Spine fracture and spinal cord injury surgery – noninvasive, minimally invasive or invasive procedures to decompress and stabilize spinal fractures and treat spinal cord injury.
- Deformity spinal surgery – involves spinal fusion surgery and instrumentation to improve the spine’s alignment for those with scoliosis or kyphosis.
- Anterior cervical surgery – surgery for decompressing the cervical spinal cord or nerves through the front of the neck.
- Artificial disc surgery – replacement of the disc in the neck with an artificial disc
- Cervical disc herniation and arthroplasty – removing the disc in the neck that is causing pain/numbness and stabilizing the space with hardware and bony material to cause the bones to grow together
- Minimally invasive spine surgery – surgery performed with specialized instruments and techniques, such as:
- Minimally invasive lumbar discectomy – removal of disc material that has pushed out of its normal space
- Minimally invasive lumbar spinal fusion surgery – using hardware to stabilize the spine and cause the bones to grow together
- Discectomy – remove one of the discs that cushions between the vertebrae because the soft tissue disc is out of place and causing pain/numbness/weakness
- Foraminotomy – increasing the space in the bone where the nerve exits the spine to create more room
- Laminotomy – opening in the back part of the spinal bones to create more room for the spinal cord
What Happens After Surgery
When the surgery is complete, you will be transferred to the recovery room where you will meet your post-op nurse. You may feel groggy, dizzy and/or nauseous from the anesthesia and you will still have tubes and monitors attached at various points on your body. The nurse will monitor your vital signs and keep you comfortable, administering medications for pain and nausea as needed.
You may be asked to walk with assistance as this is the best way to help alleviate pain without medications. Your safety is our number 1 priority. Before discharge, your doctor will:
- Give you instructions to understand your pain medication plan
- Give you instructions on identifying, caring and preventing infection
- Discuss fall precaution
- Inform you how to contact your surgeon in case of emergency
- Make sure you have all the necessary equipment
- Schedule a follow-up visit
Fredrick Hermenau, MD
Procedures
ArthrodesisSpinal Laminectomy
Spinal Laminotomy
Total Disc Arthroplasty