Minimally Invasive Spine Surgery

For patients who are suffering from back conditions of various types, including radiculartype complaints (leg pain) as well as mechanical back pain related to the degenerative process. There is a myriad of new and old technology that allows surgeons to provide the patient significant reduction in their pain with the least amount of surgical dissection. This is typically termed as minimally invasive spinal surgery.

In the past, in the case of spinal fusion surgery, we performed surgery with a large surgical incision for one or two-level disease, with a significant amount of muscle stripping in order to provide adequate visualization to place hardware and bone graft material. With our new technology, we are now able to perform minimally invasive spinal fusion surgery for one to three-level disease in patients who are suffering from both mechanical back pain and leg pain. This technology has improved the patient's ability to recover quickly, reduce their intra-operative bleeding, operative time and hospital stay. It appears post-operatively that many of the patients who have undergone the minimally invasive fusion surgery, as opposed to standard open fusion surgery, have shown a remarkable difference in their post-operative pain management requirements and their ability to return back to a functional life.

Patients with thoracic predominant scoliosis, in the younger population, it is now possible to perform a minimally invasive thorascopic spinal fusion surgery to help correct their curve, reduce their deformity, and thus reduce the risk of progression of their spinal deformity. The thorascopic approach, while incorporating a selective fusion paradigm, has allowed us to again reduce the patient's post-operative morbidity, operative time, blood loss, and reduced pain management requirements. In my hands, we have found thorascopic scoliosis reconstructive surgery to be an important part of our overall treatment for your younger population who has clear evidence of progressive thoracogenic scoliosis.

Minimally invasive surgery is also a mainstay treatment for patients who have predominant radicular complaints (leg pain) in the presence of a corresponding herniated disc. Options include Microscopic lumbar Discotomy, Microendoscopic Discotomy, and Laser Discectomy. In my hands, this is a quick and safe surgical procedure, resulting in a one-inch incision, 25 to 45 minute operative time, with a 98 percent chance of an excellent outcome in the reduction of the patient's pre-operative, disabling leg pain. All patients, with the exception of the elderly population, are able to be discharged from the hospital within hours of the operative procedure, and are able to return back to most of their pre-surgical activities within one to three weeks.

All About Herniated Disc Surgery

According to a plethora of medical research and studies, a herniated disc surgery is not the only treatment for this disorder. There are various other treatments that individuals can be subjected including resorption, where the pain subsides by itself or via the aid of regularly exercising. It is recorded that approximately 50% of individuals suffering from herniated disc recover in a period of a month. On the same hand, 96% of individuals suffering from this ailment fully recover after six months, and only 10% require surgery to curb the symptoms of the ailment. The surgery also enables individuals perform their normal functions and movement.

However, before settling for a herniated disc surgery it is advisable to determine if there is the slightest possibility that an individual will heal with time. It is recommended to persevere through the pain until it subsides than to evade such consequences via surgery. This is because even though the surgery is clinically approved there is a high risk for development of a complication. The different surgical approaches will emanate varying results on different individuals. They may completely reduce the pain or further aggravate it. Moreover, it may take more than a year to recuperate from the surgery.

Therefore, herniated disc surgery is only recommended to individuals whose medical history shows that they suffer from a persistent leg pain for more than a month even after being subjected to non-surgical treatments. In addition, an individual that also suffers from loss of motion, general body weakness and abnormal sensitivity is a suitable candidate for the surgery. On the same hand, individuals that have gone through a computed tomography (CT), magnetic resonance imaging (MRI) and myelogram tests to produce results suggesting that they require to undergo surgery in order to fully recover are also potential candidates for the procedure.

In a nut shell, individuals liable to a herniated disc surgery should portray specific conditions with regards to their diagnostic tests, physical examinations and expected results of the ailment. The decision should also be determined by the possibility of using other treatment options and your response to non-surgical treatment. In addition, factors such as severity of the symptoms, age, impact of the symptoms to the normal functioning of an individual and the general health status of an individual play a crucial role in determining whether one should be subjected to surgery or nonsurgical treatments. For example, aged individuals stand a higher possibility of being subjected to surgery because of the risk for the rapid development of other spinal related diseases. Also, if the symptoms are too aggravating to the extent of totally inhibiting the ability of individuals to engage in their normal functions, then surgery should immediately be done. However, individuals that only emanate back-pain as a symptom are rarely subjected to surgery. This is because there is a high likelihood that the ailment the individual is suffering from may not be herniated disc related.

Currently, there are two herniated disc surgery procedures in use, traditional disc surgery and laser-assisted disc surgery procedures like the percutaneous endoscopic disectomy. The latter surgical procedure is the most preferred because it arises lower health related risks, entails the use of a small incision on the patient, portrays rapid recovery and there are high chances that the back or neck pain will completely be alleviated. With the traditional disc surgery, there is a high possibility for the development of stroke and heart attack from the general use of anesthesia. This may eventually lead to death. Moreover, individuals need to use hardware and spinal fusion so as to stabilize the spine after the removal of the affected spinal components. In addition, there is a high risk for development of a wide array of infections as well as bleeding to death. On the other hand, the extensive scar formation may lead to development of new neck and back pain as well as make individuals undergo a lengthy recovery time, which may be weeks or years. Furthermore, there is no guarantee that the pain will completely subside.

By the way, a herniated disc disorder is a degeneration of the soft tissue (intervertebral disc) located between the vertebrae of the spin because of the daily wear and tear. As one ages, these discs become brittle due to the loss of their water content. With time or due to a traumatic accident to the spine, the outer wall may tear allowing the inner disc material to seep through to the spinal canal. When the material presses any nearby spinal nerve the herniated disc disorder occurs. This disorder is not dangerous in nature and can even occur unnoticed. However, it becomes problematic when the nucleus material compresses the spinal nerves. This results to development of tingling sensations, numbness, pain and weakness along the affected nerve (that is its entire course) mainly along the lumbar and cervical regions. Other than surgery, a herniated disc disorder can be treated via the prescription of pain relief medication, hot or cold therapy, physical therapy and acupuncture just to mention but a few.

How To Relieve Sciatic Nerve Pain

What Is Sciatica?

If you are feeling pain running from your lower back down to your buttocks and to your legs, you may already have a condition that is called sciatic nerve pain, or pinched nerve in the lower spine, or simply sciatica.

The sciatic nerve is the body's biggest nerve. It extends from the spinal cord down to the back of the legs and ending at the foot. This explains why if it gets pinched or irritated, pain shoots all over the back and lower extremities. Some experience numbness in the affected parts which may become extremely painful when subjected to sudden movement, while others report excruciating pain that leave them practically immobile for days.

What Causes Sciatica?

To treat this condition, it is important to understand the causes of it. Some of the common causes of sciatic nerve pain are herniated disc, spinal stenosis and degenerative disc disease.

Herniated disc or slipped disc usually occurs when one makes a sudden twisting motion or when the back is subjected to a forceful blow or impact, as in the case of vehicular accidents. Sciatic nerve pain is the most common symptom of a slipped disc and may need serious attention.

Another cause of sciatic nerve pain is spinal stenosis or the narrowing of the spinal canal which restricts the spinal cord. People aged 60 and above are prone to getting this condition. Another age-related cause of sciatic nerve pain is degenerative disc disease. This occurs when a weakened disc along the spinal cord results in excessive minute movements that expose inflammatory proteins that irritate the sciatic nerve roots.

Pain Relief for Sciatica

Pilates Exercises

A gentle exercise such as Pilates warms up and strengthens the back and abdominal muscles that support the spinal cord. Pilates targeted towards these muscle groups prevents tightening which contribute to pinched sciatic nerve. Regular Pilates helps you recover more quickly and may prevent future sciatic episodes from flaring up.

Rest

Rest in this case means minimizing movements and avoiding carrying heavy objects. Lying on the bed, unless it is flat and hard, is a no-no because the cushion only aggravates the pinched nerve. Complete bed rest is not recommended. If you have to sit, use a chair with a well supported back. Remember to take everything slowly and carefully, and don't do anything - sitting, standing, or walking for too long.

Use Heat Pad Or Take Warm Shower

Applying heat is a great sciatic nerve pain relief. Adjust your heating pad to low or medium heat then use on affected part for 15 to 20 minutes every 3 hours. You may take a warm shower as an alternative to a cycle of the heat pad.

If the sciatic nerve pain lasts more than a month and if the pain has become intolerable, you may have to see a pain relief specialist who are well versed in anatomy of the body and can perform a combination of myofascial release as well as Pilates exercises that can provide pain relief.

The Most Effective Lower Back Exercises To Relieve Back Pain

Despite what you might think, rarely is the cause of lower back pain at the site where it hurts. Most people and their therapists think it is. That's why they want to heat, rub, crunch, vibrate and slice the spot where it is most painful.

In fact you can tell how good a therapist is by watching where they go in the search for the cause of the pain. Just attacking the spot where it hurts sends out a big amber light.

Surprisingly, lower back pain is a merely a symptom that some of the bones in your lower back are out of alignment. Your immediate task is to get them back in alignment. Do that and there's a good chance the pain will go away.

When the vertebrae move out of alignment, ligaments, tendons and muscles are stretched beyond their pain threshold. The nucleus of discs is squeezed out and the disc collapses. Often the nucleus hits the spinal cord. That's when the pain really starts. You can't sneeze or cough without it feeling like there's a red hot poker being jammed into your back. You can't bend over the basin to brush your teeth. You can't bend down to put your socks on.

So what causes the vertebrae in your lower back to move out of alignment?

Answer! If the pelvis has moved out of alignment, it's highly likely the bones above it have moved out of alignment as well.

Treat the pelvis as the foundation for the bones that are above it and consider this analogy. If the foundation of your house moves then the walls will crack. You can patch up or paper over the cracks, but you'll probably have to continue to keep patching and papering until kingdom come. The solution is to underpin (and square up) the foundation so it can't move.

So the precondition for a spinal column that's in alignment is a pelvis that's in alignment.

So what causes the pelvis to move out of alignment?

Answer! Tight calf, hamstring, buttock and hip flexor muscles.

Which brings us back to the question of what are the best exercises to relieve lower back pain?

Answer! Flexibility exercises that impact on the alignment of the pelvis, particularly exercises that loosen off tight calf, hamstring, buttock and hip flexor muscles.

But that's not the full story. You also need to strengthen the whole musculo-skeletal ecosystem by regularly going to the gym and working out - or if you're averse to lifting weights start on a regular and systematic strength training program at home that includes situps, pressups, squats and the Superman back arch.

It makes sense to have a body strong enough to keep the bones of your spinal column in correct alignment.

Interestingly one of the best predictors of risk of lower back pain is the ability to do pressups. While you're doing pressups the muscles of your trunk are all being strengthened, front, back and core.

If you're looking for targets for situps, pressups and squats, 20 of each is good, 30 is better and 40 is best. Build the Superman back arch up to a couple of minutes of gentle ups and downs without your chest or legs touching the floor.

The last piece of the lower back exercise jigsaw is some relaxing exercises to settle the spinal column down, exercises where you lie on your back with both legs bent at 90 degrees and the lower legs supported by an ottoman. This is known in the trade as the static back exercise and lying in this position for 20 minutes will bring temporary relief from back pain, and over the weeks and months assist the vertebrae to gradually get back into better alignment.

Another relaxing posture using the ottoman is lying on the floor with one leg on the ottoman and the other outstretched on the flood for 20 minutes - then change legs. This is the supine groin stretch. Over 20 minutes the hip flexor muscles will gradually relax and over the weeks and months allow your vertebrae to move back into better alignment.

If you're diligent you'll spend a couple of hours on the floor each evening while you watch TV, read a book or just drift off with the faeries doing the flexibility exercises and the relaxation exercises.

The strength exercises you can do after you've been for a walk, shuffle, jog, swim, cycle... in the morning.

Now just as Rome wasn't built in a day, your lower back pain wasn't caused in a day. For most people it happens over decades, due to a poor sitting posture and lack of strength and flexibility exercises. Being 20 or more Kg over weight doesn't help matters.

Neither will back pain be cured in a day. Depending on how far out of alignment your pelvis and the bones above it are, it may take a couple of months for you to experience real relief and up to a year before you can say, 'I no longer have lower back pain.'

But the good news is that if you start doing something now, there's an 80% chance for 80% of people that they will get themselves back to 80% of good nick within a year. If you've got back pain them's good odds.

In the meantime stay tuned, highly tuned and make an immediate start on a serious strength and flexibility training program.

Back Pain Relief Using Inversion Tables - Do They Work?

Spinal traction of any kind is a pulling force intended to stretch the ligaments and muscles in the spine and add to the space separating the vertebrae. It is used by physical therapists and chiropractors, along with other treatments, to ease lower back pain in general and treat sciatica in particular.

Inversion therapy

This form of traction has been used since ancient times, and it involves having the patient hang upside down to relieve pressure on the spine, Today, a well-known piece of equipment, the inversion table, is used for this purpose, and the patient's body weight is used to stretch the spine in the inversion process. Some people feel more comfortable with partial inversion, and an inversion table can be adjusted to tilt at different angles, even a slightly inverted level of 20 - 30 degrees.

As people adjust to the treatment, the slant can be increased to 60 degrees, which will automatically add to the stretch. There is also a psychological component to this treatment, and if they feel insecure in the optimum inverted position, the muscles will contract, which will defeat the purpose of the therapy.

Adjusting to the treatment

The amount of time people spend using an inversion table is correlated with the particular angle being used at the time. Ordinarily, they start by inverting for a few minutes and work up to 10 minutes as they adjust to the process and become more relaxed while doing it. (Many patients use the inversion table 2 or 3 times daily to relieve their lower back pain.)

As the back is stretched, pressure in the nerve roots and intervertebral disks lessens and back pain is reduced. This treatment can also be beneficial to individuals with poor posture as it elongates the muscles, and medical professionals sometimes rely on using the inversion table to increase the flow of blood to the brain and boost the patient's mental alertness.

Recommendations before using an inversion table

Always consult with your physician before taking this step, and note that it is not recommended for individuals with osteoporosis, coronary or circulatory problems, high blood pressure, or related conditions. Note also that it has not been proven scientifically that the use of any type of traction will ensure long-term benefits, but it is generally used and accepted as a means of providing temporary relief for people living with chronic pain in the lower back.

What You Need to Know About a Slipped Or Herniated Disc - Part 1

Have you ever experienced serious back pain? I'm talking about back pain that was so bad that you couldn't walk or sleep or go to work? Researchers estimate that 60-80% of Americans will experience lower back pain at some point in their life. While it is not debilitating in most cases it can be quite severe and even life threatening. When your pain is as intense as what was described at the start you may have had a friend suggest that you could have a "slipped" or herniated disc. This article will describe exactly what this condition is and how you can tell if you might have it.

Your Spine: First, you must understand that the spinal column is made up of 25 movable segments. The bones in your spine are called vertebrae. Vertebrae are stacked on top of each other and span all the way from you're the base of your skull to your tailbone. The purposes of this column of spinal bones are to protect the spinal cord and to allow or limit movements. In between adjacent vertebra are intervertebral discs. These discs are made of a substance called fibrocartilage which is tough and rubbery. At the center of every disc is a gelatinous core called the nucleus pulposus. The purposes of these discs are to govern the flexibility of the spine and absorb the shock of forces on the spine.

Disc Injuries: Occasionally these rubbery discs can bulge or even tear. When this happens it is possible for the disc to deform to the point that it starts to compress nerve roots coming off of the spinal cord. These nerve roots provide all of the nerve connections from the body to the brain. Whether its fingers and toes or the liver or the heart, all parts of the body communicate with the brain through the nerve roots which are attached to the spinal cord. When these nerve roots are compressed it can cause numbness, tingling, or even weakness to muscle groups supplied by that nerve root. The most common locations for this to happen are the low back (most common) and the neck (next most common). This occurs in the mid back, also called the thoracic spine, as well but very rarely. A low back disc herniation will cause some leg symptoms and a neck herniation will usually cause arm/hand symptoms and very rarely leg symptoms as well. Disc bulges are more common and less serious than herniations. A bulging disc may not even cause any symptoms at all. This is just a stretching of part of the disc causing it to bulge in one direction. Often these will resolve own their own without any complications.

Herniations, on the other hand, occur when the outer fibers of the disc are torn and the nucleus pulposus begins to leak out. This can cause the nerve root to become compressed or inflamed. Disc herniations are usually symptomatic and can take months or years to resolve if they are not managed properly. Ways that you can determine whether your problem may be a herniated disc is the subject of my next article. Continue reading for specific signs and symptoms that you may have some damage to your disc. Once you know what a disc herniation is and how you can tell if you have one, you will be ready to learn about some of the treatment options which will be the topic of the third article in this series.

Baby Jewelry Is a Great Gift Idea - Reasons Why

There are many solid reasons why the gift of an item of baby jewelry is a great idea, both for baby and her mother. The most obvious reason is because jewellery, whether it is a bracelet, a bangle, a brooch, an anklet, a pair of earrings or even a necklace, looks simply beautiful on the infant, whether she is newborn or celebrating her first birthday.

Another reason why it's nice to give an item of jewelry to the baby, is that she will be photographed in her jewelry at all the special occasions her family attends, as well as for her Christening or Baptism, and of course, for her first birthday. For the rest of her life when she, or her family or friends, peruses her baby photos, she will see her little bracelet, or anklets which she wore especially for her portraits and photos. This means your gift will never be forgotten, nor who gave it to her at the time. Her photos and portraits will be kept in the family forever, and be a permanent reminder of her baby jewelry.

Baby jewelry is usually a treasured item. This is because we all recognise that jewelry is special, is given for special reasons and makes the recipient feel special. It will be well cared for by baby's family and can be stored easily, taking up very little space.

Baby jewelry never goes out of fashion. In fact some of the older jewelry is seen as the most beautiful of all. Unlike gifts of clothing, toys, baby equipment, which is quickly worn out, broken or superseded, baby jewelry stays up to date, always.

Baby jewelry that is saved, is often considered to be a "family heirloom." The family heirloom will occasionally be brought out during her growing up years, to show friends. Her family will occasionally sort through her jewelry, reminiscing about her babyhood.

Best of all, baby jewelry can be easily kept for the next generation. Imagine the excitement when a new baby girl arrives and the grandmother hands over the childhood jewelry box containing all her baby jewelry, to be passed on to her own baby girl. This of course, increases the sentimental value enormously.

So if you're in the market to buy a new baby girl a gift, think of these great reasons to buy an item of baby jewelry. It really is the best baby gift of all.