Lower back pain is a common health complaint around the world and can have a major impact on your quality of life.
This page is designed to give an overview of some of the leading causes of lower back pain, introduce you to Neo Medical’s cutting-edge treatment technologies, and answer some of your questions concerning what you can expect from your surgery.
It is not meant to replace any consultations you might wish to have with your physician or any other healthcare professional.
The information is intended to answer some of your questions and serve as a stimulus for you to ask further questions about your care. Not all the information here will apply to your individual treatment or its outcome.
Below you will find introductions to:
The leading causes of lower back pain
Spinal treatment options
What you can expect from your spinal surgery
Neo Universal – Neo Medical’s ground-breaking ecosystem of treatment technologies
About the Spine
The spine plays an extremely important role in human anatomy.
It provides a firm anchor for many of the muscles that support the upper body, allowing for a wide range of movement and flexibility. It also protects the spinal cord – your body’s central nervous structure that allows your brain to communicate with the rest of your body.
The spine runs all the way from the base of the skull to the base of the torso, and is made up of 24 bones called vertebrae.
These bones are grouped into different ‘regions’. From top to bottom, these regions are called:
The cervical spine,
The thoracic spine,
The lumbar spine,
and the coccyx
The image below shows how all these groups link together to make the whole spine. This person would be facing right.
The discs are made of two parts: a tough and fibrous outer layer (annulus fibrosis) and a soft, gelatinous center (nucleus pulposus). These work together to allow the spine to move, preventing friction between the vertebrae, and absorbing any shocks that may otherwise damage the spine. The joints between vertebrae are called ‘facet joints’.
Leading causes of lower back pain
What can cause pain?
Lower back pain is a very common health complaint, and one that can have a significant impact on your quality of life.
Around 80% of all people will suffer with some form of lower back pain sometime in their lives, involving pathologies – problems – that impact some combination of their muscles, nerves, and bones.
Bone and joint conditions that lead to lower back pain include those existing from birth (congenital), those that result from wear and tear (degenerative), and those that stem from injury (trauma).
Symptoms are mainly caused by spinal instability, or by disc, bone or ligaments pressing onto nervous tissue.
Degenerative Disc Disease (DDD)
As we age, the water and protein content of the body’s cartilage changes. This change results in weaker, thinner, and more fragile cartilage. Because both the discs and the joints that connect vertebrae (facet joints) are partly composed of cartilage, these areas are susceptible to these degenerative changes.
These changes can cause intervertebral discs to herniate, bulge, or leak. Bulges or leaks can result in the nerve roots and spinal cord being compressed, causing symptoms including, but not limited to, lower back and/or leg pain.
Spinal stenosis is caused by the narrowing of the spaces within the spine and subsequent pressure on the nerves that pass through them.
Spinal stenosis occurs most often in the lower back and the neck.Depending on the location and how much narrowing occurs over time, a spinal nerve or the spinal cord could become compressed and cause pain, tingling, numbness, and/or weakness.
Spondylolisthesis (‘Slipped vertebra’)
Spondylolisthesis is Latin for “slipped vertebral body”, and it is diagnosed when one vertebra slips forward over the one below it.
This condition occurs as a consequence of the general aging process in which the bones, joints, and ligaments in the spine weaken over time, and become less able to hold the spinal column in alignment. It may, however, also be caused by stress fractures, or congenital abnormalities,and in rare cases from a tumour or trauma.
Degenerative scoliosis, describes a side-to-side curvature of the spine caused by degeneration of the facet joints and intervertebral discs – the moving parts of the spine.
This adult degeneration and resulting spinal asymmetry can occur slowly over time as a person ages, and may cause symptoms including lower back and/or leg pain.
Traumatic Injury to the bones and joints
Fractures of the thoraco-lumbar spine and sacrum bone (the middle and lower regions of the spine) most commonly affect elderly people with osteoporosis. For these individuals, even minimal stresses on the spine can lead to bone fracture. Vertebral fractures in younger patients occur mainly after severe trauma, such as from motor-vehicle accidents or falls.
Low back pain can also be caused by tumors that originate in the bone of the spine and spinal cord, and those that originate elsewhere, and spread to these areas (metastases).
As these develop, they take up space within the spinal structure, applying pressure to joints and/or nerves, resulting in localized and/or dispersed pain.
Spinal treatment options
What are my Treatment Options?
With your physician you will be able to discuss treatment options appropriate for your individual situation. Back pain can often be treated with a combination of conservative treatments, such as manual therapy, exercise, medication, and lifestyle changes.
If symptoms do not improve with conservative treatment, or if symptoms are increasing or worsening, physicians may recommend spinal surgery.
A surgical technique known asSpinal Fusionis used to treat these disorders. Metal screws, rods and cages are used to fuse together two or more adjacent vertebrae. The aim is to stabilize the spine and stop the motion of spinal vertebral segments, and to relieve pain by eliminating pressure on the spinal cord or nerve roots.
Neo Medical specialise in developing advanced tools surgeons can use to carry out these procedures.
What you can expect from your spinal surgery
What Can I Expect?
Treatment options and expected outcomes will be explained to you. Preoperative instructions will be given to you by your physician. Should you have any questions regarding the procedure, do not hesitate to ask your surgeon. It’s your health, so you can never ask too many questions.
Your physician will decide, depending on your diagnosis, which type of surgery will be appropriate, and the type of instruments and implants to be used. Intervertebral implants can be placed from the front, side or back of the spine.
After being sedated, positioned correctly, and covered in the operating room, usually an X-ray will be taken of your spine to locate the area for the surgery.
Your surgeon will make incisions on your back to access to the spine. The size of these incisions can vary, from small (2-3 cm) ‘minimally invasive’ entries, to longer ones, based on different surgical techniques and the complexity of your case.
If a degenerated disc needs to be removed, the surgeon will restore the disc space with a titanium implant which will provide a mechanical support. In addition, a bone graft or substitute is placed to facilitate the bone growth between the adjacent vertebrae to fuse together, a process that usually takes about 3 to 6 months.
To provide stabilization for the spine until fusion occurs, titanium screws will be placed into the vertebrae and connected by rods. The screws and rod implants help to increase the opening around the nerve roots, relieving pressure and reducing pain.
Intervertebral implants can also be used to correct spinal deformity, restore proper spinal alignment and achieve biomechanical balance.
You will wake up in the recovery room after surgery, where your postoperative status will be carefully observed and monitored. The medical staff will bring you back to your hospital room when they consider you are doing well. In the following days your physician will provide instructions for the measures you should take for a good recovery (wound care, medication, exercises). Any limitations for activities in the coming weeks and months will also be discussed with you.
Aftercare can be essential to the effectiveness of your surgery, so if anything is unclear, remember to ask as many questions as you need to. There’s no such thing as too many questions.
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