"Back pain is a symptom, not a specific disease" says Dr. Kaixuan Liu, chief surgeon at Atlantic Spinal Center. "There are many structures in the back that can cause pain and often it isn't possible to pinpoint the source of the pain. Many cases will resolve in a few weeks with rest, anti-inflammatory medication, and physical therapy. When these measures are insufficient, an injection of a cortisone-like medicine into the lower back can relieve symptoms. Surgery is advised only when the cause of the pain can be precisely identified and generally only for those who do not respond to other treatments, whose symptoms get worse, or who experience progressive neurological decline."
Tips on Understanding Minimally Invasive Spinal Fusion
Spinal fusion is a surgical procedure that usually corrects instability of spine. It fuses together the vertebrae to make spine stable and stronger so they heal into a single, solid bone. Spinal fusion can relieve the symptoms of several conditions, including degenerative disk disease, herniated lumbar disk (in which a bulging disk pinches the nerve), spondylolisthesis (in which one vertebra slips over the bone below it), and stenosis (a narrowing of the open spaces in the spine, which puts pressure on the spinal cord and the nerves that travel through it).
In traditional (open) spinal fusion, the surgeon makes a long incision and pulls the muscles to the side to gain access to the spine. This retraction and separation of the muscles from original attachment can cause injury to the tissues and result in a lengthy and painful recovery period. Since the 1990s, however, technological advances have made it possible to treat many back conditions with less invasive surgical techniques. Minimally invasive spine surgery is performed using small incisions and avoiding significant damage to the muscles surrounding the spine which results in less bleeding, less post-surgical pain and a faster recovery.
As with any surgery, there are potential risks and complications with minimally invasive spinal fusion, although these generally occur less frequently and are less severe than with traditional surgery. Risks include bleeding, infection, persistent pain, failure to fuse, nerve damage, and muscle weakness. Risks should be discussed with the surgeon before making a decision on any procedure.
"Patients generally recover easily from minimally invasive spine surgery," says Dr. Liu. "Because the procedure does not cut muscle and too much bone, often they are up and walking the same day. Many notice an improvement in their symptoms immediately; for others, symptoms go away gradually. Overall, recovery time is significantly shorter than for open surgery."
There are conditions for which minimally invasive procedures are not appropriate, including some spinal deformities and high-grade spondylolisthesis. "But for many people, minimally invasive fusion presents an appealing alternative to traditional techniques," says Dr. Liu. "They are likely to experience less post-operative pain and, often with the help of physical therapy, regain strength and return to work and daily activities more quickly."
Kaixuan Liu, MD, PhD, is a board-certified physician who is fellowship-trained in minimally invasive spine surgery at Atlantic Spine Center.
Atlantic Spine Center is a nationally recognized leader for endoscopic and orthopaedic spine surgery with offices in NJ and NY www.atlanticspinecenter.com. www.atlanticspinecenter.nyc
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